No Association of Antenatal Synthetic Glucocorticoid Exposure and Hair Steroid Levels in Children and Adolescents.

Abstract: Antenatal synthetic glucocorticoid (sGC) treatment constitutes a potent programming factor of the hypothalamic-pituitary-adrenal (HPA) axis. Previous findings from our group revealed long-term changes in cortisol stress reactivity following antenatal […]

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Measurement of salivary adrenal-specific androgens as biomarkers of therapy control in 21-hydroxylase deficiency.

Monitoring of hormonal control represents a key part of the management in congenital adrenal hyperplasia (CAH). Monitoring strategies remain suboptimal as they rely on frequent blood tests and are not specific for adrenal-derived hormones. Recent evidence suggests a crucial role of adrenal-specific 11-oxygenated-C19 androgens in the pathogenesis of CAH.To establish the correlation between plasma and salivary adrenal-specific androgens in CAH as a novel non-invasive monitoring strategy.This prospective cross-sectional study recruited patients between 2015-2018.Multi-center study including 13 tertiary centers in the UK.Seventy-eight children with CAH and sixty-two matched healthy controls.Using liquid-chromatography tandem mass spectrometry, plasma and salivary concentrations of five steroids were measured: 17-hydroxyprogesterone, androstenedione, testosterone, 11-hydroxyandrostenedione and 11-ketotestosterone. The correlation between plasma and salivary steroids was analyzed to assess their use in clinical practice.Strong correlations between plasma and salivary steroid concentrations in patients with CAH were detected: 17-hydroxyprogesterone (rs=0.871, p<0.001), androstenedione (rs=0.931, p<0.001), testosterone (rs=0.867, p<0.001), 11-hydroxyandrostenedione (rs=0.876, p<0.001), 11-ketotestosterone (rs=0.944, p<0.001). These results were consistent for patient subgroups based on gender and age. Analyzing patient subgroups based on 17-hydroxyprogesterone concentrations established clear correlations between plasma and salivary concentrations of the adrenal specific androgen 11-ketotestosterone.The present study identified tight correlations between plasma and saliva for the adrenal-derived 11oxygenated-C19 androgen 11-ketotestosterone, as well as 17-hydroxyprogesterone and androstenedione, which are widely used for monitoring treatment in CAH. This novel combination of steroid hormones will serve as an improved non-invasive salivary test for disease monitoring of patients with CAH.

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