Saliva Diagnostics in Asthma

摘要

There are similarities in the inflammatory immune response in the upper (sinus, nasal) and lower (bronchial) airways of individuals with atopic asthma. We hypothesize that due to the direct anatomic relation with the mouth, cytokine and pathogen composition of the airway will be reflected in saliva. Salivary analysis of cytokines and pathogens could offer noninvasive rapid diagnostic information on contributors to asthma control deterioration. Methods: Patients all underwent a detailed history and physical exam focused on asthma control (patients with asthma) and dental health before collection of 10 ml whole saliva with a neutral masticatory stimulus. From a set of 165 patients with asthma in varying states of control and 40 healthy individuals, preliminary analysis was performed on whole saliva from 20 in each group. Salivary cytokines were measured by ELISA and microsphere-based antibody array. The presence of common respiratory viral pathogens was detected by PCR amplification of salivary pellet DNA. Results: Compared with levels in healthy control subjects, VEGF, RANTES/CCL5, IL-6, and TIMP-1, but not eotaxin-3/CCL26, were elevated in saliva of patients with asthma. As a group, 13/ 20 patients with asthma had one or two respiratory viruses detected by PCR; six of these had typical viral URTI symptoms. Notably, the prevalence of viral detection was not different between patients with stable asthma and those with poorly controlled asthma. Conclusion: Inflammatory proteins and viral pathogens known to be expressed in the asthmatic airway can be detected in whole saliva. Specific salivary (and/or nasal lavage) cytokine and pathogen profiles from a multi-analyte array may provide biomarkers of deteriorated asthma control.