Relationship between 24-hour urinary-free cortisol excretion and salivary cortisol levels sampled from awakening to bedtime in healthy subjects

The utility of repeated salivary cortisol sampling as a substitute for 24-hour urinary-free cortisol (UFC) assessment was examined. Forty-four participants completed both 24-hour collections and 6 salivary collections at wake-up, 08:00, 12:00, 16:00, 20:00 and bedtime, during the same 24-hour period. The results demonstrated that mean, maximum, and amplitude (maximum minus minimum) for salivary cortisol all correlated positively with urinary cortisol, but the associations of these variables with urinary-free cortisol excretion were relatively small. Furthermore, a single salivary sample taken at wake-up was as good an indicator of overall cortisol production as the measures derived from multiple salivary samples. An examination of subject compliance indicated that many subjects failed to collect the timed salivary collections as instructed. The authors conclude that diurnal salivary cortisol sampling versus 24-hour urinary cortisol collections are likely to provide different information about ambient hypothalamic-pituitary-adrenal productivity, and therefore these measures should not be used interchangeably. In addition, subject compliance is a serious consideration in designing studies that employ home salivary collections.     

Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants

BackgroundCortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life.Methods130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist.ResultsA significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life.ConclusionsCortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.     

Plasma cortisol in cattle: Circadian rhythm and exposure to a simulated high altitude of 5,000 m

After a 2 week control period at 400 m, cattle were exposed to 5,000 m simulated altitude for 2 weeks, which was followed by a 2-week post-altitude control period. Plasma cortisol values from blood samples taken every 30 min for a total of 24 h indicated that cortisol was secreted episodically and that a circadian rhythm existed. When cortisol values were grouped into 4, 6-h periods, plasma cortisol was most abundant from 06:00 to 12:00 h with an average of 0.96µ g/100 ml and least abundant from 00:30 to 06:00 h with an average of 0.55µ g/100 ml. Plasma cortisol increased from 0.42 to 3.08µ g/100 ml during the 4 h ascent to 5,000 m and decreased to near normal levels the following day. A rhythmic plasma cortisol pattern was maintained after one day at simulated high altitude.     

鳜肝脏和心脏生物钟基因表达节律分析

在12h光照、12h黑暗交替(Light-Dark; LD)光制下,研究分析了褪黑素和皮质醇水平在鳜血清中的昼夜变化规律,以及13个生物钟基因(Arntl1、Clock、Cry1a、Cry3、Cry-dash、Npas2、Npas4、Nr1d1、Nr1d2、Per1、Per3、Rora和Tim)在鳜(Siniperca chuatsi)肝脏和心脏中的昼夜表达规律。试验在一昼夜内的ZT0(06:00)、ZT3(09:00),ZT6(12:00),ZT9(15:00),ZT12(18:00),ZT15(21:00),ZT18(24:00),ZT21(03:00,2nd d),ZT24(06:00,2nd d) (Zone time,ZT) 9个时间点随机抽取3尾鳜采集其血清、肝脏和心脏。经SPSS 单因素方差分析和Matlab余弦分析,结果显示: 鳜血清中褪黑素和皮质醇含量均呈现出昼夜节律性振荡,褪黑素含量白天显著降低(P0.05),夜间显著上升,皮质醇含量白天缓慢降低,夜间ZT15(21:00)-ZT18(24:00)显著升高,随后开始缓慢降低; 两种激素最低相位都为ZT15(21:00)。在13个生物钟基因中,Cry-dash、Npas4、Nr1d1、Per1和Tim 5个基因在鳜肝脏内具有明显的昼夜节律性,其中Npas4、Nr1d1、Per1、Tim的表达规律相似,皆呈现出光照阶段表达降低,黑暗阶段表达升高的趋势; 但Cry-dash则表现出光照阶段先升高后降低,黑暗阶段先降低后升高的规律。在鳜心脏中,Arntl1、Clock、Cry1a、Npas2、Nr1d1、Nr1d2、Per3、Rora和Tim 9个基因都表现出明显的昼夜节律,表达趋势分为两种: Arntl1、Clock、Nr1d2的表达量在光照阶段降低,黑暗阶段升高; 而Cry1a、Npas2、Nr1d1、Per3、Rora和Tim的表达量在ZT0(06:00)-ZT15(21:00)持续低水平,ZT15(21:00)-ZT18(24:00)表达量显著上升,ZT18(24:00)-ZT21(03:00)表达量降低。研究结果表明: 生物钟基因在鳜肝脏和心脏中所表达的昼夜节律不同。     

Influence of acoustic stimulation on the circadian and ultradian rhythm of premature infants

The aim of the present study was to evaluate the development of the circadian rhythm of the salivary cortisol in premature infants and its correlation with the onset of the sleep–activity behavior pattern during the first 3 weeks of life under controlled light:dark conditions. Furthermore, we investigated the influence of acoustic stimulation by audiotaped lullabies or the maternal voice on the cortisol values and long-term sleep–activity patterns. The study was a block-randomized, prospective clinical trial with a study population of 62 preterm neonates (30?<?37 gestational age). We compared two study groups who listened either to music or to the maternal voice (music: N?=?20; maternal voice: N?=?20) with a matched control group (N?=?22). The acoustic stimulation took place every evening between 20:00 and 21:00?h for 30?min over a period of 2 weeks. The cortisol values and activity–rest behavior of the neonates were determined during the first 3 weeks of life on the 1st, 7th and 14th day. Actigraphic monitoring was used to record the activity pattern continuously over 24?h and a validated algorithm for neonates was used to estimate sleep and wakefulness. The saliva samples were obtained 10?min before and 10?min after the acoustic interventions for the study groups. Additionally, saliva samples were obtained from the control group seven times over a 24-h period (20:00, 21:00, 01:00, 05:00, 08:00, 13:00 and 17:00?h). The cortisol data were analyzed by fast Fourier transformation to assess periodic characteristics and frequencies. Hierarchical linear modeling was further performed for the statistical analysis. Results: The cortisol rhythm analysis indicated a circadian rhythm pattern for only one premature infant, all others of the neonates showed no circadian or ultradian rhythm in cortisol. Cortisol level of the premature neonates was significantly higher during the first day of the study period at night-time (median: 17.1?nmol/L, IQR?=?9.7–24.4?nmol/L) than on days 7 (median: 9.6?nmol/L, IQR?=?4.7–14.6?nmol/L; Tukey-HSD, z?=?4.12, p?<?0.001) and 14 (IQR?=?5.8–13.7?nmol/L; Tukey-HSD, z?=?2.89, p?<?0.05). No significant effect of acoustic stimulation was observed on the cortisol concentration and sleep–wake behavior. The activity–sleep rhythm of preterm neonates was dominated by ultradian rhythm patterns with a prominent period length of 4?h (30.5%). Activity frequencies of neonates were also significantly higher overnight on the first study day (mean: 329?±?185.1?U) than of night seven (mean: 260.2?±?132.4?U; Tukey-HSD, z?=?2.50, p?<?0.05). Quiet-activity patterns increased, whereas high-activity patterns decreased during the observation period. Average sleep time increased significantly during the study time from day 1 to day 7 (Tukey-HSD, z?=?2.51, p?<?0.05). In conclusion, premature infants showed higher cortisol levels – without a circadian rhythmicity – and higher activity frequencies in the first days after birth which may reflect an adaptation process of neonates after birth. Cortisol concentrations and the activity patterns were not influenced by music interventions.     

Neuro-endocrine correlations of hypothalamic-pituitary-thyroid axis in healthy humans

Neuro-endocrine hormone secretion is characterized by circadian rhythmicity. Melatonin, GRH and GH are secreted during the night, CRH and ACTH secretion peak in the morning, determining the circadian rhythm of cortisol secretion, TRH and TSH show circadian variations with higher levels at night. Thyroxine levels do not change with clear circadian rhythmicity. In this paper we have considered a possible influence of cortisol and melatonin on hypothalamic-pituitary-thyroid axis function in humans. Melatonin, cortisol, TRH, TSH and FT4 serum levels were determined in blood samples obtained every four hours for 24 hours from ten healthy males, aged 36-51 years. We correlated hormone serum levels at each sampling time and evaluated the presence of circadian rhythmicity of hormone secretion. In the activity phase (06:00 h-10:00 h-14:00 h) cortisol correlated negatively with FT4, TSH correlated positively with TRH, TRH correlated positively with FT4 and melatonin correlated positively with TSH. In the resting phase (18:00 h-22:00 h-02:00 h) TRH correlated positively with FT4, melatonin correlated negatively with FT4, TSH correlated negatively with FT4, cortisol correlated positively with FT4 and TSH correlated positively with TRH. A clear circadian rhythm was validated for the time-qualified changes of melatonin and TSH secretion (with acrophase during the night), for cortisol serum levels (with acrophase in the morning), but not for TRH and FT4 serum level changes. In conclusion, the hypothalamic-pituitary-thyroid axis function may be modulated by cortisol and melatonin serum levels and by their circadian rhythmicity of variation.     

Biological rhythm of saliva ghrelin in humans

Background: We previously reported that ghrelin in saliva, orexigenic hormone that induces NPY release, was produced and released by salivary glands in humans. The purpose of this study was to investigate a possible circadian rhythm in saliva ghrelin concentration in human subjects as a function of time and meal. Saliva samples were collected at three-hour intervals throughout a 24-h period in 12 healthy volunteer males and ten healthy volunteer females who were provided with meals on a fixed schedule, and saliva collections were made within 15 minutes after each meal. Saliva ghrelin levels were measured by using a commercial radioimmunoassay (RIA) kit that uses ¹²⁵I-labeled bioactive ghrelin as a tracer and a rabbit polyclonal antibody raised against full-length octanoylated human ghrelin. Immunohistochemical analysis of salivary glands was also performed. The results of this investigation indicated the following. (1) The saliva ghrelin level was slightly higher in female subjects in comparison with male subjects. (2) Saliva ghrelin levels were elevated before each meal and fell to trough levels after eating. (3) Saliva ghrelin levels showed a circadian rhythm that rose throughout the day to a zenith at 0300, then dropped at 0600 - 0900. (4) Saliva ghrelin also weakly correlated with BMI. (5) Immunohistochemical analysis showed that ghrelin was localized in the striated and excretory ducts of salivary glands of human. The present work is the first report of the circadian rhythm of saliva ghrelin level in human subjects as a function of time and meal. Meal plays an important role in lowering saliva ghrelin concentration in humans. However, present data did not exclude whether the circadian changes in saliva ghrelin expression were regulated by the biological clock or by food intake.     

Marker rhythms of circadian system function: a study of patients with metastatic colorectal cancer and good performance status

Cancer patients may exhibit normal or altered circadian rhythms in tumor and healthy tissues. Four rhythms known to reflect circadian clock function were studied in 18 patients with metastatic colorectal cancer and good performance status. Rest-activity was monitored by wrist actigraphy for 72 h before treatment, and its circadian rhythm was estimated by an autocorrelation coefficient at 24h and a dichotomy index that compared the activity level when in and out of bed. Blood samples (9-11 time points, 3-6 h apart) were drawn on day 1 and day 4 of the first course of chronochemotherapy (5-fluorouracil: 800 mg/m2/day; folinic acid: 300 mg/m2/day; oxaliplatin: 25 mg/m2/day). Group 24h rhythms were validated statistically for plasma concentrations of melatonin, 6-alpha-sulfatoxymelatonin, and cortisol and for lymphocyte counts. Significant individual 24h rhythms were displayed in melatonin by 15 patients, cortisol by seven patients, lymphocytes by five patients, and prominent circadian rhythms in activity were displayed by 10 patients; only one patient exhibited significant rhythms in all the variables. The results suggest the rhythms of melatonin, cortisol, lymphocytes, and rest/activity reflect different components of the circadian system, which may be altered differently during cancer processes. Such 24h rhythm alterations appeared to be independent of conventional clinical factors.     

Effects of weight, temperature and behaviour on the circadian rhythm of salivary cortisol in growing pigs

In farm animals, salivary cortisol has become a widely used parameter for measuring stress responses. However, only few studies have dealt with basal levels of concentration of cortisol in pigs and its circadian rhythm. The aim of this study was to examine the effects of ambient temperature and thermoregulatory behaviour on the circadian rhythm of salivary cortisol levels in fattening pigs. Subjects were 30 fattening pigs of different weight (60 to 100 kg), kept in six groups in an uninsulated building in pens with partly slatted floors. Saliva samples were taken every 2 h over periods of 24 h at different ambient temperatures at two times in winter and four times in summer. Thermoregulatory behaviour was recorded in the same 24-h time periods. The effect of time of day, body weight, ambient temperature and behaviour on the cortisol level was analysed using a mixed-effects model. Two peaks of cortisol levels per day were found. This circadian pattern became more pronounced with increasing weight and on days where thermoregulatory behaviour was shown. Mean cortisol levels per day were affected by weight but not by thermoregulatory behaviour. From our data, we conclude that long-term variations in cortisol concentration may be influenced by increasing age and weight more than by the respective experimental situation. In assessing animal welfare, it seems more reliable to consider the circadian pattern of cortisol concentration instead of only one value per day.     

Circadian rhythm of serum testosterone levels in male beagle dogs--effects of lighting time zone

In a previous study, the author found that serum testosterone (T) levels in male beagle dogs showed a circadian rhythm which was lowest at 12:00, and increased to a peak at 18:00-6:00, thereafter decreasing until 12:00. The reason was thought to be that dogs were breeding under rigid controlled conditions. The present study was performed to investigate the effects of lighting on the circadian rhythm of T level by means of a reversal of the lighting time zone, because lighting is considered an important factor in modulating T levels. Six male beagle dogs of 2 years were used in this study. The routine lighting time (8:00-20:00) and dark time (20:00-8:00) zone in the breeding room was reversed completely and T levels were measured at intervals of 1-5 weeks for up to 54 weeks. Blood samples were collected at 6:00, 12:00, 18:00 and 24:00. The results showed that the circadian rhythm of the T level and the T level at each blood sampling time did not change significantly within 54 weeks. As a result, it was recognized that the circadian rhythm of the T level in male dogs may not be affected by changes in the lighting time zone.     

Hypoxic alterations of cortisol circadian rhythm in man after simulation of a long duration flight

Fatigue is often reported after long duration flights. Mild hypobaric hypoxia caused by pressurisation may be involved in this effect through disruption of circadian rhythms, independently of the number of time zones crossed. In this controlled crossover study, we assessed the effects of two levels of hypoxia equivalent to 8000 and 12,000 ft on the circadian rhythm of plasma cortisol, a marker of the circadian time structure. Sixteen healthy young male volunteers (23-39 years) were exposed in a hypobaric chamber for 8 h (08:00-16:00 h) to 8000 ft, followed 4 weeks later to 12,000 ft. Plasma cortisol was assayed during two 24-h cycles (control and hypoxic exposure) every 2h in all subjects. We found a significant change in the pattern of cortisol secretion during both hypoxic exposures, with an initial fall in cortisol followed by a transient rebound, whereas the phase and the 24-h mean level remained unchanged. The change in cortisol pattern followed the alterations in autonomic balance assessed by heart rate variability (HRV) spectral analysis. The normalised high frequencies and the low-to-high frequencies ratio showed a significant shift toward sympathetic dominance with some differences in time course for both altitudes studied. HRV analysis improved the interpretation of cortisol 24-h profiles. Our data, which strongly suggest that prolonged mild hypoxia alters the expression of cortisol circadian rhythm, should be taken into account to interpret secretory rhythm changes after transmeridian flights.     

Influence of long-term exposure to an air-conditioned environment on the diurnal cortisol rhythm

In the present study, the influence of the long-term use of air-conditioning in summer on the cortisol rhythm was examined by measuring the rhythm in subjects who had been exposed to air-conditioning for a short [S] or long [L] time. Investigations were conducted twice in July and September. Atmospheric temperature and relative humidity near the subjects were measured for three days in each season. Saliva samples for cortisol analysis were collected every 2 hours during the daytime beginning at 8:00 h with subsequent sampling times at 10:00, 12:00, 14:00, 16:00, 18:00, 20:00 and 22:00 h. A questionnaire on sleep and duration of air-conditioning use was also undertaken. Ambient mean temperature was higher in the S group (mean+/-SD; 30.8+/-1.2 degrees C in July, 28.0+/-0.8 degrees C in September) than in the L group (28.0+/-1.2 degrees C in July, 27.3+/-1.0 degrees C in September) (p<0.01), while mean relative humidity did not differ. There were no differences in bedtime, waking time and sleeping hours either between groups or months. Diurnal patterns of salivary cortisol rhythm in July and September were similar in the S group, but the L group had a delayed rise of morning cortisol secretion in September compared with July. These results suggest that long-term exposure to an air-conditioned environment might adversely affect the human cortisol rhythm.     

Effect of bromocriptine on the control of plasma aldosterone diurnal variation in normal supine man.

In order to investigate the role of prolactin in the control of the circadian rhythm of plasma aldosterone (PA), plasma renin activity (PRA), cortisol (PC), aldosterone and prolactin (PRL) levels were determined in samples at 4-hour intervals from 5 normal supine men over a period of 24 h under basal conditions and subsequently over a period of 24 h during suppression of prolactin release by bromocriptine (CB-154). After suppression of prolactin, statistically signific1nt circadian rhythms in PC and PA have been detected with a moderate decrease of PA concentration, while the PC level remained unalterated. PRA rhythmicity persisted with a significant shift of acrophase and remarkable reduction of plasma levels. Moreover, during CB administration a significant correlation was obtained between PA and PC, while no correlation was detected between PA and PRA. These data are consistent with the following concepts: (a) the prolactin does not play a significant role in the regulation of circadian rhythm and concentration of plasma aldosterone in normal supine men, and (b) bromocriptine induces a remarkable reduction of PRA and a variable decrease in plasma aldosterone, but it does not influence the secretion of cortisol in normal subjects.     

Circadian rhythm in peak expiratory flow: alteration with nocturnal asthma and theophylline chronotherapy

We investigated changes in the circadian rhythm of peak expiratory flow (PEF) in seven persons with nocturnal asthma for a 24h span when (1) they were symptom free and their disease was stable, (2) their asthma deteriorated and nocturnal symptoms were frequent, and (3) they were treated with theophylline chronotherapy. Subjects recorded their PEF every 4h between 07:00 and 23:00 one day each period. Circadian rhythms in PEF were assessed using the group-mean cosinor method. The circadian rhythm in PEF varied according to asthma severity. Significant circadian rhythms in PEF were detected during the period when asthma was stable and when it was unstable and nocturnal symptoms were frequent. When nocturnal symptoms were present, the bathyphase (trough time) of the PEF rhythm narrowed to around 04:00; during this time of unstable asthma, the amplitude of the PEF pattern increased 3.9-fold compared to the symptom-free period. No significant group circadian rhythm was detected during theophylline chronotherapy. Evening theophylline chronotherapy proved to be prophylactic for persons whose symptoms before treatment had occurred between midnight and early morning. Changes in the characteristics of the circadian rhythm of PEF, particularly amplitude and time of bathyphase, proved useful in determining when to institute theophylline chronotherapy to avert nocturnal asthma symptoms. (Chronobiology International, 17(4), 513-519, 2000)     

Circadian rhythms of salivary cortisol content during long-term space flight

Adaptation mechanisms of adrenal function related to secretion of cortisol were studied under conditions of microgravity. Parameters of diurnal rhythms of salivary cortisol were studied by Russian cosmonauts on board orbital station Mir during long-term space flights (SF). The preflight circadian rhythms of salivary cortisol in cosmonauts were characterized by the morning maximum occurring at 9∶43 a.m., the fluctuation amplitude 6.05 nmol/1, and the daily average concentration 8.79 nmol/l. The characteristics of cortisol diurnal rhythm changed under conditions of long-term space flight. On average, the rhythm measure and amplitude decreased after two months of flight. The postflight maximum concentration of free cortisol tended to occur later in the day. Evidently, the motor activity during SF, i.e., prophylactic exercises along with other factors, significantly influenced the parameters of cortisol circadian rhythm that was revealed by the individual variability of findings during the flight. After the long-term SF, individual ratios of salivary and plasma cortisol levels increased against the background of increased plasma content of the hormone, i.e., the fraction of free, physiologically active hormone in the total pool of circulating molecules decreased.     

Circadian rhythm parameters of endocrine functions in elderly subjects during the seventh to the ninth decade of life

The circadian rhythm of 17 endocrine parameters (ACTH, aldosterone, cortisol, C-peptide, DHEA-S, FSH, growth hormone, insulin, LH, 17-OH progesterone, prolactin, testosterone, total T3, total T4 and TSH and estradiol and progesterone in women only) were studied in 63 clinically apparently healthy men (124 profiles) and 86 women (154 profiles) during the 7th to 9th decade of life. The subjects lived under very uniform conditions in a home for the aged with their daily schedule standardized by institutional routine with rest at night on the average from 21:30 to 06:30 local time and 3 daily meals at 08:30, 13:00 and 18:30. Blood was drawn over a 24-h span at 4-h intervals. Circadian periodicity was ascertained and the rhythm parameters quantified by cosinor analysis. In clinically healthy elderly subjects, circadian periodicity persisted in most parameters studied well into the 9th decade of life. The timing of the circadian rhythm was comparable between subjects in their 7th decade and 9th decade of life with the exception of cortisol and DHEA-S, which showed a phase advance with advancing age. A decrease in circadian amplitude is limited during this part of the human life span to only a few of the functions investigated and with the exception of prolactin in the women, a decrease in amplitude did accompany a decrease in MESOR.     

Circadian Rhythm of Salivary Cortisol in Asian Elephants (Elephas maximus): A Factor to Consider During Welfare Assessment

Elevated glucocorticoid levels during an extended time period might be a stress indicator in nonhuman animals. Therefore, knowledge of the circadian pattern of cortisol secretion is very important to correctly interpret data obtained for welfare assessment of animals in captivity through salivary cortisol. In order to define the circadian rhythm of salivary cortisol secretion in the Asian elephant (Elephas maximus), morning and evening saliva samples of 3 Asian elephants were collected and analyzed by radioimmunoassay. Significantly higher salivary cortisol concentrations were found in the morning than in the evening in all individuals. These results show that salivary cortisol of Asian elephants follows a diurnal pattern of secretion, which could be taken into account when using this methodology to assess welfare in captive Asian elephants.     

CIRCADIAN RHYTHM IN PEAK EXPIRATORY FLOW: ALTERATION WITH NOCTURNAL ASTHMA AND THEOPHYLLINE CHRONOTHERAPY*

We investigated changes in the circadian rhythm of peak expiratory flow (PEF) in seven persons with nocturnal asthma for a 24h span when (1) they were symptom free and their disease was stable, (2) their asthma deteriorated and nocturnal symptoms were frequent, and (3) they were treated with theophylline chronotherapy. Subjects recorded their PEF every 4h between 07:00 and 23:00 one day each period. Circadian rhythms in PEF were assessed using the group-mean cosinor method. The circadian rhythm in PEF varied according to asthma severity. Significant circadian rhythms in PEF were detected during the period when asthma was stable and when it was unstable and nocturnal symptoms were frequent. When nocturnal symptoms were present, the bathyphase (trough time) of the PEF rhythm narrowed to around 04:00; during this time of unstable asthma, the amplitude of the PEF pattern increased 3.9-fold compared to the symptom-free period. No significant group circadian rhythm was detected during theophylline chronotherapy. Evening theophylline chronotherapy proved to be prophylactic for persons whose symptoms before treatment had occurred between midnight and early morning. Changes in the characteristics of the circadian rhythm of PEF, particularly amplitude and time of bathyphase, proved useful in determining when to institute theophylline chronotherapy to avert nocturnal asthma symptoms. (Chronobiology International, 17(4), 513–519, 2000)     

Circadian rhythms of basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), cortisol, and melatonin in women with breast cancer

Background: Circadian rhythms in plasma concentrations of many hormones and cytokines determine their effects on target cells. Methods: Circadian variations were studied in cortisol, melatonin, cytokines (basic fibroblast growth factor [bFGF], EGF, insulin-like growth factor-1 [IGF-1]), and a cytokine receptor (insulin-like growth factor binding protein-3 [IGFBP-3]) in the plasma of 28 patients with metastatic breast cancer. All patients followed a diurnal activity pattern. Blood was drawn at 3h intervals during waking hours and once during the night, at 03:00. The plasma levels obtained by enzyme-linked immunoassay (ELISA) or radioimmunoassay (RIA) were evaluated by population mean cosinor (using local midnight as the phase reference and by one-way analysis of variance (ANOVA). Results: Cortisol and melatonin showed a high-amplitude circadian rhythm and a superimposed 12h frequency. bFGF showed a circadian rhythm with an acrophase around 13:00 with a peak-to-trough interval (double amplitude) of 18.2% and a superimposed 12h frequency. EGF showed a circadian rhythm with an acrophase around 14:20, a peak-to-trough interval of 25.8%, and a superimposed 12h frequency. IGF-1 showed a high value in the morning, which is statistically different t test) from the low value at 10:00, but a regular circadian or ultradian rhythm was not recognizable as a group phenomenon. IGFBP-3 showed a low-amplitude (peak-to-trough difference 8.4%) circadian rhythm with the acrophase around 11:00 and low values during the night. Conclusions: (1) Circadian periodicity is maintained in hospitalized patients with metastatic breast cancer. (2) Ultradian (12h) variations were superimposed on the circadian rhythms of the hormones and several of the cytokines measured. (3) Studies of hormones and cytokines in cancer patients have to take their biologic rhythms into consideration. (4) The circadian periodicity of tumor growth stimulating or restraining factors raises questions about circadian and/ or ultradian variations in the pathophysiology of breast cancer. (Chronobiology International, 18(4), 709-727)