Advancing Point-of-Care (PoC) Testing Using Human Saliva as Liquid Biopsy

Comparison of Salivary Calcium Level in Dentulous and Edentulous Patients

OBJECTIVES

Calcium is an inorganic component of the saliva, which is especially important in oral and dental health. This study sought to compare unstimulated salivary calcium level of dentulous and edentulous patients.

MATERIALS AND METHODS

This case-control study was conducted on 72 participants, including 36 dentulous and 36 edentulous patients. The unstimulated salivary flow rate of patients and the mean salivary calcium concentration were measured and compared. The data were analyzed using the nonparametric Mann-Whitney U-test.

RESULTS

The mean age of participants was 56.3 years. The mean number of teeth was 18.9 in the dentulous group. No significant difference was noted in salivary calcium level of dentulous and edentulous patients. The mean salivary calcium concentration was 0.61 ± 0.3875 mmol/L in dentulous and 0.8025 ± 0.5975 mmol/L in edentulous patients. Salivary calcium level had a significant inverse correlation with salivary flow rate (r = -0.370, p = 0.027), and by every 1-unit increase in salivary flow rate, salivary level of calcium significantly decreased by 3.85 units.

CONCLUSION

Edentate had averagely higher salivary calcium level compared to dentulous. The salivary concentration of calcium ion is not correlated to the presence or absence of teeth. Salivary flow rate reduces the calcium concentration.

Comparative Glycomics of Immunoglobulin A and G From Saliva and Plasma Reveals Biomarker Potential

The N-glycosylation of immunoglobulin (Ig) G, the major antibody in the circulation of human adults, is well known for its influence on antibody effector functions and its alterations with various diseases. In contrast, knowledge on the role of glycans attached to IgA, which is a key immune defense agent in secretions, is very scarce. In this study we aimed to characterize the glycosylation of salivary (secretory) IgA, including the IgA joining chain (JC), and secretory component (SC) and to compare IgA and IgG glycosylation between human plasma and saliva samples to gain a first insight into oral cavity-specific antibody glycosylation. Plasma and whole saliva were collected from 19 healthy volunteers within a 2-h time window. IgG and IgA were affinity-purified from the two biofluids, followed by tryptic digestion and nanoLC-ESI-QTOF-MS(/MS) analysis. Saliva-derived IgG exhibited a slightly lower galactosylation and sialylation as compared to plasma-derived IgG. Glycosylation of IgA1, IgA2, and the JC showed substantial differences between the biofluids, with salivary proteins exhibiting a higher bisection, and lower galactosylation and sialylation as compared to plasma-derived IgA and JC. Additionally, all seven N-glycosylation sites, characterized on the SC of secretory IgA in saliva, carried highly fucosylated and fully galactosylated diantennary N-glycans. This study lays the basis for future research into the functional role of salivary Ig glycosylation as well as its biomarker potential.

Diagnostic value of salivary CRP and IL-6 in patients undergoing anti-TNF-alpha therapy for rheumatic disease

Introduction

Saliva has been increasingly used as a diagnostic medium for disease detection and monitoring. The aim of this observational, prospective, pilot study was to investigate whether salivary concentrations of CRP and IL-6 correlate with those in serum and with the clinical course of a rheumatic disease.

Materials and methods

Nineteen patients with rheumatic disease newly scheduled for anti-TNFα therapy were included. Patients received anti-TNFα treatment (adalimumab, certolizumab, golimumab or infliximab) as per standard protocols. CRP and IL-6 were measured with high-sensitivity immunoassays before and after 12 weeks of therapy, according to standard regimens. The data were analyzed with nonparametric statistics.

Results

Concentrations of CRP in saliva correlated significantly with those in serum (R = 0.62; p < 0.0001) and decreased markedly after successful response to treatment. In patients with a limited response to treatment salivary CRP levels increased. In contrast to CRP, the salivary concentrations of IL-6 did not change significantly over the course of therapy and they did not correlate with serum IL-6 concentrations. Salivary levels of neither CRP nor IL-6 corresponded to parameters of oral health and hygiene.

Conclusions

Salivary CRP but not IL-6 could be of potential use for monitoring the rheumatic disease activity.

Role of Salivary Biomarkers in Oral Cancer Detection

Oral cancers are the sixth most frequent cancer with a high mortality rate. Oral squamous cell carcinoma accounts for more than 90% of all oral cancers. Standard methods used to detect oral cancers remain comprehensive clinical examination, expensive biochemical investigations, and invasive biopsy. The identification of biomarkers from biological fluids (blood, urine, saliva) has the potential of early diagnosis. The use of saliva for early cancer detection in the search for new clinical markers is a promising approach because of its noninvasive sampling and easy collection methods. Human whole-mouth saliva contains proteins, peptides, electrolytes, organic, and inorganic salts secreted by salivary glands and complimentary contributions from gingival crevicular fluids and mucosal transudates. This diagnostic modality in the field of molecular biology has led to the discovery and potential of salivary biomarkers for the detection of oral cancers. Biomarkers are the molecular signatures and indicators of normal biological, pathological process, and pharmacological response to treatment hence may provide useful information for detection, diagnosis, and prognosis of the disease. Saliva's direct contact with oral cancer lesions makes it more specific and potentially sensitive screening tool, whereas more than 100 salivary biomarkers (DNA, RNA, mRNA, protein markers) have already been identified, including cytokines (IL-8, IL-1b, TNF-α), defensin-1, P53, Cyfra 21-1, tissue polypeptide-specific antigen, dual specificity phosphatase, spermidine/spermineN1-acetyltransferase , profilin, cofilin-1, transferrin, and many more. However, further research is still required for the reliability and validation of salivary biomarkers for clinical applications. This chapter provides the latest up-to-date list of known and emerging potential salivary biomarkers for early diagnosis of oral premalignant and cancerous lesions and monitoring of disease activity.

Saliva biomarkers in neurological disorders: A "spitting image" of brain health?

In this issue of the Biomedical Journal, we learn how biomarkers in saliva may be able to provide insight into the health of the brain and the central nervous system. We also discover how computational modeling can help to identify potential epitopes for vaccine development against Chlamydia, the world's most common sexually transmitted infection.

Microfluidic Line-Free Mass Sensor Based on an Antibody-Modified Mechanical Resonator

This research proposes a mass sensor based on mechanical resonance that is free from power supply lines (line-free) and incorporates both microfluidic mechanisms and label-free techniques to improve its sensitivity and reusability. The microfluidic line-free mass sensor comprises a disk-shaped mechanical resonator, a separate piezoelectric element used to excite vibrations in the resonator, and a microfluidic mechanism. Electrical power is used to actuate the piezoelectric element, leaving the resonator free from power lines. The microfluidic mechanism allows for rapid, repeat washings to remove impurities from a sample. The microfluidic line-free mass sensor is designed as a label-free sensor to enable high-throughput by modifying and dissociating an antibody on the resonator. The resonator was fabricated by photolithography and the diameter and thickness were 4 mm and 0.5 mm, respectively. The line-free mass sensor enabled a high Q-factor and resonance frequency of 7748 MHz and 1.402 MHz, respectively, to be achieved even in liquids, facilitating the analysis of human salivary cortisol. The line-free mass sensor could be used for repeated measurements with the microfluidic mechanism, and the resonator could be fully washed out. It was concluded that the microfluidic line-free mass sensor was suitable to analyze the concentration of a salivary hormone, cortisol, in human saliva samples, and that it provided high-throughput suitable for point-of-care testing.

A Three-MicroRNA Signature as a Potential Biomarker for the Early Detection of Oral Cancer

Oral squamous cell carcinoma (OSCC) is often diagnosed at a late stage and may be malignantly transformed from oral leukoplakia (OL). This study aimed to identify potential plasma microRNAs (miRNAs) for the early detection of oral cancer. Plasma from normal, OL, and OSCC patients were evaluated. Small RNA sequencing was used to screen the differently expressed miRNAs among the groups. Next, these miRNAs were validated with individual samples by quantitative real-time polymerase chain reaction (qRT-PCR) assays in the training phase (n = 72) and validation phase (n = 178). The possible physiological roles of the identified miRNAs were further investigated using bioinformatics analysis. Three miRNAs (miR-222-3p, miR-150-5p, and miR-423-5p) were identified as differentially expressed among groups; miR-222-3p and miR-423-5p negatively correlated with T stage, lymph node metastasis status, and clinical stage. A high diagnostic accuracy (Area under curve = 0.88) was demonstrated for discriminating OL from OSCC. Bioinformatics analysis reveals that miR-423-5p and miR-222-3p are significantly over-expressed in oral cancer tissues and involved in various cancer pathways. The three-plasma miRNA panel may be useful to monitor malignant progression from OL to OSCC and as potential biomarkers for early detection of oral cancer.

Role of Salivary Biomarkers in Detection of Cardiovascular Diseases (CVD)

Human whole mouth saliva (WMS) is secreted by salivary glands, namely parotid, submandibular/sublingual and other minor glands of the oral cavity. It is secreted in a systematic way, and contain informative proteins and peptides for the early detection of contagious diseases and organ-related diseases. The role of WMS as a liquid biopsy for the detection of cardiovascular diseases (CVD) through Myoglobin (MYO), Cardiac troponin I (cTnI), Creatine phosphokinase MB (CK-MB), Myeloperoxidase (MPO), brain natriuretic peptide (NT-proBNP), Exosomal miRNA, C-Reactive Protein (CRP), Matrix metalloproteinase-8 (MMP-8), MMP-9 and tissue inhibitor of MMP-8 (TIMP-1), leukotriene B4 has been well reported in last decade, that have been reviewed in the literature comprehensively below.