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

该项目旨在开发、验证新的唾液测试，并将其引入NHS(以及全世界)，以简化肾上腺功能不全患者的诊断和治疗。肾上腺产生必要的应激激素皮质醇，如果没有皮质醇，患者就会死于循环衰竭，这就是所谓的肾上腺危象。肾上腺功能不全可能是由于长期使用类固醇治疗引起的，类固醇通常用于炎症性疾病，如哮喘、类风湿性关节炎和最近的新冠肺炎。目前，肾上腺功能不全的诊断需要每天去医院就诊，然而曼彻斯特大学NHS基金会信托基金的布莱恩·基维尔教授已经开发出一种唾液测试，将极大地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拯救生命，减少不必要的临床医生与患者接触的需要，减轻患者的负担，并通过在医院实验室进行家庭采样和远程检测来降低成本。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Diural，该项目将使该项目能够审查特定唾液类固醇(皮质醇和皮质醇)分析的有效性，以及将其引入患者的日常护理。至关重要的是，将使患者受益的好想法要找到一种方法，在尽可能短的时间内转化为临床实践。如果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业界的合作和早期参与。创新学者借调是**曼彻斯特大学NHS基金会信托基金**发展基维尔教授创新的理想工具，**提供了一条途径，在适当的行业前瞻和支持下，将新的唾液诊断测试直接应用于临床实践。

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.