MAR 22, 2018 10:30 AM PDT

Measuring Cortisol in Clinical Settings: Pitfalls, Challenges and Promises

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  • Division Director of Chemistry and Toxicology (Former), Bureau of Laboratories at Michigan State Government
      LiSheng Chen, PhD, has over 10 years of experience in directing and managing clinical laboratories in the academic center, industry and government regulatory agencies. The most recent position she held is Division Director of Chemistry and Toxicology, Bureau of Laboratories at Michigan State Government. In her previous positions, she was Associate Director of Automated Laboratory at University of Rochester Medical Center, Staff Fellow at US Food and Drug Administration and Laboratory Director for a startup, Firefly Diagnostics. Dr. Chen has strong interest in endocrine testing and related applications with advanced technologies; she has developed several novel clinical assays and improved existing methods for the clinical diagnosis through her career. Dr. Chen obtained her Ph.D. in Nutritional Biochemistry from University of California at Berkeley, and completed two postdoctoral fellowships at University of California-Davis and Mayo Clinic respectively. She is board certified in Clinical Chemistry by American Board of Clinical Chemistry and is a fellow of the National Academy of Clinical Biochemistry.


    DATE: March 22, 2018
    TIME: 10:30AM PDT, 1:30PM EDT

    Cortisol plays a central role in the diagnosis of adrenal excess/insufficiency and in the assessment of stress adaptation and related diseases. The hydrophobic nature and the episodic/ circadian pattern of section challenge the clinical diagnostic accuracy of cortisol measurement. Commonly used automated immunoassays suffer cross-reactivity with other steroid analogues and exhibit significant inter-assay variability. Recently introduced liquid chromatography tandem mass spectrometry (LC-MS/MS) method, with superior specificity and sensitivity, provides a reliable alternative for measuring serum total and serum/urine free cortisol and is the method of choice for measuring salivary cortisol. However, assay standardization and the subsequent validations of reference ranges and cutoff values for dynamic testing remain to be established for LC-MS/MS-based cortisol assays. Rapid in-suite cortisol testing facilitates the use of adrenal vein sampling (AVS) for the differential diagnosis of primary aldosteronism; and real-time monitoring of cortisol levels will enable wider and better use of cortisol as stress biomarker in response to environmental and behavioral triggers. The recent technical advancements in cortisol biosensors and the development of integrated ambient ionization-miniature MS system hold the promises of realizing point-of-care (POC) cortisol monitoring and of potentially broad clinical applications.

    Learning Objectives:

    • Clinical utilities of cortisol measurement in different types of specimens
    • Methodologies and assay performances of current cortisol clinical assays
    • Cortisol POC devices: biosensors and ambient ionization mass spectrometry

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