This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Activation of the pituitary adrenal function during stressful events is a major physiological defense mechanism marked by elevated adrenocorticotropic hormone (ACTH) production and increased glucocorticoid secretion. Currently used measures to assess the integrity of the adrenal function rely on serum cortisol determinations. With the high degree of protein binding for cortisol in the circulation, its serum concentration is changed with alterations in these binding proteins. A recent study demonstrated that serum free cortisol levels are better markers for glucocorticoid secretion. This study will investigate the value of measuring salivary cortisol concentration as a marker for serum free cortisol level in critically ill adult patients. It will also study the value of measuring ACTH-dependent adrenal androgens (DHEA/DHEA-S) as markers for adrenal function in this population. The hypothesis is that salivary cortisol concentration strongly correlates with the serum free cortisol level and that such measurements would be a reliable and practical surrogate for glucocorticoid secretion in critically ill patients. This would be particularly important in patients with hypoproteinemia where measured total serum levels can be misleadingly low. The study will enroll 38 adult men and women in the intensive care unit and 19 healthy volunteers of similar age and gender distribution (a total of 57 subjects). Subjects will have a clinical assessment by the endocrine team to determine eligibility for study. Subjects will have one standard cortrosyn stimulation test involving blood and saliva collection. For all normal volunteers, this test will be conducted in an outpatient visit at the GCRC. The endocrine team will provide a written clinical evaluation of all patients involved in the study, including diagnostic and therapeutic recommendations pertinent to each patient's endocrine clinical assessment. The data obtained from this protocol will serve as a pilot study for a larger multi-center investigation evaluating these measures to define illness-specific adrenal responses.

Agency
National Institute of Health (NIH)
Institute
National Center for Research Resources (NCRR)
Type
General Clinical Research Centers Program (M01)
Project #
5M01RR000080-44
Application #
7378059
Study Section
Special Emphasis Panel (ZRR1-CR-1 (01))
Project Start
2006-04-01
Project End
2007-03-31
Budget Start
2006-04-01
Budget End
2007-03-31
Support Year
44
Fiscal Year
2006
Total Cost
$549
Indirect Cost
Name
Case Western Reserve University
Department
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Randis, Tara M; Rice, Madeline Murguia; Myatt, Leslie et al. (2018) Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis. J Perinat Med 46:926-933
Clark, Erin A S; Weiner, Steven J; Rouse, Dwight J et al. (2018) Genetic Variation, Magnesium Sulfate Exposure, and Adverse Neurodevelopmental Outcomes Following Preterm Birth. Am J Perinatol 35:1012-1022
Askie, Lisa M; Darlow, Brian A; Finer, Neil et al. (2018) Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. JAMA 319:2190-2201
Saade, G R; Thom, E A; Grobman, W A et al. (2018) Cervical funneling or intra-amniotic debris and preterm birth in nulliparous women with midtrimester cervical length less than 30 mm. Ultrasound Obstet Gynecol 52:757-762
Inker, Lesley A; Grams, Morgan E; Levey, Andrew S et al. (2018) Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium. Am J Kidney Dis :
Juraschek, Stephen P; Miller 3rd, Edgar R; Appel, Lawrence J (2018) Orthostatic Hypotension and Symptoms in the AASK Trial. Am J Hypertens 31:665-671
Bustos, Martha L; Caritis, Steve N; Jablonski, Kathleen A et al. (2017) The association among cytochrome P450 3A, progesterone receptor polymorphisms, plasma 17-alpha hydroxyprogesterone caproate concentrations, and spontaneous preterm birth. Am J Obstet Gynecol 217:369.e1-369.e9
Chen, Teresa K; Appel, Lawrence J; Grams, Morgan E et al. (2017) APOL1 Risk Variants and Cardiovascular Disease: Results From the AASK (African American Study of Kidney Disease and Hypertension). Arterioscler Thromb Vasc Biol 37:1765-1769
Srinivasan, Lakshmi; Page, Grier; Kirpalani, Haresh et al. (2017) Genome-wide association study of sepsis in extremely premature infants. Arch Dis Child Fetal Neonatal Ed 102:F439-F445
Gibson, Kelly S; Stark, Sydney; Kumar, Deepak et al. (2017) The relationship between gestational age and the severity of neonatal abstinence syndrome. Addiction 112:711-716

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