Segmentovaný vlasový kortizol jako nástroj pro dlouhodobé sledování pacientů různých kohort
| Title in English | Segmented hair cortisol as a tool for long-term monitoring of patients from different cohorts |
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| Authors | |
| Year of publication | 2025 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Introduction: Currently available methods for monitoring endogenous cortisol in patients of the studied cohorts (adrenal insufficiency, replacement therapy, psychiatric spectrum disorders, ectopic ACTH production) rely on measuring acute levels (plasma, saliva, urine) only at a short time point; therefore, any kind of chronic cortisol exposure is difficult to assess, as it requires collection of samples at several different time points. Cortisol levels in segmented hair (3–6 cm) can reflect chronic cortisol exposure and may serve to better monitor glucocorticoid replacement therapy, individualized therapy of patients with depressive disorder or borderline personality disorder, or to assess the status of ectopic ACTH production (e.g., small cell carcinoma - SCLC). Methods: Hair samples were collected from patients on cortisol replacement therapy, patients with psychiatric disorders, patients with SCLC, and appropriate controls to monitor retrospective hair cortisol values over several months. Samples were segmented at 1 cm intervals and cortisol levels were determined using liquid chromatography with mass spectrometry. An advanced probability correction was made for the decrease in levels towards the distal ends and, in the case of available data, correlation was also performed with acute values in plasma and urine, which were obtained using standardized immunoanalytical methods. Results: Hair cortisol levels can be successfully corrected to the initial segment and compared both with the reference interval and between individual segments, i.e. as a longitudinal analysis. In patients undergoing substitution therapy, this allows monitoring the degree of substitution longitudinally over several months without the influence of circadian rhythmicity. In psychiatric patients, the respective diagnoses can be distinguished and the progression of the disease can be monitored over time or, if necessary, phases of remission or relapse can be predicted. In patients with SCLC, comorbidity in the form of ectopic ACTH production can be detected and appropriate therapy can be started in a timely manner, leading to an increase in median survival. Conclusion: Longitudinal monitoring of cortisol levels using hair sample segmentation proves to be a beneficial and non-invasive tool to reduce the risk of overdose, long-term monitoring, and improve the overall health of patients of different cohorts. |
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