Sialochemistry; A Diagnostic Tool
UCLA group profiled and analyzed saliva from patients with oral cancer. Four genes from the NSTC (IL-8, ornithine decarboxylase, spermidine acetyltransferase and IL-1ß) were able to discriminate and predict whether a saliva sample was from a patient with cancer or from a healthy subject, with a sensitivity and specificity of 91 percent each characteristic (Figure 5). The group has validated these salivary transcriptome biomarkers for oral cancer detection in approximately 300 subjects. The behavior of these salivary transcriptome biomarkers is consistent i.e their levels are significantly higher in the saliva of patients with oral cancer than in the saliva of matched control subjects. 25 However, before a salivary diagnostic test can replace a more conventional one, the diagnostic value of a new salivary test has to be compared with accepted diagnostic methods. The usefulness of a new test has to be determined in terms of sensitivity, specificity, correlation with established disease diagnostic criteria, and reproducibility.
Conclusion
It is becoming increasingly apparent to investigators and clinicians in a variety of disciplines that saliva has many diagnostic uses and is especially valuable in the young, the old and in large scale screening and epidemiologic studies. The saliva has found use as a diagnostic aid in an increasing number of systemic diseases that can affect salivary gland function and composition Changes in salivary flow rate may affect the concentration of salivary markers and also their availability due to changes in salivary pH. . In addition, many serum markers can reach whole saliva in an unpredictable way (i.e., GCF flow and through oral wounds).These parameters will affect the diagnostic usefulness of many salivary constituents .Whole saliva also contains proteolytic enzymes derived from the host and from oral micro-organisms). These enzymes can affect the stability of certain diagnostic markers. Some molecules are also degraded during intracellular diffusion into saliva.
Different diseases that have inflammatory processes in common will show the same changes in their sialochemical patterns and are very sensitive. At the same time, the specificity regarding classified diseases is low. Therefore a correct diagnosis will always require a full clinical and laboratory investigation. However. sialochemistry is a useful means of chronologically, monitoring qualitative and quantitative changes.
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