Saliva as a Diagnostic Tool in Oral Diseases

Year 2020, Volume: 10 Issue: 3, 135 - 139, 24.12.2020

Özlem Kart Ayşen Yarat

https://doi.org/10.26650/experimed.2020.0042

Abstract

Saliva is a body fluid, which is secreted from 3 major salivary glands (parotid, submandibular and sublingual) and many minor salivary glands. It contains organic and inorganic substances with 99% water, and has several functions such as contribution to ar-ticulation, digestion, cleansing and protection of the oral mucosa, and antimicrobial effects. The concentration of saliva’s substances vary according to the responses to physiological processes in the human body. Containing genetic materials such as DNA and RNA also highlights saliva as a potential diagnostic tool. Saliva analysis has advantages such as being cheaper, non-invasive, easier pa-tient cooperation, and low technical sensitivity compared to blood tests; it can be used in the diagnosis of many diseases or routine risk assessments. It is also promising for its advantages in collec-tion and storage of the samples. Advances in molecular biology, genomics, and proteomics have revealed the importance of saliva in the detection of many diseases, coining the term salivaomics. The early diagnosis of the diseases in which symptoms can be seen in late stages, may provide an easier treatment and improve the prognosis. In this review, the biomarkers of saliva in the presence of different diseases and the advantages of their use in diagnosis were examined.

Keywords

Saliva, oral diseases, diagnosis

Ağız Hastalıklarında Tanı Aracı Olarak Tükürük

Abstract

Tükürük; başlıca üç majör tükürük bezi (parotid, submandibular ve sublingual) ve birçok minör tükürük bezinden salgılanan bir vücut sıvısıdır. İçerisinde %99 suyla birlikte organik ve inorganik maddeler bulunduran tükürüğün; artikülasyon, sindirim, ağız mu-kozasının temizlenmesi ve korunması ile antimikrobiyal etkiler gibi birçok işlevi vardır. Tükürüğün içerisindeki maddelerin konsantras-yonları vücuttaki fizyolojik süreçlere verilen yanıtlara göre değişik-lik gösterir. DNA ve RNA gibi genetik materyalleri barındırması da tükürüğü potansiyel bir teşhis aracı olarak öne çıkarmaktadır. Kan tahlillerine göre hasta kooperasyonunun daha kolay olması, daha ucuz, non-invaziv ve teknik hassasiyetin az olması gibi avantajları olan tükürük testleri; birçok hastalığın teşhisinde kullanılabileceği gibi rutin risk değerlendirmelerinde de kullanılabilir. Örnek toplan-ması ve saklanmasındaki avantajlarından dolayı da gelecek vaad etmektedir. Moleküler biyoloji, genomik ve proteomik alanlarında-ki gelişmeler sayesinde salivaomik terimi ortaya çıkmış ve birçok hastalığın saptanmasında tükürüğün önemi belirtilmiştir. Özellikle semptomların geç görülmeye başladığı hastalıkların tükürük test-leri sayesinde erken teşhis edilmesi, tedaviyi büyük oranda kolay-laştırabilir ve prognozu iyileştirebilir. Bu derlemede, farklı hasta-lıkların varlığında tükürükte bulunan biyobelirteçler ve teşhiste kullanımının avantajları incelenmiştir.

Keywords

Tükürük, ağız hastalıkları, teşhis

References

• 1. Emekli N, Yarat A. Tükürük. Nobel Tıp Kitapevleri, İstanbul, 2008.
• 2. Sharma S, Gaur P, Gupta S. Impact of saliva on health: An overview. EJBPS 2018; 5(6): 202-4.3. Martina E, Campanati A, Diotallevi F, Offidani A. Saliva and oral dis-eases. J Clin Med 2020; 9: 466. [CrossRef ]
• 4. Wu DT, Tao O, Trinh N, Javaid MA, Ahmed AS, Durand R, et al. Saliva - A promising tool for diagnosing oral diseases. Curr Oral Health Rep 2018; 5: 242-9. [CrossRef ]
• 5. Yordanova M, Gerova D, Galunska B. Saliva application in oral and systemic diseases. Scr Sci Med 2018; 50(2): 13-8. [CrossRef ]
• 6. Akyüz S, Yarat A, Emekli Alturfan E, Kaya S. Flouride in saliva and its impact on health. In: Preedy VR, editor. Fluorine: Chemistry, Analysis, Function and Effects (Food and Nutritional Components in Focus). London: Royal Society of Chemistry 2015.p.173-85. [CrossRef ]
• 7. Yarat A, Emekli Alturfan E, Akyüz S. Calcium in saliva and impact on health. In: Preedy VR, editor. Calcium: Chemistry, Analysis, Function and Effects (Food and Nutritional Components in Focus). London: Royal Society of Chemistry 2015.p.364-83. [CrossRef ]
• 8. Zhang CZ, Cheng XQ, Li JY, Zhang P, Yi P, Xu X, et al. Saliva in the diagnosis of diseases. Int. J. Oral Sci. 2016 Sep 2. [CrossRef ]
• 9. Tóthová L, Kamodyová N, Cervenka T, Celec P. Salivary markers of oxidative stress in oral diseases. Front Cell Infect Microbiol 2015; 5: 73. [CrossRef ]
• 10. Tasoulas J, Patsouris E, Giaginis C, Theocharis S. Salivaomics for oral diseases biomarkers detection. Expert Rev Mol Diagn 2015; 17.
• 11. Bhat M, Bhat D. Salivary diagnostics in oral diseases. In: Gokul S, editor. Saliva and Salivary Diagnostics (book online) 2019 May (cit-ed 2020 Mar 2): (19 pages). Available from: URL: https://www.in-techopen.com/books/saliva-and-salivary-diagnostics/salivary-di-agnostics-in-oral-diseases [CrossRef ]
• 12. Buzalaf MAR, Ortiz AC, Carvalho TS, Fideles SOM, Araújo TT, Mo-raes SM, et al. Saliva as a diagnostic tool for dental caries, peri-odontal disease and cancer: is there a need for more biomarkers?. Expert Rev Mol Diagn 2020; 20(3): 543-55. [CrossRef ]
• 13. Jessica, Auerkari EI. Saliva as a diagnostic tool in forensic odontol-ogy. J Dentomaxillofac Sci 2019; 4(3): 124-7. [CrossRef ]
• 14. Pillai G, Krishnan AR, Subodh A, Rajan NS. Saliva: A diagnostic tool. World J Pharm Pharm Sci 2020; 9(5): 426-35.
• 15. Guo L, Shi W. Salivary biomarkers for caries risk assessment. J Calif Dent Assoc 2013; 41(2) :107-18.
• 16. Zhang X, Kulasinghe A, Karim R, Punyadeera C. Saliva diagnostics for oral diseases. In: Streckfus C, editor. Advances in Salivary Diag-nostics. Springer, Berlin, Heidelberg 2015; 131-56. [CrossRef ]
• 17. Silva Fidalgo TK, Freitas-Fernandes LB, Ammari M, Mattos CT, de Souza IPR, Maia LC. The relationship between unspecific s-IgA and dental caries: a systematic review and meta-analysis. J Dent 2014; 42(11): 1372-81. [CrossRef ]
• 18. Öztürk LK, Furuncuoglu H, Atala MH, Uluköylü O, Akyüz S, Yarat A. Association between dental-oral health in young adults and salivary glutathione, lipid peroxidation and sialic acid levels and carbonic anhydrase activity. Braz J Med Biol Res 2008; 41: 956-9. [CrossRef ]
• 19. Maciejczyk M, Pietrzykowska A, Zalewska A, Knaś M, Daniszewska I. The significance of matrix metalloproteinases in oral diseases. Adv Clin Exp Med 2016; 25: 383-90. [CrossRef ]
• 20. Gao X, Jiang S, Koh D, Hsu CYS. Salivary biomarkers for dental car-ies. Periodontol 2000. 2016; 70: 128-41. [CrossRef ]
• 21. Ezhil I, Savitha G, Kumar MPS. Saliva as a diagnostic tool: A review. Drug Invent. Today 2018; 10(11): 2188-93.
• 22. Zwier N, Huysmans MCDNJM, Jager DHJ, Ruben J, Bronkhorst EM, Truin GJ. Saliva parameters and erosive wear in adolescents. Car-ies Res 2013; 47(6): 548-52. [CrossRef ]
• 23. Irani S, Barati I, Badiei M. Periodontitis and oral cancer - current concepts of the etiopathogenesis. Oncol Rev 2020; 14(1): 465: 23-34. [CrossRef ]
• 24. Garcés MÁS, Escoda CG. Periimplantitis. Med Oral Patol Oral Cir Bucal 2004; 9: 63-74.
• 25. Lorenzo-Pouso A, Pérez-Sayáns M, Bravo SB, López-Jornet P, García-Vence M, Alonso-Sampedro M, et al. Protein-based sal-ivary profiles as novel biomarkers for oral diseases. Dis Markers (journal online) 2018 Nov 7 (cited 2020 Mar 2): 6141845: (22 pages). Available from: URL: https://www.hindawi.com/journals/dm/2018/6141845/ [CrossRef ]
• 26. Roi A, Rusu LC, Roi CI, Luca RE, Boia S, Munteanu RI. A new approach for the diagnosis of systemic and oral diseases based on salivary biomolecules. Dis Markers (journal online) 2019 Feb 17 (cited 2020 Mar 2): 8761860: (11 pages). Available from: URL: https://www.hindawi.com/journals/dm/2019/8761860/ [CrossRef ]
• 27. Alassiri S, Parnanen P, Rathnayake N, Johannsen G, Heikkinen AM, Lazzara R et al. The ability of quantitative, specific, and sen-sitive point-of-care/chair-side oral fluid immunotests for aMMP-8 to detect periodontal and peri-implant diseases. Dis Mark-ers (journal online) 2018 Aug 5 (cited 2020 Mar 2): 1306396: (5 pages). Available from: URL: https://www.hindawi.com/journals/dm/2018/1306396/ [CrossRef ]
• 28. Ateş G, Öztürk H. Detection of total antioxidant capacity of saliva in periodontal diseases. EÜ Dişhek Fak Derg 2018; 39(3): 165-74. [CrossRef ]
• 29. Başer Ü, Işık HG, Ateş G, Işık G. The effect of initial periodontal ther-apy on saliva and plasma total antioxidant capacity of non-smok-ing periodontitis patients. EÜ Dişhek Fak Derg 2015; 36(1): 38-44. [CrossRef ]
• 30. Ramos-Casals M, Brito-Zerón P, Sisó-Almiral A, Bosch X. Primary Sjögren Syndrome. BMJ 2012; 344: e3821. [CrossRef ]31. Aktaş A, Giray B, Aktaş G. Saliva; composition and function, impor-tance for diagnosis. ADO Journal of Clin Sci 2009; 3(2): 361-7.
• 32. Khuder SA, Al-Hashimi I, Mutgi AB, Altorok N. Identification of potential genomic biomarkers for Sjögren's Syndrome using data pooling of gene expression microarrays. Rheumatol Int 2015; 35(5): 829-36. [CrossRef ]
• 33. Selifanova E, Beketova T, Spagnuolo G, Leuci S, Turkina A. A novel proposal of salivary lymphocyte detection and phenotyping in patients affected by Sjogren's Syndrome. J Clin Med. 2020; 9(2): 521. [CrossRef ]
• 34. Özbayrak S, Pekiner FN. Ağız Kanserleri: Erken Tanı Bakımından Dişhekimliği. İstanbul: Quintessence; 2016. p.37-55.
• 35. Par M, Tarle Z. Psychoneuroimmunology of oral diseases - a re-view. Stoma Edu J 2019; 6(1): 55-65. [CrossRef ]
• 36. Koray M, Dülger O, Ak G, Horasanli S, Üçok A, Tanyeri H, et al. The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus. Oral Dis 2003; 9(6): 298-301. [CrossRef ]
• 37. Tekin M, Çam OH. Oral Mukoza Hastalıkları ve Semptomatolojisi. Klinik Gelişim 2012; 25: 93-8.
• 38. Brailo V, Vucicevic-Boras V, Lukac J, Biocina-Lukenda D, Zilic-Ala-jbeg I, Milenovic A, et al. Salivary and serum interleukin 1 beta, interleukin 6 and tumor necrosis factor alpha in patients with leu-koplakia and oral cancer. Med Oral Patol Oral Cir Bucal 2012; 17(1): e10-5. [CrossRef ]
• 39. Camisasca DR, Gonçalves LR, Soares MR, Sandim V, Nogueira FCS, Garcia CHS, et al. A proteomic approach to compare saliva from individuals with and without oral leukoplakia. J Proteomics 2017; 151: 43-52. [CrossRef ]
• 40. Ghizoni JS, Nichele R, Oliveira MT, Pamato S, Pereira JR. The utiliza-tion of saliva as an early diagnostic tool for oral cancer: microRNA as a biomarker. Clin Transl Oncol 2020; 22(6): 804-12. [CrossRef ]
• 41. Kaczor-Urbanowicz KE, Carreras-Presas CM, Aro K, Tu M, Garcia-Godoy F, Wong DTW. Saliva diagnostics - Current views and directions. Exp Biol Med (Maywood) 2017; 242(5): 459-72. [CrossRef ]
• 42. Abdul Rehman S, Khurshid Z, Hussain Niazi F, Naseem M, Al Waddani H, Sahibzada HA, et al. Role of salivary biomarkers in detection of cardiovascular diseases (CVD). Proteomes 2017; 5(3): 21. [CrossRef ]
• 43. Isola G, Polizzi A, Muraglie S, Leonardi R, Lo Giudice A. Assessment of vitamin C and antioxidant profiles in saliva and serum in pa-tients with periodontitis and ischemic heart disease. Nutrients 2019; 11(12): 2956. [CrossRef ]
• 44. Mrag M, Kassab A, Omezzine A, Belkacem Chebil R, Ben Fredj Ismail F, Nabiha D, et al. Saliva diagnostic utility in patients with type 2 diabetes: Future standard method. J Med Biochem 2019; 13. [CrossRef ]
• 45. Abd-Elraheem SE, El Saeed AM, Mansour HH. Salivary changes in type 2 diabetic patients. Diabetes Metab Syndr 2017; 11(2): 637-41. [CrossRef ]
• 46. Takeuchi Y, Furuchi M, Kamimoto A, Honda K, Matsumura H, Ko-bayashi R. Saliva-based PCR tests for SARS-CoV-2 detection. J Oral Sci 2020; 62(3): 350-1. [CrossRef ]
• 47. Pasomsub E, Watcharananan SP, Boonyawat K, Janchompoo P, Wongtabtim G, Suksuwan W, et al. Saliva sample as a non-in-vasive specimen for the diagnosis of coronavirus disease-2019 (COVID-19): a cross-sectional study. Clin Microbiol Infect 2020; 15. [CrossRef ]
• 48. Deepa T, Thirrunavukkarasu N. Saliva as a potential diagnostic tool. Indian J Med Sci 2010; 64(7): 293-306. [CrossRef ]
• 49. Emekli Alturfan E, Yarat A, Akyüz S. Selenium in saliva and impact on health. In: Preedy VR, editor. Selenium: Chemistry, Analysis, Function and Effects (Food and Nutritional Components in Focus). London: Royal Society of Chemistry; 2015.p.341-53. [CrossRef ]