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LETTER TO EDITOR
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 44-45

Renewed focus in salivary diagnostics


1 Department of Periodontology, HP Government Dental College and Hospital, Shimla, Himachal Pradesh, India
2 Department of Orthodontics and Dentofacial Orthopaedics, HP Government Dental College and Hospital, Shimla, Himachal Pradesh, India

Date of Submission21-Jul-2020
Date of Decision21-Aug-2020
Date of Acceptance09-Sep-2020
Date of Web Publication5-Oct-2020

Correspondence Address:
Deepak Sharma
Department of Periodontology, HP Government Dental College and Hospital, Shimla - 171 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomr.jomr_14_20

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How to cite this article:
Sharma D, Negi N. Renewed focus in salivary diagnostics. J Oral Maxillofac Radiol 2020;8:44-5

How to cite this URL:
Sharma D, Negi N. Renewed focus in salivary diagnostics. J Oral Maxillofac Radiol [serial online] 2020 [cited 2020 Nov 25];8:44-5. Available from: https://www.joomr.org/text.asp?2020/8/2/44/297218



Sir,

Saliva, a dynamic biofluid, contains various enzymes, electrolytes, proteins, nucleic acids, antimicrobial constituents, hormones, cytokines, and antibodies. Its composition virtually reflects the entire state of health and disease in a body, and it has the potential of being a diagnostic medium for a broad range of diseases, such as in the detection of oral, systemic inflammatory, neoplastic, immunologic diseases, and others, and is rightly called the “mirror of body health.”[1]

Personalized medicine, with the help of biosensors, lab-on-chip systems, individual genetics, smartphone monitoring parameters, and microfluidic devices, has improved the primary health-care system. It gives consistent, accurate, quick, efficient results and streamlines the workflow. Salivary diagnostics has an enormous impact on health-care delivery, being noninvasive, operationally and economically suitable, and well credentialed, while bioinformatics further enhances its diagnostic performance. Because the emphasis is switching more toward prevention and early detection of a variety of diseases, salivary point-of-care (PoC) diagnostics is replacing the central laboratory and offers efficient, fast, quick, and easy automation.[2]

The severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) pandemic has affected millions of individuals in >200 countries and regions and has caused >500,000 deaths worldwide till July 2020 and is called public health emergency of international concern by the World Health Organization.[3]

Rapid and accurate detection of COVID-19 is crucial in controlling the outbreak within the community and in hospitals. The current gold standard for COVID-19 diagnosis is real-time reverse transcription-polymerase chain reaction detection of SARS-CoV-2 from nasopharyngeal and oropharyngeal swabs and sometimes from lower respiratory tract samples. Low sensitivity, discomfort to patients, exposure risks to health-care workers, and global shortages of swabs and personal protective equipment, however, necessitate the validation of new diagnostic approaches. As the functional receptor for SARS-CoV-2 is the angiotensin-converting enzyme-2 receptor, significantly lower expression of it has been found in the pharyngeal cells as opposed to salivary glands.[4]

In recent studies, it was found that saliva yielded greater detection sensitivity and consistency than nasopharyngeal samples in the detection of respiratory viruses, including coronaviruses.[5],[6] This makes saliva a relatively better diagnostic specimen for COVID-19 as opposed to pharyngeal specimens. In addition, this noninvasive biofluid can be easily collected from symptomatic and asymptomatic patients without the wastage of gloves and personal protection equipment, does not require trained medical staff, multiple samples can be obtained, it is safer and comfortable for patients, minimizes the risk of cross-contamination and nosocomial transmission, storage and transport is economical, and has easier diagnostic manipulation, so it can be efficiently used in situ ations where pharyngeal sampling is difficult, not possible, or contraindicated.[7] Salivary diagnostics may play a pivotal role in the detection of COVID-19 and can offer mass screening of the population. However, more randomized clinical trials are required to validate the results of preliminary studies on the use of saliva as a specimen for diagnosis of COVID-19 and development of a PoC test.

In challenging time like this, the enforcement of developing PoC diagnostics is of utmost importance due to the limited infrastructure and health-care workers. It would be instrumental in early diagnosis, immediate management, and prompt containment of the diseases like the COVID-19 pandemic.[8],[9] The next decade will bring breakthroughs in terms of precision, efficiency, and bedside monitoring through personalized medicine.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wei F, Wong DT. Point-of-care platforms for salivary diagnostics. Chin J Dent Res 2012;15:7-15.  Back to cited text no. 1
    
2.
Khan RS, Khurshid Z, Yahya Ibrahim Asiri F. Advancing Point-of-Care (PoC) Testing Using Human Saliva as Liquid Biopsy. Diagnostics (Basel). 2017;:39.  Back to cited text no. 2
    
3.
Available from: http://www.who.int'Publications'm'item. [Last accessed on 2020 Jul 16].  Back to cited text no. 3
    
4.
Fakheran O, Dehghannejad M, Khademi A. Saliva as a diagnostic specimen for detection of SARS-CoV-2 in suspected patients: a scoping review. Infect Dis Poverty. 2020;9:100.  Back to cited text no. 4
    
5.
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet 2020;395:514-23.  Back to cited text no. 5
    
6.
To KK, Yip CC, Lai CY, Wong CK, Ho DT, Pang PK, et al. Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: A diagnostic validity study. Clin Microbiol Infect 2019;25:372-8.  Back to cited text no. 6
    
7.
Sri Santosh T, Parmar R, Anand H, Srikanth K, Saritha M. A review of salivary diagnostics and its potential implication in detection of COVID-19. Cureus 2020;12:e7708.  Back to cited text no. 7
    
8.
Khurshid Z. Salivary point-of-care technology. Eur J Dent 2018;12:1-2.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
Loeffelholz MJ, Tang YW. Laboratory diagnosis of emerging human coronavirus infections-the state of the art. Emerg Microbes Infect 2020;9:747-56.  Back to cited text no. 9
    




 

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