Abstract
There is continuous and growing interest in research into new alternatives to standard biomarkers to detect and follow-up disease, reducing physical and psychological stress in patients needing regular and invasive medical examinations for the evaluation of pathologies, including inflammatory bowel diseases (IBD). Saliva is one of the most promising body fluids in the research of new biomarkers, thanks to the large number of molecules it contains. Many molecules present in saliva are often directly correlated to their concentration in the blood but may be affected by the condition of the oral cavity. This means that a careful selection of a specific biomarker is required for each pathology, especially pathologies such as IBD, which may induce inflammation in the oral cavity. Here, we analyze the currently used and the proposed new salivary biomarkers (i.e., calprotectin, cytokines, IgA, cortisol, and oxidative stress markers) for the detection and follow-up of the main subtypes of IBD, known as ulcerative colitis and Crohn’s disease.
Highlights
Saliva is a very complex fluid containing a wide range of molecular components and molecules, including enzymes, hormones, antibodies, and growth factors, and it has recently been considered a potential alternative to blood- and tissue-based diagnostics for many diseases
Of the salivary components analyzed, IL-6 has the most interleukins studied, and the results are in accordance with an increase in its amount in the saliva both [21,36,37,38,47] in patients with Crohn’s disease (CD) and Ulcerative colitis (UC), whereas contradictory results have been observed for salivary tumor necrosis factor (TNF)-α [21,36], circulating IL-6, and TNF-α, which are commonly used as indicators of disease activity in inflammatory bowel diseases (IBD) and the state of endoscopic disease activity in IBD [88,89]
The presence of inflammatory cytokines in saliva has been strongly correlated to IBD [21,36,37], but their concentrations may be influenced by the state of the oral cavity, as oral inflammation and periodontitis are very common in patients with IBD [23,91]
Summary
Saliva is a very complex fluid containing a wide range of molecular components and molecules, including enzymes, hormones, antibodies, and growth factors, and it has recently been considered a potential alternative to blood- and tissue-based diagnostics for many diseases. Despite the exponential increase in the knowledge of the pathogenesis of IBD, an invasive diagnosis remains necessary to confirm the state of pathology and its management, and as such, new noninvasive diagnostic tools are necessary to reduce the psychological and physical stress for patients with IBD. Not all these studies have evaluated the impact of the presence of periodontal disease or other oral inflammations that could affect the salivary content, leading to confounding results due to altering the levels of the biomarkers in saliva [23]. We aim to discuss the principal and newly proposed inflammatory and stress biomarkers in saliva related to the pathophysiological mechanisms and symptomatology in inflammatory bowel diseases
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