Laura Smy1, Kaitlyn Shaw2, Anne Smith2, Evan Russell3, Stan Van Uum3, Michael Rieder3, Bruce Carleton2, Gideon Koren4. 1. 1] The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada [2] Graduate Department of Pharmaceutical Science, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. 2. 1] Child & Family Research Institute, Vancouver, British Columbia, Canada [2] Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada [3] Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British Columbia, Canada. 3. Department of Physiology and Pharmacology, Western University, London, Ontario, Canada. 4. 1] The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada [2] Graduate Department of Pharmaceutical Science, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada [3] Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Abstract
BACKGROUND: Asthma is the most common chronic condition in childhood, and the recommended pharmacotherapy for long-term control includes the use of inhaled corticosteroids (ICS). ICS were designed to act at the site of inflammation in the lung, thus decreasing systemic absorption and reducing the risk of adverse effects associated with corticosteroid use (e.g., HPA suppression and its consequent effects). Available data show that measurement of hair cortisol successfully reflects endogenous cortisol levels. We sought to examine whether hair cortisol measurements can be used to identify HPA suppression surrounding ICS therapy in children with asthma. METHODS: Hair samples were collected from the vertex posterior region of the head of 18 asthmatic children. We compared their hair cortisol concentration during ICS use with the concentration prior to ICS use. RESULTS: During ICS therapy, median hair cortisol levels were twofold lower compared with the period of no ICS use (median 89.8 ng/g vs. 198.2 ng/g, P = 0.0015). CONCLUSION: Hair cortisol is an effective biomarker of the HPA suppression associated with ICS therapy and can be a sensitive tool for determining systemic effects of ICS use and monitoring adherence. Future research is needed to characterize the effect of untreated asthma on hair cortisol concentrations, if any.
BACKGROUND:Asthma is the most common chronic condition in childhood, and the recommended pharmacotherapy for long-term control includes the use of inhaled corticosteroids (ICS). ICS were designed to act at the site of inflammation in the lung, thus decreasing systemic absorption and reducing the risk of adverse effects associated with corticosteroid use (e.g., HPA suppression and its consequent effects). Available data show that measurement of hair cortisol successfully reflects endogenous cortisol levels. We sought to examine whether hair cortisol measurements can be used to identify HPA suppression surrounding ICS therapy in children with asthma. METHODS: Hair samples were collected from the vertex posterior region of the head of 18 asthmatic children. We compared their hair cortisol concentration during ICS use with the concentration prior to ICS use. RESULTS: During ICS therapy, median hair cortisol levels were twofold lower compared with the period of no ICS use (median 89.8 ng/g vs. 198.2 ng/g, P = 0.0015). CONCLUSION: Hair cortisol is an effective biomarker of the HPA suppression associated with ICS therapy and can be a sensitive tool for determining systemic effects of ICS use and monitoring adherence. Future research is needed to characterize the effect of untreated asthma on hair cortisol concentrations, if any.
Authors: Amanda F Hamel; Jerrold S Meyer; Elizabeth Henchey; Amanda M Dettmer; Stephen J Suomi; Melinda A Novak Journal: Clin Chim Acta Date: 2010-10-27 Impact factor: 3.786
Authors: M D Lougheed; C Lemière; S D Dell; F M Ducharme; J Mark Fitzgerald; R Leigh; C Licskai; B H Rowe; D Bowie; A Becker; Louis-Philippe Boulet Journal: Can Respir J Date: 2010 Jan-Feb Impact factor: 2.409
Authors: Arvid W A Kamps; Marco Molenmaker; Ramses Kemperman; Betty S van der Veen; Gianni Bocca; Nic J G M Veeger Journal: Acta Paediatr Date: 2014-05-29 Impact factor: 2.299
Authors: L Manenschijn; J W Koper; E L T van den Akker; L J M de Heide; E A M Geerdink; F H de Jong; R A Feelders; E F C van Rossum Journal: J Clin Endocrinol Metab Date: 2012-07-27 Impact factor: 5.958
Authors: L Jollin; R Thomasson; B Le Panse; A Baillot; N Vibarel-Rebot; A M Lecoq; V Amiot; J De Ceaurriz; K Collomp Journal: Eur J Clin Invest Date: 2009-10-29 Impact factor: 4.686
Authors: Francine M Ducharme; Gilles Chabot; Constantin Polychronakos; Francis Glorieux; Bruce Mazer Journal: Pediatrics Date: 2003-02 Impact factor: 7.124
Authors: Maaike P Smit; Ed H G van Leer; Gerard Noppe; Yolanda B de Rijke; Dieneke Kramer van Driel; Erica L T van den Akker Journal: Horm Res Paediatr Date: 2017-07-14 Impact factor: 2.852
Authors: Elham Hossny; Nelson Rosario; Bee Wah Lee; Meenu Singh; Dalia El-Ghoneimy; Jian Yi Soh; Peter Le Souef Journal: World Allergy Organ J Date: 2016-08-12 Impact factor: 4.084
Authors: Mark A Ferro; Ellen L Lipman; Ryan J Van Lieshout; Jan Willem Gorter; Lilly Shanahan; Michael Boyle; Kathy Georgiades; Brian Timmons Journal: BMJ Open Date: 2019-11-03 Impact factor: 2.692
Authors: Marcela Lopez; Monica O Ruiz; Cynthia R Rovnaghi; Grace K-Y Tam; Jitka Hiscox; Ian H Gotlib; Donald A Barr; Victor G Carrion; Kanwaljeet J S Anand Journal: Pediatr Res Date: 2021-01-18 Impact factor: 3.756
Authors: Esmé J Baan; Erica L T van den Akker; Marjolein Engelkes; Yolanda B de Rijke; Johan C de Jongste; Miriam C J M Sturkenboom; Katia M Verhamme; Hettie M Janssens Journal: Pediatr Pulmonol Date: 2019-10-25