It has been documented that cortisol release in response to acute stressors is reduced in patients with atopic dermatitis, allergic rhinitis, and other atopic diseases compared to that in healthy subjects. We aimed to test the hypothesis that atopic patients exert reduced salivary cortisol awakening response (CAR) in comparison with healthy subjects. The hypothesis was tested on a stressful and a relax day selected subjectively. Moreover, we evaluated the impact of trait anxiety. The sample consisted of 60 subjects, out of which 28 were patients with atopy and 32 healthy volunteers of both sexes. Saliva samples were collected in the morning to evaluate CAR as well as in the early afternoon and evening to look at cortisol concentrations during the rest of the day. The results showed reduced CAR in atopic patients compared to that in healthy subjects. This effect was modulated by sex with a significant difference observed in males. While CAR was reduced, atopic patients had unchanged cortisol concentrations throughout the day. The evening cortisol was even higher in atopic patients. If the subjects were stratified according to the trait anxiety, no significant differences in CAR between high and low anxiety were observed. No differences in cortisol variables including CAR were observed between the stressful and relax day. In conclusion, this study presents evidence on reduced CAR suggesting an insufficient HPA axis reactivity in atopy. Furthermore, the data in atopic patients demonstrate that reduced HPA axis reactivity does not necessarily mean lower cortisol concentrations throughout the day. This might be of relevance to immune system function and the course of the disease.

中文翻译：

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患有特应性疾病的患者在一天的其余时间中皮质醇的唤醒反应减弱，但皮质醇浓度却没有降低。

据报道，与健康受试者相比，特应性皮炎，过敏性鼻炎和其他特应性疾病患者对急性应激源的皮质醇释放减少。我们旨在检验以下假设：与健康受试者相比，特应性患者的唾液皮质醇觉醒反应（CAR）减少。在主观选择的压力大和放松的一天对假设进行了测试。此外，我们评估了特质焦虑的影响。该样本由60名受试者组成，其中28名患有特应性疾病的患者和32名男女健康志愿者。早上收集唾液样本以评估CAR，下午和傍晚则收集唾液样本以检查一天中其余时间的皮质醇浓度。结果显示，与健康受试者相比，特应性患者的CAR降低。这种作用受性别调节，在男性中观察到显着差异。虽然减少了CAR，但是特应性患者全天的皮质醇浓度没有变化。特应性患者的夜间皮质醇更高。如果根据特质焦虑对受试者进行分层，则高焦虑和低焦虑之间的CAR均无显着差异。在紧张和放松的一天之间没有观察到包括CAR在内的皮质醇变量的差异。总之，这项研究提出了降低CAR的证据，提示特应性HPA轴反应性不足。此外，特应性患者的数据表明，HPA轴反应性降低并不一定意味着全天皮质醇浓度降低。