Stress Evaluation in Adult Patients with Atopic Dermatitis Using Salivary Cortisol

Abstract

The symptoms of atopic dermatitis (AD) are often aggravated by stress, and AD can also lead to psychological stress due to social isolation and discrimination. The salivary cortisol level reflects psychological stress, and it is a good index to assess chronic stress. In this study, we measured the salivary cortisol levels in patients with AD (n = 30) and compared them with those of healthy control subjects (n = 42). AD patients were also evaluated for general disease severity using the Scoring Atopic Dermatitis (SCORAD) index. The serum levels of TARC, total IgE, and lactate dehydrogenase (LDH) and peripheral blood eosinophil counts were measured by laboratory tests. The Skindex-16 was used as a skin disease-specific, quality of life measure, instrument. The results showed that the saliva cortisol level was significantly higher in AD patients compared to healthy subjects (P < 0.01). The salivary cortisol level was significantly correlated with the SCORAD index (r = 0.42, P < 0.05) while the serum TARC and LDH levels were positively correlated with the SCORAD index. However, no statistically significant correlations were observed between the salivary cortisol level and Skindex-16. These results suggest that the saliva cortisol level is therefore a useful biomarker to evaluate the stress in AD patients.

Salivary Biomarkers in Psychological Stress Diagnosis

“…Cortisol is a steroid hormone (also known as hydrocortisone), produced by the adrenal glands in response to the adrenocorticotropic hormone, and is the final product of the hypothalamic-pituitaryadrenal (HPA) axis [12,14,18,25]. So, cortisol can directly influence the central nervous system, affecting those brain's areas involved in the control of blood pressure [4].…”

“…During stressful situations (acute and chronic stress), the body responds by increasing the production of cortisol, secreted by the adrenal cortex in the HPA axis [14,25]. Circadian rhythm, negative feedback, and stress reactions are known as factors that regulate cortisol secretion [21].…”

“…Stress can alter oral homeostasis and is associated with gingivitis, periodontal diseases; development of halitosis too [11]. Stress has been associated with emotional eating behavior and symptoms of atopic dermatitis and other skin pathologies (wound healing, burns) are often aggravated by stress [12][13][14].…”

Glucan Supplementation Regulates Secretory Immunity and Stress

“…Current literature offers clear evidence showing that psychological stress affects human immune reactions (Cieslak et al, 2003;Mizawa et al, 2013). Some studies have demonstrated that stress can significantly influence antibody response of vaccinated individuals (Cohen et al, 2001).…”

Efeito da música sobre o estresse em pacientes renais crônicos em tratamento hemodialítico: estudo quase-experimental

“…A resposta mais comum a um fator de estresse é a ansiedade, que pode ser entendida como um estado de apreensão, tensão e preocupação (ATKINSON, et al, 1995 O cortisol salivar é capaz de refletir o estresse psicológico (MIZAWA et al, 2013); devido a isso, diversos estudos têm utilizado este marcador como parâmetro fisiológico para avaliação do estresse (MIZAWA et al, 2013;RAGHAVENDRA et al, 2009;BILLHULT et al, 2008). Ainda, a avaliação do cortisol salivar tem se tornado uma alternativa importante, pois o procedimento para coleta das amostras de saliva Adaptar-se às condições estressoras da HD é um processo árduo e o profissional de saúde pode ser de extrema ajuda para auxiliar o indivíduo e sua família neste processo, conhecendo as manifestações de cada um e escolhendo, em conjunto com o paciente, formas alternativas de enfrentá-lo.…”