PERIODONTICS
Discussion
Saliva is an excellent natural ultrafiltrate that
contains local substances as well as others derived
from the blood. In saliva we can detect a myriad
markers such as: cytokines (TNF-α, IL-6, IFN-γ,
MIP-1β), C Reactive Protein (CRP), antioxidant
biomarkers
(uric
acid,
malondialdehyde,
antioxidant enzymes, total antioxidant capacity)
insulin resistance markes (adipokines) or cortisol
(13, 14,16).
Steroids, such as cortisol, not bound by carrier
proteins, can diffuse freely into saliva, being the
free fraction. The concentration of cortisol in saliva
is independent of the salivary flow rate and strongly
correlated with circulating cortisol concentration.
In the reference literature, cortisol is the most
common used indicator of stress, released by the
hypothalamo-pituitary-adrenal (HPA) axis, under
the influence of several factors such as chronic
inflammation (13,17).
The most important effects of cortisol release
are: supression of the inflammatory response,
modifying cytokine profiles, elevation of blood
glucose levels and alteration of certain growth
factors levels (18, 19). Low levels of cortisol
were detected in patients with primary adrenal
insufficiency (Addison’s disease) and ACTH
deficiency (20,21). Higher levels of cortisol were
found in patients with systemic (Cushing’s disease,
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