TH1- and TH2-mediated inflammatory diseases are associated with different endocrine and immunological responses to stress

Poster Abstracts

SALIVARY CORTISOL LEVELS AFTER AWAKENING AS A NEW INDEX FOR ADRENOCORTICAL ACTIVITY: NORMAL VALUES AND RECENT FINDINGS Stefan Wiist, Jutta M. Wolf, Dirk H. Hellhammer, Clemens Kirschbaum Center for Psychobiological and Psychosomatic Research, DietrichstraBe 10-l 1. 54290 Trier, Germany The availability of appropriate markers of hypothalamus-pituitary-adrenal axis activity can be regarded as a substantial prerequisite for investigations of this neuroendocrine system. However, due to specific disadvantages the established indices - e.g. single cortisol assessments at fixed times in the morning - are of limited use. In contrast, in recent studies from our laboratory early morning salivary cortisol levels were measured repeatedly with strict reference to the time of awakening. In these studies, the observed cortisol response to awakening was consistent and showed good intraindividual stability across time. It was found to be independent of the time of awakening or total time slept, but influenced by a number of factors including gender, persisting pain, burnout and chronic stress. In order to receive information about normal values and distribution characteristics, the present study measured cortisol levels after awakening repeatedly in 400 volunteers. Data analysis of the first 203 participants (123 females, 80 males; mean age of 40.8 yr) revealed a 57.4% mean increase of cortisol levels within the first 30 minutes after awakening. In 81.3% of the subjects, a cottisol response to awakening could be observed, while the remaining 18% were non-responders. In correspondence with earlier findings, woman showed significantly higher morning cortisol levels compared to male subjects. Additionally, high social stnxs and lack of social recognition, as well as high selfesteem were significantly associated with an increased cottisol response to awakening. Furthermore, subjects with low birth weight (S 24OOg) and/or a delivery before 37” week of pregnancy showed a markedly diminished cortisol response to awakening in later adulthood in comparison to subjects with higher birth weight (t 3350g) and/or term birth (>39* week). In conjunction with our earlier findings the results of the present study strongly suggest that the assessment of early morning cortisol secretion is a useful index which can provide important information on (re)activity of the HPA axis in addition to challenge tests like stimulation with hCRH, ACTH or dexamethasone. I’llI-

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