Correlation of the Protein Expression of Salivary Cortisol, Serum Vitamin B12 and Interleukin 1 Beta in Patients with Recurrent Aphthous Stomatitis

This study will help in determining which molecules participate in the ulceration with an integrated approach combining external and internal factors. Recurrent aphthous stomatitis (RAS) is a common condition affecting the oral mucosa. Clinically it is manifested through recurrent painful lesions. A total of 28 subjects were recruited for this systematic case-controlled study (14 Control and 14). Whole unstimulated saliva was used for measuring Cortisol and IL-1 b levels. Patients with RAS lesions exhibited an elevated salivary cortisol level as against their healthy counterparts. The mean value for salivary cortisol among RAS patients was determined to be 16.2 nM/dL as against the control group which had a mean salivary cortisol of 12 nM/dL. Overall, this study helps provide insights into the correlation of the different biomarkers and RAS patients which can eventually lead to better therapeutic options and prevent recurrence in patients.

The Effect of a Probiotic Complex on the Gut-Brain Axis: A Translational Study

<b><i>Background:</i></b> The gut-brain axis refers to the network of connections that involve multiple biologic systems, allowing bidirectional communication between the gut and the brain. This communication is mainly mediated by gut microbiota, thanks to its ability to modulate several processes like the production of neurotransmitters. As such, keeping a balanced gut microbiota through probiotic intake could be a valid solution in supporting the right gut-brain communications. <b><i>Methods:</i></b> A two-step in vitro screening of five different probiotic strains was carried out to select the best performers in the modulation of stress markers. A first selection on SK-N-DZ neuronal cell lines was performed to evaluate the inhibition of the epigenetic enzyme LSD1, promotion of GABA, and expression of serotonin. Three out of five strains were tested for their ability to promote serotonin synthesis in the Caco2 cell line. As a result, <i>Limosilactobacillus reuteri</i> PBS072 and <i>Bifidobacterium breve</i> BB077 were selected as the best performing strains. To confirm their effects in humans, a proof-of-concept trial was carried out to evaluate stress-related parameters for 28 days of product intake in a group of 30 stressed students. <b><i>Results:</i></b> A significant improvement of cognitive functions, in terms of short-term memory, attention, and executive performance, as well as of psychophysiological markers, such as salivary cortisol level, skin conductance, sleep quality, and anxiety, were observed. <b><i>Conclusions:</i></b> According to the results, <i>L. reuteri</i> PBS072 and <i>B. breve</i> BB077 are potential probiotic candidates for improving stress resilience, cognitive functions, and sleep quality.

Redesign of Computer-Based Test (CBT) With Total Ergonomic Approach to Reduces an Academic Stress and Improve The CBT Participants Score

Computer-based Test (CBT) is a form of assessment method using a set of Multiple Choice Questions (MCQs). CBT has been applied by many educational institutions to evaluate their student’s competencies, one of those institutions is medical school. The standard of the CBT examination in medical school is arranged according to the Indonesia Medical Licensing Examination which listed that the examination must be contained of 200 MCQs in 200 minutes without a break session. This standard causes academic stress on the CBT participants and able to affect the CBT score. Aims: demonstrated the total ergonomic approach CBT redesign in reducing academic stress and improving participant’s CBT score compare with the Indonesia Medical Licensing Examination CBT design. Method: this was an experimental study employed a two-period cross-over design. The study variable was the academic stress measured by the salivary cortisol level and participant’s CBT score. Result: the salivary cortisol level in the middle of CBT was decrease significantly (p<0.05) as much as 9.88 (38.98%) from the initial salivary cortisol level of 25.34 ng/mL on the Indonesia Medical Licensing Examination CBT design becoming 15.46 ng/mL on the total ergonomic approach CBT redesign. The CBT score also increase significantly as much as 5.23 points (p<0.05) or increasing 16.20% from the 32.28 points on the Indonesia Medical Licensing Examination CBT design which become 37.51 points on the total ergonomic approach CBT redesign. Conclusion: the total ergonomic approach CBT redesign was able to reduce 38.98% of the academic stress and improving 16.20% participant’s CBT score compare with the Indonesia Medical Licensing Examination CBT design. Index Terms— ergonomic, Computer-based Test (CBT), academic stress

Salivary Alpha-amylase Enzyme and Salivary Cortisol Level in Depression after Treatment with Fluoxetine

Hypothalamic-Pituitary-Adrenal (HPA) axis and its end product cortisol have been extensively investigated in patients with depressive disorders for many years. Recently, salivary alpha-amylase (sAA) had emerged as a new biomarker with non-invasive and more convenience protocol for measuring sympathetic activity which were also associated with depression. Selective Serotonin Reuptake Inhibitor (SSRI) is antidepressant drug extensively used to treat depression. The aim of this study was to determine whether decrease of sAA and salivary cortisol levels could be observed in subjects with depression who were treated by fluoxetine. The total subjects were 25 depressed subjects and 10 healthy controls. sAA was examined before therapy, and after 2, 4 and 6 weeks of fluoxetine administration using a portable cocorometer. Salivary cortisol was examined before therapy, after 4 and 6 weeks of fluoxetine administration with Elisa method. The therapeutic effect was assessed with Hamilton Depression Rating Scale (HDRS). Results: sAA and cortisol level were significantly decreased after fluoxetine administration (p<0.001) followed by at least 50% reduction of HDRS scores after 6 weeks of fluoxetine administration. Levels of sAA and cortisol were higher in the depression group than in the healthy control. Conclusions: Measurement of sAA levels can be used as a potential biomarker of therapeutic response in depressed patients in addition to salivary cortisol.

Assessment and Correction of Stress in Preterm Infants and Their Mothers

The objective was to study the peculiarities of hormonal stress in preterm infants in the NICU and their mothers, and to investigate how skin-to-skin contact influences it. The study included 60 preterm infants with GA˂32 weeks who were treated in NICU and their mothers. The overall design was a baseline-response design. Saliva was collected before (baseline) and after skin-to-skin contact to measure cortisol by enzyme immunoassay method. Infant baseline salivary cortisol level was 0.587 [0.239; 1,714] µg/dL. It was significantly higher in neonates who had invasive ventilation (1.00 [0.38; 2.44]) µg/dL compared to non-ventilated infants (0.335 [0.156; 1.236]) µg/dL, p = 0.022; and positively correlated with the Apgar score at 1st and 5th minutes (r=-0.36; p = 0.011 and r=-0.34; p = 0.017) and duration of ventilation (r = 0.70; p = 0.0000). Maternal baseline salivary cortisol level was 0.212 [0.123; 0.378]µg/dL. There was significant decreasing of salivary cortisol after Kangaroo mother care with skin-to-skin contact in infants (0.162 [0.111; 0.231]) µg/dL, p˂0.001 and mothers (0.096 [0.077; 0.156]) µg/dL, p˂0.001. Conclusion: Preterm infants in the NICU and their mothers experience stress confirmed by the increased baseline cortisol levels. Kangaroo mother care with skin-to-skin contact reduces the stress and normalizes salivary cortisol levels in both infant and mother in the NICU.

Salivary Alpha Amylase Enzyme and Salivary Cortisol Level in Depression after Treatment with Fluoxetine

BACKGROUND: Hypothalamic-pituitary-adrenal axis and its end product cortisol have been extensively investigated in patients with depressive disorders for many years. Recently, salivary alpha-amylase (sAA) had emerged as a new biomarker with non-invasive and more convenience protocol for measuring sympathetic activity which were also associated with depression. Selective Serotonin Reuptake Inhibitor is antidepressant drug extensively used to treat depression. AIM: The aim of this study was to determine whether decrease of sAA and salivary cortisol levels could be observed in subjects with depression who were treated by fluoxetine. METHODS: The total subjects were 25 depressed subjects and ten healthy controls. sAA was examined before therapy, and after 2, 4, and 6 weeks of fluoxetine administration using a portable cocorometer. Salivary cortisol was examined before therapy, after 4 and 6 weeks of fluoxetine administration with Elisa method. The therapeutic effect was assessed with Hamilton Depression Rating Scale (HDRS). RESULTS: sAA and cortisol levels were significantly decreased after fluoxetine administration (p < 0.001), followed by at least 50% reduction of HDRS scores after 6 weeks of fluoxetine administration. Levels of sAA and cortisol were higher in the depression group than in the healthy control. CONCLUSIONS: Measurement of sAA levels can be used as a potential biomarker of therapeutic response in depressed patients in addition to salivary cortisol.

Effect of one-month treatment with methylphenidate on salivary cortisol level of attention deficit hyperactivity disorder children

Background Attention deficit hyperactivity disorder (ADHD) is one of the most common neuropsychological disorders that affects children, adolescents, and adults. Dysfunction of the hypothalamic-pituitary-adrenal axis (HPA) has been implicated in its pathophysiology. So, this study aimed to compare the salivary cortisol level between ADHD children and healthy children. It also compared the salivary cortisol level of ADHD children before treatment and 1 month after treatment with methylphenidate. Results This study showed that there was a statistically significant decrease in salivary cortisol level of the ADHD group, specifically hyperactive/impulsive subtype compared to the control group. Furthermore, it showed a statistically significant increase of salivary cortisol level after treatment compared to before treatment in the ADHD group. Conclusions HPA axis dysfunction may be related to the pathophysiology of ADHD, specifically hyperactive/impulsive subtype. Methylphenidate positively affects the HPA axis of ADHD children.

Changes in the cortisol and oxytocin levels of first-time pregnant women during interaction with an infant: a randomized controlled trial

Background During pregnancy, physiological, psychological, and social changes affect pregnant women’s childcare anxiety and childrearing behavior. However, there are scarce reports on hormonal evaluation related to such anxiety and behavior. Herein, we evaluated changes in salivary cortisol (primary outcome) and oxytocin (secondary outcome) levels of first-time pregnant women when interacting with an infant and discussed the relation of these changes to the women’s stress level. Methods This was a two-arm randomized controlled trial. Participants were randomly assigned using a web-based randomization system. The experimental group involved interaction with an infant for 30 min. The control group involved watching a DVD movie of an infant for 30 min. Saliva samples were collected at preintervention and postintervention. Saliva samples were assayed, and all data were compared between and within the groups using independent t-test and paired t-test with a two-sided 5% significance level. This study was approved by the Research Ethics Committee of St. Luke’s International University. Results A total of 102 women were randomly assigned to the experimental (n = 51) and control (n = 51) groups. Finally, 38 women in the experimental group and 42 women in the control group were analyzed. The salivary cortisol level significantly decreased after the interventions in both groups (t = 4.57, p = 0.00; t = 5.01, p = 0.00). However, there were no significant differences in the salivary cortisol (t = 0.349, p = 0.73) and oxytocin (t = − 1.945, p = 0.58) levels between the two groups. Conclusions The salivary cortisol level of first-time pregnant women significantly decreased in the experimental and control groups postintervention, although no significant difference was found between the two groups. Such decrease indicates stress reduction and release among these women. The absence of a significant increase in salivary oxytocin level in both groups may be related to the limitations of an insufficient number of samples that could be analyzed owing to the small saliva volume in some samples and the lack of adequate tactile stimulation of the intervention protocol. These results and procedural limitations provide useful insights into approaching subsequent studies aiming at continuously optimizing detection procedures. Trial registration UMIN000028471 (Clinical Trials Registry of University Hospital Information Network. July 31, 2017- Retrospectively registered.