Detection and potential utility of C-reactive protein in saliva of neonates.

Anjali Iyengar,Jessica K Paulus,Jill L Maron,Daniel J Gerlanc

doi:10.3389/fped.2014.00131

Abstract

Objective: We aimed to detect C-reactive protein (CRP) in neonatal saliva and evaluate its diagnostic utility.Study Design: Salivary and serum samples (n = 89) were collected from 40 neonates. Salivary CRP levels were determined using an enzyme-linked immunosorbent assay; serum CRP was measured per hospital protocol. Correlation coefficients with 95% confidence intervals and robust linear regression measured association while receiver–operator characteristic curves described the accuracy of salivary CRP in discriminating abnormal serum CRP thresholds of ≥10 and 5 mg/L. Corresponding sensitivities and specificities were calculated for these salivary cutpoints.Results: The area under the curve for salivary CRP in predicting serum CRP levels of ≥10 and 5 mg/L were 0.81 and 0.76, respectively. The corresponding sensitivity and specificity for raw salivary CRP to discriminate a serum CRP of ≥5 mg/L was 0.54 and 0.95, respectively. The corresponding sensitivity and specificity for raw salivary CRP to discriminate a serum CRP of ≥10 mg/L was 0.64 and 0.94, respectively. A statistically significant correlation was observed between serum and salivary CRP (r = 0.62, p < 0.001).Conclusion: C-reactive protein is detectable in neonatal saliva and can predict abnormal serum CRP thresholds. Salivary CRP analysis represents a feasible screening tool for detecting abnormal serum CRP levels.

Highlights

C-reactive protein (CRP) is an extensively utilized biomarker for monitoring sepsis, post-surgical complications, and inflammation in the pediatric and neonatal populations [1]
C-reactive protein is detectable in neonatal saliva and can predict abnormal serum CRP thresholds
Salivary C-reactive protein levels in neonates no exclusion criteria based on gender, genetic disorder, disease was conducted on the dataset by randomly selecting one paired process, or clinical status

Summary

Introduction

C-reactive protein (CRP) is an extensively utilized biomarker for monitoring sepsis, post-surgical complications, and inflammation in the pediatric and neonatal populations [1]. Produced in the liver in response to IL-6, CRP levels rise rapidly during infection and/or inflammation [1, 2]. A current limitation to the usefulness of serial CRP monitoring in the neonatal population is its reliance on frequent blood draws in a vulnerable population with limited blood volumes. Developing a non-invasive assay for the quantification of CRP in neonates could reduce neonatal side-effects and improve its clinical utility. Saliva is an excellent biofluid to non-invasively monitor the neonate. Filtered from whole blood in the salivary glands, saliva is an important reservoir of systemic proteins and immunoglobulins, electrolytes, nucleic acids, microorganisms, toxins, and drugs

Methods

Results

Conclusion