Saliva as a diagnostic fluid

In the last 10 years, the use of saliva as a diagnostic fluid has become somewhat of a translational research success story. Technologies are now available enabling saliva to be used to diagnose disease and predict disease progression. This review describes some important recent advances in salivary diagnostics and barriers to application and advancement. This review will also stimulate future research activity.

A nurse-managed smoking cessation intervention during pregnancy

OBJECTIVE

To evaluate the effectiveness of a nurse-managed smoking cessation intervention in an outpatient setting among pregnant women who smoked.

DESIGN

Prospective; control group participants' cessation rates were assessed 6-12 weeks after clinic contact. They were compared to cessation rates for subsequent intervention participants 6-12 weeks after receiving a nurse-managed smoking cessation intervention.

SETTING/PARTICIPANTS

One hundred seventy-eight women who were daily smokers, during their first visit after confirmation of pregnancy at a teaching hospital prenatal clinic.

INTERVENTION

Fifteen-minute individualized intervention delivered by an advanced-practice nurse, combined with a telephone contact by an advanced-practice nurse 7-10 days after the clinic visit.

MAIN OUTCOME MEASURES

Self-report of smoking, confirmed by saliva cotinine.

RESULTS

Intervention group participants had a self-reported abstinence rate of 19% compared with 0% among control group participants. The cotinine-validated abstinence rate for the intervention group was 15.5%, compared with 0% in the control group. African Americans were more likely to quit, compared with white participants who received the intervention.

CONCLUSION

A nurse-managed intervention combined with a telephone contact may be an effective strategy for intervening with pregnant smokers, especially African Americans.

Relationship between 3-methoxy-4-hydroxyphenylglycol and homovanillic acid in saliva and plasma of healthy volunteers

Plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) and homovanillic acid (HVA) levels may reflect changes in central noradrenergic and dopaminergic activity, respectively. The relationship between MHPG and HVA in saliva and plasma was investigated to evaluate the utility of salivary metabolite measurement as a relatively noninvasive and useful alternative to plasma analysis. MHPG and HVA in saliva and plasma, collected concurrently, from 12 healthy volunteers, were measured by high-performance liquid chromatography. Concentration of free MHPG in saliva correlated significantly with plasma free MHPG. Salivary free MHPG was significantly higher than in plasma. Enzymatic hydrolysis of conjugated MHPG corroborated other work that plasma free MHPG, MHPG-glucuronide, and MHPG-sulfate were in roughly equal proportions. Unpredictably, in saliva, free MHPG was greater than 80% of the total. Salivary and plasma free HVA concentrations also correlated significantly, but salivary HVA levels were significantly lower than in plasma. Conjugated HVA was consistently less than 10% of total both in saliva and plasma. These findings suggest that salivary MHPG and HVA can reflect plasma metabolite levels. Although local factors may influence their formation and concentration in saliva, large changes in plasma free MHPG or HVA could be reflected by parallel changes in saliva.

Evaluation of the Salivette as sampling device for monitoring beta-adrenoceptor blocking drugs in saliva

The Salivette was evaluated with a range of racemic beta-adrenoceptor blocking drugs with different lipophilicity. Recovery from the Salivette appeared to be independent of the stereochemical configuration of the drugs but a significant loss of drug due to the Salivette was observed for all tested drugs. The performance of the method, in terms of accuracy and precision, fitted well within the generally accepted criteria for validation, except near the limit of quantification. The Salivette is successfully used for quantitating salivary beta-blocking drugs.

Cotinine in an ultrafiltrate of saliva

BACKGROUND

We have developed a device for the simplified collection of a prepurified sample of saliva in the mouth.

METHOD

The device is based on the principle of an osmotic pump and accumulated about 1.2 ml of an ultrafiltrate of saliva within 8 min. We have investigated the ultrafiltrate for its utility as a biological medium in the evaluation of cigarette smoking status.

RESULTS

(a) In 58 matched samples from 13 subjects, the correlation coefficient for the cotinine concentration in the saliva and the ultrafiltrate was 0.95; (b) in matched plasma and ultrafiltrate samples from 27 smokers, the correlation coefficient for the cotinine concentrations was 0.96 with plasma containing 1.2 times the ultrafiltrate mean; (c) in a nonsmoker, elevated cotinine levels could be detected in the ultrafiltrate more than 24 hr after smoking 2 cigarettes, and the pattern of rise and decrease reflected that in whole saliva; and (d) in a habitual smoker; the mean cotinine concentration in the ultrafiltrate was 157 ng/ml (SD +/- 25.7 ng/ml) during a period of smoking 15 cigarettes per day and dropped to a mean of 47 ng/ml (SD +/- 10.5) when smoking was reduced to 5 cigarettes per day; after cessation of smoking, detectable concentrations of cotinine persisted for up to 5 days.

CONCLUSION

The device facilitated the aesthetic, noninvasive collection of a biological sample useful in the validation of smoking status.