The use of salivary cortisone in the diagnosis and management of adrenal disease

该项目旨在开发、验证并将新的唾液测试引入NHS（以及全世界），以简化肾上腺功能不全患者的诊断和治疗。肾上腺产生必需的应激激素皮质醇，如果没有这种激素，病人就会死于循环衰竭，即所谓的肾上腺危机。肾上腺功能不全可能由长期类固醇治疗引起，这种治疗通常用于炎症性疾病，如哮喘、类风湿性关节炎和最近的Covid-19。目前，肾上腺功能不全的诊断需要到医院就诊一天，然而曼彻斯特大学NHS基金会信托基金的Brian Keevil教授开发了一种唾液测试，将大大简化肾上腺功能不全的诊断和治疗。唾液检测将通过早期诊断挽救生命，减少不必要的医患接触，减轻患者负担，并通过家庭抽样和医院实验室远程检测降低成本。通过曼彻斯特大学NHS基金会信托基金的创新学者奖，Keevil教授借调到Diurnal公司，这是一家在开发激素药物产品方面拥有世界领先专业知识的英国公司，将允许该项目检查特定唾液类固醇（可的松和皮质醇）检测的有效性，并将其引入患者的日常护理。重要的是，对患者有益的好想法要在尽可能短的时间内进入临床实践。没有正确的基础设施和支持，许多项目无法完成。将医疗创新引入医疗保健的关键是与行业的协作和早期参与。创新学者借调是**曼彻斯特大学NHS基金会信托发展Keevil教授创新的理想工具，**提供了一条途径，在适当的行业远见和支持下，加速新的唾液诊断测试直接进入临床实践。

This project aims to develop, validate and introduce new salivary tests into the NHS (and worldwide) to simplify the diagnosis and treatment of patients with adrenal insufficiency. The adrenal produces the essential stress hormone cortisol without which patients die from circulatory collapse in what is called an adrenal crisis. Adrenal insufficiency may be caused by prolonged steroid treatment which is commonly used in inflammatory disorders such as asthma, rheumatoid arthritis and most recently Covid-19\. Currently, diagnosis of adrenal insufficiency requires a day case visit to hospital, however Professor Brian Keevil, at the Manchester University NHS Foundation Trust, has developed a salivary test that will greatly simplify the diagnosis and treatment of adrenal insufficiency. Salivary testing will save lives through early diagnosis, reduce the need for unnecessary clinician-patient contact, reduce the burden to patients and reduce cost through home sampling and remote testing in hospital laboratories. The secondment of Professor Keevil to Diurnal, a UK Company with world-leading expertise in developing hormone pharmaceutical products, through the Innovation Scholars award the Manchester University NHS Foundation Trust will allow the project to examine the validation of the specific salivary steroid (cortisone and cortisol) assays and their introduction in to the everyday care of patients. It is critical that good ideas that will benefit patients find a way to move through to clinical practice in the shortest timeframe possible. Without the correct infrastructure and support many projects fail to reach completion. The key to introducing medical innovation to healthcare is collaboration and early involvement with industry. The Innovation Scholars secondment is the ideal vehicle to develop Professor Keevil's innovation at **Manchester University NHS Foundation Trust,** providing a pathway to accelerate the new salivary diagnostic tests directly into clinical practice with the appropriate industry forethought and backing.