Saliva as a potential tool for cystic fibrosis diagnosis

Diagnostic Pathology

Carlos Emílio Levy³  Ilma Aparecida Paschoal²  Antonio Fernando Ribeiro³  José Dirceu Ribeiro³  Regina Maria de Holanda Mendonça⁵  Fernando Augusto de Lima Marson¹  Aline Cristina Gonçalves⁴ 

[1] Department of Genetics, Faculty of Medical Sciences, University of Campinas, P.O. Box: 6111, Campinas, SP, 13081-970, Brazil;Department of Medical Clinics, Faculty of Medical Sciences, University of Campinas, P.O. Box: 6111, Campinas, SP, 13081-970, Brazil;Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, P.O. Box: 6111, Campinas, SP 13081-970, Brazil;Department of Clinical Pathology, Alexander Fleming Street 105, FCM12, Second floor, Barão Geraldo, Campinas, SP, 13083-881, Brazil;Boldrini Children's Center, Campinas, Brazil

关键词: CFTR;    Lung disease;    Cystic fibrosis;    Ion concentration;    Saliva;   

Others  :  807357
DOI  :  10.1186/1746-1596-8-46

 received in 2012-12-19, accepted in 2013-03-10,  发布年份 2013

【 摘 要 】

Background

Saliva and sweat are modified by cystic fibrosis (CF). In both cases the chloride and sodium ion concentrations for healthy subjects and CF patients differ, this representing a possible alternative tool for CF diagnosis. In this context, the aim of this study was to compare the concentrations of these ions in saliva samples taken from CF patients and healthy subjects.

Methods

A case–control study was carried out at a university CF center, in which the saliva samples were analyzed on an ABL 835 Radiometer^® to determine the ion concentration.

Results

For the CF patients (n = 80) the values for the biochemical parameters of chloride, potassium and sodium ion concentration were higher (p < 0.009) and the volume and pH of the saliva were lower than in the case of healthy subjects (p < 0.009). For the healthy subjects group (n = 84) versus CF patients, according to the ROC curve, the values for sodium were: cutoff: 13.5 mmol/L, sensitivity: 73.4%, specificity: 70.6%; and for chloride: cutoff: 20 mmol/L, sensitivity: 68.1%, specificity: 72.9%.

Conclusions

The chloride and sodium concentrations in the saliva samples were higher for CF patients in comparison with healthy subjects. Thus, saliva as a tool for CF diagnosis can be considered a new challenge, and a population study including patients in all age classes needs to be performed, in different countries over the world, to extend the database to include a broad spectrum of information in order to identify normal ion concentration ranges for CF patients according to age, genotype and environment.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2614233148750145 webcite

【 授权许可】

   
2013 Gonçalves et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Strausbaugh SD, Davis PB: Cystic fibrosis: a review of epidemiology and pathobiology. Clin Chest Med 2007, 28(2):279-288.
• [2]Di Sant'SAgnese PA, Darling RC, Perara GA, Shea E: Abnormal electrolyte composition of sweat in cystic fibrosis of the pancreas. Am J Dis Child 1953, 86(5):618-619.
• [3]Gibson LE, Cooke RE: A test for concentration of electrolytes in sweat in cystic fibrosis of the pancreas utilizing pilocarpine by iontophoresis. Pediatrics 1959, 23(3):545-549.
• [4]Mishra A, Greaves R, Massie J: The limitations of sweat electrolyte reference intervals for the diagnosis of cystic fibrosis: a systematic review. Clin Biochem Rev 2007, 28(2):60-76.
• [5]Ledford H: Drugs best’s cystic fibrosis mutation. Nature 2012, 482(7384):145.
• [6]Catalán MA, Nakamoto T, Gonzalez-Begne M, Camden JM, Wall SM, Clarke LL, Melvin JE: CFTR and ENaC ion channels mediate NaCl absorption in the mouse submandibular gland. J Physiol 2010, 588(Pt 4):713-724.
• [7]Greabu M, Battino M, Mohora M, Totan A, Didilescu A, Spinu T, Totan C, Miricescu D, Radulescu R: Saliva-a diagnostic window to the body, both in health and in disease. J Med Life 2009, 2(2):124-132.
• [8]Pfaffe T, Cooper-White J, Beyerlein P, Kostner K, Punyadeera C: Diagnostic potential of saliva: current state and future applications. Clin Chem 2011, 57(5):675-687.
• [9]Chiappin S, Antonelli G, Gatti R, De Palo EF: Saliva specimen: A new laboratory tool for diagnostic and basic investigation. Clin Chim Acta 2007, 383(1–2):30-40.
• [10]Faul F, Erdfelde E, Lang AG, Buchner A: G*Power 3: A flexible sta-tistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007, 39:175-191.
• [11] : SPSS 17.0 for Windows (computer program). Statistical Package for Social Science (SPSS). Release Version 17.0.1. Chicago (IL): SPSS. Incorporation; 2011. Available from:http://www.spss.com webcite
• [12]Drăghici S: Data analysis tools for DNA microarrays. New York: Chapman & Hall/CRC; 2003.
• [13]Chernick WS, Barbero GJ, Parkins FM: Studies on submaxillary saliva in cystic fibrosis. J Pediatr 1961, 59(6):890-898.
• [14]Marmar J, Barbero GJ, Sibinga MS: The pattern of parotid gland secretion in cystic fibrosis of the pancreas. Gastroenterology 1966, 50(4):551-556.
• [15]Lawson D, Saggers BA, Chapman MJ: Screening for Cystic Fibrosis by measurement of Unstimulated Parotid Saliva Sodium Levels. Arch Dis Childh 1967, 42(226):689-690.
• [16]Wiesmann UN, Boat TF, di Sant'Agnese PA: Sodium concentration in unstimulated parotid saliva and on oral mucosa in normal subjects and in patients with cystic fibrosis. J Pediatr 1970, 76(3):444-448.
• [17]Fritz ME, Caplan DB, Leever D, Levitt J: Composition of parotid saliva on different days in patients with cystic fibrosis. Am J Dis Child 1972, 123(2):116-117.
• [18]Blomfield J, Warton KL, Brown JM: Flow rate and inorganic components of submandibular saliva in cystic fibrosis. Arch Dis Child 1973, 48(4):267-274.
• [19]Kollberg H, Danielsson A, Glitterstam K, Henriksson R, Marklund S: Studies on parotid saliva in cystic fibrosis. Acta Paediatr Scand 1982, 71(2):321-322.
• [20]Jimenez-Reyes M, Sanchez-Aguirre JF: Sodium and chloride concentrations in mixed saliva. Appl Radiat Isot 1996, 47(3):273-277.
• [21]Pfaffe T, Cooper-White J, Beyerlein P, Kostner K, Punyadeera C: Diagnostic Potential of Saliva: Current State and Future Applications. Clinical Chemistry 2011, 57(5):675-687.
• [22]Blomfield J, Rush AR, Allars HM, Brown JM: Parotid gland function in children with cystic fibrosis and child control subjects. Pediatr Res 1976, 10(6):574-578.
• [23]Ceder O, Van Dijken J, Ericson T, Kollberg H: Ribonuclease in different types of saliva from cystic fibrosis patients. Acta Paediatr Scand 1985, 74(1):102-106.
• [24]Pedersen AM, Bardow A, Jensen SB, Nauntofte B: Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis 2002, 8(3):117-129.
• [25]Mandel ID: The diagnostic uses of saliva. J Oral Pathol Med 1990, 19(3):119-125.