Endocrine Abstracts

Background: Measurement of salivary glucocorticoids is gaining popularity as it offers a non-invasive collection technique, enabling sampling in the community or home environment, allowing tailored capture of steroid circadian rhythm and improved patient experience. Current popular salivary collection methods cannot be used in very young children due to choking and the requirement for active participation. There is little data on saliva stability during home collection.

Objectives: To compare salivary glucocorticoids sampled using different collection techniques; assess the salivary glucocorticoids stability under different storage conditions; evaluate time taken for salivary glucocorticoid collection and assess caregiver acceptability comparing the SalivaBio and a new salivary collection device designed for infants and young children – the SaliPacä (SalivaBio swab encased in an infant pacifier).

Methods: To compare devices, six healthy adults collected saliva samples using Salivette Cortisol®, passive drool and SalivaBio on retiring for bed, awakening and 3pm for five days. In the stability study volunteers provided saliva stored on SalivaBio swabs at 4°C, room temperature or 50°C for 24, 48, 72 hours or one week, replicating potential postage conditions. Salivary cortisol and cortisone concentrations were measured by LCMS. The SalivaBio and SaliPac feasibility study compared time to collect 1ml of saliva and caregiver acceptability in 30 children <6yrs.

Results: There was no difference in salivary glucocorticoid concentrations collected using the three different methods. Salivary cortisol & cortisone were stable for 72 hours at room temperature and 4oC, with cortisone stable at 4°C and cortisol at room temperature out to a week. High temperature accelerated degradation. Repeated freeze-thaw cycles did not cause significant degradation. In children <6yrs the SalivaBio & SaliPac were well tolerated and collected sufficient saliva for salivary steroid analysis in under four minutes with no significant difference in collection time. There was a high level of acceptability in caregivers, who felt confident they could perform successful salivary collection at home using the SalivBio or SaliPac.

Conclusions: Salivette, passive drool and SalivaBio collect salivary samples with comparable cortisol & cortisone concentrations, which are stable under conditions that replicate home collection. Our novel SaliPac is an acceptable device for salivary sampling in young children.