salivary cortisol
salivary cortisol
Overview
Salivary cortisol is the fraction of the steroid hormone cortisol measured in saliva, and it is widely used as a non-invasive biomarker of hypothalamic-pituitary-adrenal (HPA) axis activity. Because salivary cortisol reflects the biologically active, unbound portion of circulating cortisol, it is commonly used in research and clinical settings to assess stress responses, adrenal function, and endocrine dysregulation.
In biomedical research, salivary cortisol is especially useful for monitoring dynamic changes over time, such as responses to acute stress, surgery, pain, exercise, or endocrine interventions. It is frequently paired with other markers of autonomic or endocrine activity, including salivary alpha-amylase, plasma hormone profiling, and targeted metabolomics, to characterize stress physiology more comprehensively.
Focus of Latest Publications
Recent publications involving salivary cortisol have focused on its use as a biomarker in cortisol-monitoring and stress-related assay development, rather than on salivary cortisol as a therapeutic target. Several studies evaluated new sensing platforms intended to measure cortisol in biological samples with greater sensitivity or practicality. These included a wearable electrochemical sweat sensor based on molecularly imprinted polymer nanoparticles and a conductive aerogel, a time-gated fluorescent aptamer system designed to suppress autofluorescence in complex matrices, and a triple-mode SERS-LFIA point-of-care platform for ultrasensitive cortisol detection. Together, these reports emphasize the need for rapid, non-invasive, and highly sensitive cortisol measurement methods.
The analytical studies generally aimed to improve detection in physiologically relevant or clinically useful settings. The time-gated aptamer sensors were reported to detect cortisol across physiologically relevant concentration ranges, with reversible responses and minute-scale temporal resolution, and were demonstrated in undiluted human serum. The wearable sweat sensor showed a wide detection range from 10 pM to 100 μM, a low detection limit, and selectivity against interfering substances, with screen-printing used to support wearable fabrication and potential mass production. The SERS-LFIA platform was presented as a point-of-care approach intended to overcome the limited sensitivity of conventional colloidal gold-based lateral flow assays for low-abundance small-molecule hormones such as cortisol.
Other recent publications addressed clinical contexts in which cortisol assessment is relevant to adrenal insufficiency and critical illness. Protocol papers described trials of hydrocortisone and fludrocortisone for critical illness-related corticosteroid insufficiency and supplemental hydrocortisone during stress in patients with prednisolone-induced adrenal insufficiency, both using biomarker-based approaches to guide or evaluate treatment. A case report of refractory hyponatremia after traumatic brain injury highlighted the diagnostic importance of reassessing adrenal function when cortisol deficiency is suspected, while another report on delayed postoperative hyponatremia after pituitary surgery examined the relationship between postoperative cortisol and sodium dynamics. Collectively, these studies show salivary cortisol being used within broader efforts to refine diagnosis, monitoring, and treatment of adrenal and stress-related disorders.