There are similarities in the inflammatory immune response in the upper (sinus, nasal) and lower (bronchial) airways of atopic asthmatics. We hypothesize that due to the direct anatomic relation with the mouth, cytokine concentrations 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
Whole saliva was collected from 20 healthy volunteers and 20 asthmatics in varying states of control. Patients all underwent a detailed history and physical exam focused on asthma control (asthmatics) and dental health. Salivary cytokines were measured by ELISA and microsphere-based multiplex array. The presence of common respiratory viral pathogens was detected by PCR amplification of salivary pellet DNA.
Results
Compared to healthy controls, VEGF, RANTES/CCL5, IL-6, and TIMP-1, but not eotaxin-3/CCL26, were elevated in asthmatic saliva. As a group, 13/20 asthmatics had one or two respiratory viruses detected by PCR; of which six had typical viral URTI symptoms. The prevalence of viral detection was not different between stable and uncontrolled asthmatics.
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 distinguish varied causes of deteriorated asthma control.
1Pulmonary Center, Boston University Medical Center, Boston, MA
2Boston University Graduate School of Dental Medicine, Boston, MA
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