Modulation of test anxiety-induced salivary protein secretion by ovarian steroid hormones: a preliminary study

In women the menstrual cycle influences mood and anxiety. Aim of this study was to preliminarily investigate whether different ovarian steroid hormone levels may modulate the psychophysiological responses elicited by test anxiety. Specifically, we compared the secretion of anxiety-induced salivary proteins of healthy women in the early follicular (Pre-Ov group) (low ovarian steroid hormones levels) and mid-luteal (Post-Ov group) (medium/high ovarian steroid hormones levels) phase of the menstrual cycle, during the simulation of an oral examination. Saliva samples were collected before and after a relaxation period and at two post-simulation times and analyzed by two-dimensional electrophoresis and western blot. Proteins corresponding to spots differentially expressed in the two groups across the session were identified through mass spectrometry and most of them corresponded to acute stress and/or oral mucosa immunity biomarkers. The task induced an increase in alpha-amylase, carbonic anhydrase and cystatin S, and a decrease in immunoglobulin light/J chains in both groups. Analogous changes in these proteins have previously been linked to psychological or physical stress. However, specific spots corresponding, for example, to cystatins and 14-3-3 protein, changed exclusively in the Pre-Ov group, while prolactin-inducible protein, polymeric immunoglobulin receptor, fragments of alpha-amylase and immunoglobulins only in the Post-Ov group, indicating a potential modulation of their secretion by ovarian steroid hormones. Overall, the results provide preliminary evidence that ovarian steroid hormones may be a driving factor for differences in physiological responses induced by test anxiety. The results are promising, but further validation in a larger sample is needed.