Analyses of hair and salivary cortisol for evaluating hypothalamic–pituitary–adrenal axis activation in patients with autoimmune disease
Open accessAbstract
Although many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic-pituitary-adrenal axis (HPA), controversial results have been described. Our objective was to study HPA axis activity in women with autoimmune disease compared to healthy women. Therefore, we analyzed salivary cortisol over the course of a day, and hair cortisol concentrations from the three preceding months, from 65 women divided into two groups: healthy women (n = 30), with a mean age of 44.70 ± 11.65 years; and women with autoimmune disease (n = 35), with a mean age of 48.26 ± 9.04 years. The latter group comprises women with systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and systemic sclerosis (SSc). Perceived stress and psychopathological symptomatology were also evaluated. Autoimmune disease group scored higher on the somatization subscale SCL-90-R and lower on the anxiety subscale than the control group. Regarding HPA axis activation, the area under curve for cortisol levels during the day was higher for the autoimmune disease group. In addition, higher cortisol levels in hair were found in the group with autoimmune disease. Our findings show greater short and long-term HPA axis activity in women with autoimmune disease than in healthy women.
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Clinical data shows elevated cortisol levels in patients with autoimmune diseases, supporting the link between chronic stress and autoimmunity.
“Clinical data shows elevated cortisol levels in patients with autoimmune diseases, supporting the link between chronic stress and autoimmunity [14].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [14]
The Conclusions report higher hair cortisol and greater short- and long-term HPA-axis activity in women with autoimmune disease than in healthy women. The Discussion describes hair cortisol as a retrospective measure of chronic stress, but reports similar psychological stress measures in the two groups. The findings concern women with three specified autoimmune diseases and do not establish that chronic stress causes autoimmunity. (LLM, conf=0.85)
Experimental — accuracy not yet measuredHigher cortisol levels were observed in both saliva and hair samples of women with autoimmune diseases compared to healthy controls.
“Higher cortisol levels were observed in both saliva and hair samples of the affected group, alongside elevated somatization scores and lower anxiety scores.”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [14]
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- Authors
- Montero-López, E., Santos-Ruiz, A., González, R., Navarrete-Navarrete, N., Ortego-Centeno, N., Martínez-Augustín, O., Rodríguez-Blázquez, M., & Peralta-Ramírez, M. I.
- Affiliations
- Department of Clinical Psychology, University of Granada, Granada, Spain;
- Department of Health Psychology, School of Health Sciences, University of Alicante, Alicante, Spain;
- Universidad de Granada (ES)
- Systemic Autoimmune Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain;
- Systemic Autoimmune Disease Unit, Internal Medicine Service, San Cecilio Clinical Hospital, Granada, Spain;
- Department of Biochemistry and Molecular Biology II, CIBERehd, School of Pharmacy, University of Granada, Granada, Spain;
- Complejo Hospitalario de Jaén (ES)
- Corresponding author
- González, Raquel
- Venue
- Stress
- Publisher
- Informa UK Limited
- Published
- 2017-08-30
- Volume
- 20
- Issue
- 6
- Pages
- 541-548
- ISSN
- 1025-3890 (ISSN-L)
- 1607-8888
- OpenAlex
- W2753420391
- Cited by
- 22
- References
- 41
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 2
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stress (publishedVersion)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion)
- Repositorio Institucional de la Universidad de Alicante (Universidad de Alicante) (submittedVersion)
- Funders
- Spanish Ministry of Science and Innovation
- Ministerio de Ciencia e Innovación (PSI2010-15780)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- hypothalamic-pituitary-adrenal axis, autoimmune disease, salivary cortisol, hair cortisol, systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, perceived stress, psychopathology, somatization, anxiety, women
- MeSH terms
- Adult, Autoimmune Diseases, Female, Hair, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Lupus Erythematosus, Systemic, Middle Aged, Pituitary-Adrenal System, Saliva, Scleroderma, Systemic, Sjogren's Syndrome, Stress, Psychological, Case-Control Studies
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