Researchers at UCLA have published the foundation science to use saliva as the specimen for sophisticated diagnostic testing
Someday soon, when your dentist asks you to say “Ah”, he will then collect a saliva specimen and use a chairside point-of-care test (POCT) to screen you for any number of conditions and diseases. This is the goal of a research team at the University of California, Los Angeles (UCLA), who recently developed what they call the Salivaomics Knowledge Base (SKB). It is a web-based data management system dedicated to help clinicians use saliva as a diagnostic tool.
“It was seven years ago when a visionary investment was made with the goal of demonstrating that saliva could be a non-invasive specimen for use in diagnosis,” stated David Wong, D.M.D., D.M.Sc . He is Associate Dean of Research at UCLA’s School of Dentistry and is a member of the saliva research team funded by grants from the National Institute of Health (NIH). It was the NIH’s National Institute of Dental and Craniofacial Research which provided the funding for research and development of the Salivaomics Knowledge Base.
“The goal is to turn this bio-fluid into a resource that can be used in doctors’ and dentists’ offices for a large number of clinical applications and early detection of diseases,” noted Wong. “The NIH initiative is to substantiate this fluid in two sequential steps. In step one, our research was channeled to deciphering and mapping the entire saliva proteome of human saliva. That has been accomplished.
“In the second phase, the NIH is funding research to develop point-of-care testing applications that utilize saliva as the specimen,” he explained. “The idea is to use a drop of saliva to charge POC testing systems to support chairside or bedside testing by dentists and physicians, respectively. Our research indicates that saliva has biomarkers that hold great potential to be clinically useful in the early detection of several diseases.”
“The Salivaomics Knowledge Base contains the scientific content and the diagnostic toolboxes that will enable the use of saliva in clinical formats,” added Wong. “The SKB showcases the scientific development and clinical relevance of saliva as a source for useful biomarkers. This is the basis for salivary diagnostics.
“Relative to many other sources of specimens for clinical diagnostics, saliva is a latecomer,” noted Wong. “But that is quickly changing. In the past five years, we have four diagnostic alphabets that use this bio-fluid to determine disease diagnostic information. These saliva-based biomarkers are being incorporated into emerging POC technologies and are almost ready for commercialization.”
Wong acknowledges that there is ample skepticism about saliva’s value as a reliable specimen for diagnostic testing. “Our approach is to use science to overcome such skepticism,” he said. “The lack of a scientific foundation has prevented saliva from escalating to a more viable diagnostic option. We now know that there are 1,166 identifiable proteins in saliva. That’s a landmark achievement and is one important reason why saliva will be accepted as a valuable diagnostic bio-fluid.”
Wong is confident that saliva has the potential to be disruptive in clinical diagnostics. “No crystal ball is needed on this subject,” declared Wong. “There is a new diagnostic industry on the horizon. This diagnostic industry will not replace blood chemistry. Rather, it will meet other needs and it will play a role in personalized medicine that is tailored to the needs of the individual consumer.”
Wong and his research team are optimistic about how their research will find applications in clinical diagnostics. They know that most patients want to avoid the needle sticks necessary to collect a blood sample. Thus, if POC tests can utilize saliva as the specimen, these will be more patient-friendly and are likely to gain rapid acceptance by both patients and clinicians.
Another potentially disruptive element to the use of saliva as a specimen for accurate diagnostic testing is that such POC tests can bring dentists into new clinical pathways. Since many Americans visit their dentists once or twice a year, this positions dentists as a viable venue for providing screening tests for large numbers of Americans. If the cost of saliva-based diagnostic assays are cheap enough, this may allow mass screening for a variety of diseases and conditions to be conducted during an individual’s annual or semi-annual dental exam.