Physiological whole saliva is a unique body fluid constantly washing the mucous membranes of the mouth, throat, and larynx. Saliva is a clear, slightly acidic mucinous-serous secretion, composed of various electrolytes, small organic substances, proteins, peptides, and polynucleotides. There are many ways to use saliva as a biological fluid (biofluid). The significant advantages of saliva as a unique diagnostic material are its availability and the noninvasive method of collection. The aim of this review is to emphasize the diagnostic value of saliva as a research material in the configuration of its structure and secretion disorders. The data were obtained using the MEDLINE (PubMed) search engine, as well as an additional manual search. The analysis covered 77 articles selected from a group of 1986 publications and initially qualified for devising. The results were evaluated and checked for the correctness of qualifying in accordance with inclusion and exclusion criteria. The diagnostic use of saliva has attracted the attention of many researchers due to its noninvasive nature and relative simplicity of collection. In addition, it should be noted that the determination of chemical and physical saliva parameters can be effectively performed in the patient's presence in the dental office.

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A Review of Selected Studies That Determine the Physical and Chemical Properties of Saliva in the Field of Dental Treatment.

The Global Burden of Oral Diseases affects 3.5 billion people worldwide, representing the number of people affected by the burden of untreated dental caries, severe periodontal disease, and edentulism. Thus, much more efforts in terms of diagnostics and treatments must be provided in the fight of these outcomes. In this sense, recently, the study of saliva as biological matrix has been identified as a new landmark initiative in the search of novel and useful biomarkers to prevent and diagnose these conditions. Specifically, saliva is a rich reservoir of different proteins and peptides and accessible due to recent advances in molecular biology and specially in targeted and unbiased proteomics technologies. Nonetheless, emerging barriers are an obstacle to the study of the salivary proteome in an effective way. This review aims at giving an overall perspective of salivary biomarkers identified in several oral diseases by means of molecular biology approaches.

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Protein-Based Salivary Profiles as Novel Biomarkers for Oral Diseases.

Saliva is a highly versatile biological fluid that is easy to gather in a non-invasive manner-and the results of its analysis complement clinical and histopathological findings in the diagnosis of multiple diseases. The objective of this review was to offer an update on the contribution of salivary biomarkers to the diagnosis and prognosis of diseases of the oral cavity, including oral lichen planus, periodontitis, Sjogren's syndrome, oral leukoplakia, peri-implantitis, and medication-related osteonecrosis of the jaw. Salivary biomarkers such as interleukins, growth factors, enzymes, and other biomolecules have proven useful in the diagnosis and follow-up of these diseases, facilitating the early evaluation of malignization risk and the monitoring of disease progression and response to treatment. However, further studies are required to identify new biomarkers and verify their reported role in the diagnosis and/or prognosis of oral diseases.

https://www.mdpi.com/1422-0067/21/14/5173/pdf

Salivary Biomarkers and Their Application in the Diagnosis and Monitoring of the Most Common Oral Pathologies.

The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.

/pdf/cytokines-cortisol-and-nitric-oxide-as-salivary-biomarkers-2pl77a17c5.pdf

Cytokines, cortisol, and nitric oxide as salivary biomarkers in oral lichen planus: a systematic review.

Objectives: Oral lichen planus (OLP) is a common disease whose aetiopathogenesis is linked to psychological disorders. This study aims to determine the influence of anxiety and depression in OLP patients, define the perception of quality of life in these patients and check for potential differences between atrophic/ ulcerative and reticular lesions. Materials and Methods: A group of 48 OLP patients and a control group of 40 patients were selected. In order to assess anxiety, depression and quality of life, Hospital Anxiety and Depression Scale (HADS) and Oral Health Impact Profile 14 (OHIP-14) tests were completed. Results: OLP patients showed higher scores on HADS (anxiety p < 0.01, depression p < 0.05) and OHIP-14 (physical pain p < 0.05, psychological discomfort p = 0.001). Patients with reticular lesions obtained higher scores in HADS (anxiety p = 0.001, depression p < 0.001), whereas patients with atrophic/ ulcerative lesions obtained higher scores in OHIP-14 (p = 0.02). Conclusions: Psychological disorders play an important role as a trigger for OLP and are responsible for many relapses. Psychological support would be advisable in order to improve their mental health, as this would have a positive impact on their quality of life and would lead to a better progression of the disease.

Psychological disorders and quality of life in oral lichen planus patients and a control group

Background

Oral lichen planus (OLP) is a chronic mucocutaneous disease, inflammatory and autoimmune in character, in which the pathogenesis is not fully understood Psychological stress has also been implicated in triggering or exacerbating the disease



Objective

The aim of this study was to evaluate the psychological profile, sleep, and salivary biological markers—cortisol, immunoglobin A (IgA), and adiponectin – in patients with oral lichen planus (OLP)



Methods

The sample consisted of 65 patients (33 with OLP and 32 control patients) Patients completed hospital anxiety and depression scales (HADD, HADA) Questionnaires were used to assess sleepiness: the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS) A visual analog scale (VAS) was used for rating pain Unstimulated whole saliva was evaluated, together with total proteins: cortisol, IgA, and adiponectin



Results

Patients with OLP obtained significantly higher HADA and PSQI scores than control subjects (P = 0001, P = 0012, respectively) Total salivary protein (flow at rest) analysis found that total proteins were higher in the OLP group (P = 0001) In the OLP group, IgA was 803 ± 513 vs the control group 489 ± 328 (P = 0005) Mean cortisol was 05 ± 03 μg/dl in the OLP group vs 04 ± 02 μg/dl in the control group (P = 0010) The OLP group showed a correlation between the HADA variable and pain (r = 0358; P = 0041), HADD (r = 0568; P = 0001), and PSQI (r = 0537; P = 0001)



Conclusions

OLP patients presented worse psychological profiles and sleep disturbances, as well as higher values for IgA, cortisol, and total proteins than control subjects

Cristina Aznar Cayuela

Papers

Oral lichen planus: salival biomarkers cortisol, immunoglobulin A, adiponectin.