Aldosterone, the main mineralocorticoid hormone, plays a central role in the homeostatic

regulation of blood pressure, plasma sodium and potassium levels. When dysregulated, aldosterone is pathogenic and contributes to the development and progression of cardiovascular and kidney diseases.

Aldosterone is part of the renin-angiotensin aldosterone system. Primary hyperaldosteronism is characterized by overproduction of aldosterone or in a result of excessive renin secretion. On the other hand, secondary hyperaldosteronism is due to overactivity of renin-angiotensin system.

The ratio of renin to aldosterone is an effective screening test for primary hyperaldosteronism related to adrenal adenomas. An ACTH stimulation test can help in determining the cause of hypoaldosteronism with low aldosterone response indicating a primary aldosteronism, while a large response indicates a secondary hypoaldosteronism.

Cortisol is a hormone synthesized from cholesterol in the adrenal glands and Cortisone is its inactive metabolite. Cortisol and Cortisone are useful markers for the diagnosis of mineralocorticoid or glucocorticoid excess, adrenal congenital hyperplasia (CAH) and adrenal insufficiency.

Furthermore, Cortisol increases in Cushing’s syndrome, decreases in Addison’s disease and can be associate with cardiovascular disease, anti-inflammatory and immunosuppressive effects. Urinary free Cortisol and Cortisone is a good indicator of free Cortisol and Cortisone concentrations in serum and plasma. Their simultaneous measurement is very useful for the therapy monitoring.

Interest in salivary matrix is rapidly increasing because, in addition to useful metabolic information, it can be collected through a simple, non-invasive method and without medical supervision. Cortisol and Cortisone are steroid hormones synthesized from cholesterol in the adrenal glands. Cortisol and Cortisone are useful markers for the evaluation of mineralcorticoid or glucocorticoid excess, adrenal congenital hyperplasia (CAH) and adrenal insufficiency. Furthermore, salivary cortisol increases in Cushing’s syndrome, decrease in Addison’s disease and can be associate with cardiovascular disease, anti-inflammatory and immunosuppressive effects.

The evaluation of salivary Cortisol and Cortisone is a good indicator of free Cortisol and Cortisone concentrations, because they are not linked to transport proteins, in serum and plasma. For this reason, they are at very low concentrations in the saliva samples (about 5 times lower than plasma and serum). The present method using LC-MS/MS allows the simultaneous quantification of salivary Cortisol and Cortisone in a fast highly sensitive and specific way.