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Can Saliva Proteins Be Used to Predict the Onset of Acute Myocardial Infarction among High-Risk Patients?

Rahim MA, Rahim ZH, Ahmad WA, Hashim OH - Int J Med Sci (2015)

Bottom Line: In this review, we discuss the utility of human salivary proteomes and tabulate the recent salivary biomarkers found in subjects with acute myocardial infarction as well as respective methods employed.In a clinical setting, since acute myocardial infarction contributes to large cases of mortality worldwide, an early intervention using these biomarkers will provide an effective solution to reduce global heart attack incidence particularly among its high-risk group of type-2 diabetes mellitus patients.Current challenges in saliva collection are also addressed to improve the quality of saliva samples and produce robust biomarkers for future use in clinical applications.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia ; 5. Faculty of Dentistry, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.

ABSTRACT
Human saliva plays a pivotal role in digesting food and maintaining oral hygiene. The presence of electrolytes, mucus, glycoproteins, enzymes, antibacterial compounds, and gingival crevicular fluid in saliva ensures the optimum condition of oral cavity and general health condition. Saliva collection has been proven non-invasive, convenient, and inexpensive compared to conventional venipuncture procedure. These distinctive advantages provide a promising potential of saliva as a diagnostic fluid. Through comprehensive analysis, an array of salivary proteins and peptides may be beneficial as biomarkers in oral and systemic diseases. In this review, we discuss the utility of human salivary proteomes and tabulate the recent salivary biomarkers found in subjects with acute myocardial infarction as well as respective methods employed. In a clinical setting, since acute myocardial infarction contributes to large cases of mortality worldwide, an early intervention using these biomarkers will provide an effective solution to reduce global heart attack incidence particularly among its high-risk group of type-2 diabetes mellitus patients. The utility of salivary biomarkers will make the prediction of this cardiac event possible due to its reliability hence improve the quality of life of the patients. Current challenges in saliva collection are also addressed to improve the quality of saliva samples and produce robust biomarkers for future use in clinical applications.

No MeSH data available.


Related in: MedlinePlus

Comparison of plasma and salivary biomarkers in relation to AMI. NP: natriuretic peptide; h-FABP: heart-type fatty-acid binding protein; MR-proADM: midregional-proadrenomedullin; CgA: chromogranin A; sLOX-1: soluble lectin-like oxidized low-density lipoprotein receptor-1; Lp-PLA2: lipoprotein-associated phospholipase A2; GGT: gamma-glutamyl transferase; ANP: atrial natriuretic peptide; TNF-α: tumour necrosis factor- alpha; cTn: cardiac troponin; MMP: matrix metalloproteinase; MPO: myeloperoxidase; SAA: salivary alpha-amylase; GRO-α: growth related oncogene-alpha; sICAM-1: soluble intercellular adhesion molecule-1
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Figure 2: Comparison of plasma and salivary biomarkers in relation to AMI. NP: natriuretic peptide; h-FABP: heart-type fatty-acid binding protein; MR-proADM: midregional-proadrenomedullin; CgA: chromogranin A; sLOX-1: soluble lectin-like oxidized low-density lipoprotein receptor-1; Lp-PLA2: lipoprotein-associated phospholipase A2; GGT: gamma-glutamyl transferase; ANP: atrial natriuretic peptide; TNF-α: tumour necrosis factor- alpha; cTn: cardiac troponin; MMP: matrix metalloproteinase; MPO: myeloperoxidase; SAA: salivary alpha-amylase; GRO-α: growth related oncogene-alpha; sICAM-1: soluble intercellular adhesion molecule-1

Mentions: The prospect of utilizing saliva samples in the diagnosis of AMI is appealing to a large group of scientists due to its noninvasive and economical nature. Extensive biomarker research on CVD has elucidated various proteins associated with this disease. Since approximately 27% of the whole saliva proteins resemble those found in plasma 26, similar proteins present in both saliva and plasma will be very useful to facilitate monitoring of both disease progression and therapeutic treatments among these patients. In association with AMI, some studies on plasma proteins revealed significant biomarkers involved in myocardial injury, myocardial stress, inflammation, neuroendocrine activation, atherosclerotic process, platelet activation, plaque instability, endothelial dysfunction, oxidative stress, and myocardial stretch. Out of all these proteins, natriuretic peptides, C-reactive protein (CRP), creatine kinase (CK), and cardiac troponin were included as commonly used cardiac biomarkers in acute cardiac care 27. In a clinical setting, a kit for measuring human salivary CRP, a common biomarker related to cardiovascular inflammation, has been developed by Salimetrics®. Another recent cutting-edge technology is Oral Fluid NanoSensor Test (OFNASET) which provides portable, cheap, accurate, definitive, and quantitative results. Besides its intended use in oral cancer, this particular alternative can possibly benefit the point-of-care multiplex detection of salivary biomarkers among AMI patients 28. Given the above-mentioned clinical benefits of saliva collection, a patient's salivary proteome should be very useful in determining heart condition of the patient in order to predict AMI. Several studies have demonstrated salivary biomarkers associated with AMI, as shown in Table 1. By comparing these salivary biomarkers with those in plasma, as elaborated by Kossaify et al. 27, CRP, CK, CD40 ligand, cardiac troponin I, cardiac troponin T, some families of interleukin (IL), tumour necrosis factor alpha, matrix metalloproteinase (MMP), and myeloperoxidase share similarities with plasma biomarkers which also play significant roles in inflammation and plaque instability (Figure 2). Although these discoveries may enlighten the diagnostic utility of salivary proteomes as biomarkers in relation to CVD, none of the salivary biomarkers listed above have been verified to predict the onset of AMI. All of these studies, as tabulated in table 1, were conducted retrospectively after the incidence. On the other hand, prospective studies should be able to alternatively facilitate the researchers to find predictive AMI biomarkers. In future, these newly detected salivary biomarkers will conceivably provide an early molecular diagnosis and eventually increase the survival rate of cardiovascular patients as opposed to that of plasma. However, more validation needs to be carried out in order to find robust and discriminatory biomarkers for this disease.


Can Saliva Proteins Be Used to Predict the Onset of Acute Myocardial Infarction among High-Risk Patients?

Rahim MA, Rahim ZH, Ahmad WA, Hashim OH - Int J Med Sci (2015)

Comparison of plasma and salivary biomarkers in relation to AMI. NP: natriuretic peptide; h-FABP: heart-type fatty-acid binding protein; MR-proADM: midregional-proadrenomedullin; CgA: chromogranin A; sLOX-1: soluble lectin-like oxidized low-density lipoprotein receptor-1; Lp-PLA2: lipoprotein-associated phospholipase A2; GGT: gamma-glutamyl transferase; ANP: atrial natriuretic peptide; TNF-α: tumour necrosis factor- alpha; cTn: cardiac troponin; MMP: matrix metalloproteinase; MPO: myeloperoxidase; SAA: salivary alpha-amylase; GRO-α: growth related oncogene-alpha; sICAM-1: soluble intercellular adhesion molecule-1
© Copyright Policy
Related In: Results  -  Collection

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Figure 2: Comparison of plasma and salivary biomarkers in relation to AMI. NP: natriuretic peptide; h-FABP: heart-type fatty-acid binding protein; MR-proADM: midregional-proadrenomedullin; CgA: chromogranin A; sLOX-1: soluble lectin-like oxidized low-density lipoprotein receptor-1; Lp-PLA2: lipoprotein-associated phospholipase A2; GGT: gamma-glutamyl transferase; ANP: atrial natriuretic peptide; TNF-α: tumour necrosis factor- alpha; cTn: cardiac troponin; MMP: matrix metalloproteinase; MPO: myeloperoxidase; SAA: salivary alpha-amylase; GRO-α: growth related oncogene-alpha; sICAM-1: soluble intercellular adhesion molecule-1
Mentions: The prospect of utilizing saliva samples in the diagnosis of AMI is appealing to a large group of scientists due to its noninvasive and economical nature. Extensive biomarker research on CVD has elucidated various proteins associated with this disease. Since approximately 27% of the whole saliva proteins resemble those found in plasma 26, similar proteins present in both saliva and plasma will be very useful to facilitate monitoring of both disease progression and therapeutic treatments among these patients. In association with AMI, some studies on plasma proteins revealed significant biomarkers involved in myocardial injury, myocardial stress, inflammation, neuroendocrine activation, atherosclerotic process, platelet activation, plaque instability, endothelial dysfunction, oxidative stress, and myocardial stretch. Out of all these proteins, natriuretic peptides, C-reactive protein (CRP), creatine kinase (CK), and cardiac troponin were included as commonly used cardiac biomarkers in acute cardiac care 27. In a clinical setting, a kit for measuring human salivary CRP, a common biomarker related to cardiovascular inflammation, has been developed by Salimetrics®. Another recent cutting-edge technology is Oral Fluid NanoSensor Test (OFNASET) which provides portable, cheap, accurate, definitive, and quantitative results. Besides its intended use in oral cancer, this particular alternative can possibly benefit the point-of-care multiplex detection of salivary biomarkers among AMI patients 28. Given the above-mentioned clinical benefits of saliva collection, a patient's salivary proteome should be very useful in determining heart condition of the patient in order to predict AMI. Several studies have demonstrated salivary biomarkers associated with AMI, as shown in Table 1. By comparing these salivary biomarkers with those in plasma, as elaborated by Kossaify et al. 27, CRP, CK, CD40 ligand, cardiac troponin I, cardiac troponin T, some families of interleukin (IL), tumour necrosis factor alpha, matrix metalloproteinase (MMP), and myeloperoxidase share similarities with plasma biomarkers which also play significant roles in inflammation and plaque instability (Figure 2). Although these discoveries may enlighten the diagnostic utility of salivary proteomes as biomarkers in relation to CVD, none of the salivary biomarkers listed above have been verified to predict the onset of AMI. All of these studies, as tabulated in table 1, were conducted retrospectively after the incidence. On the other hand, prospective studies should be able to alternatively facilitate the researchers to find predictive AMI biomarkers. In future, these newly detected salivary biomarkers will conceivably provide an early molecular diagnosis and eventually increase the survival rate of cardiovascular patients as opposed to that of plasma. However, more validation needs to be carried out in order to find robust and discriminatory biomarkers for this disease.

Bottom Line: In this review, we discuss the utility of human salivary proteomes and tabulate the recent salivary biomarkers found in subjects with acute myocardial infarction as well as respective methods employed.In a clinical setting, since acute myocardial infarction contributes to large cases of mortality worldwide, an early intervention using these biomarkers will provide an effective solution to reduce global heart attack incidence particularly among its high-risk group of type-2 diabetes mellitus patients.Current challenges in saliva collection are also addressed to improve the quality of saliva samples and produce robust biomarkers for future use in clinical applications.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia ; 5. Faculty of Dentistry, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.

ABSTRACT
Human saliva plays a pivotal role in digesting food and maintaining oral hygiene. The presence of electrolytes, mucus, glycoproteins, enzymes, antibacterial compounds, and gingival crevicular fluid in saliva ensures the optimum condition of oral cavity and general health condition. Saliva collection has been proven non-invasive, convenient, and inexpensive compared to conventional venipuncture procedure. These distinctive advantages provide a promising potential of saliva as a diagnostic fluid. Through comprehensive analysis, an array of salivary proteins and peptides may be beneficial as biomarkers in oral and systemic diseases. In this review, we discuss the utility of human salivary proteomes and tabulate the recent salivary biomarkers found in subjects with acute myocardial infarction as well as respective methods employed. In a clinical setting, since acute myocardial infarction contributes to large cases of mortality worldwide, an early intervention using these biomarkers will provide an effective solution to reduce global heart attack incidence particularly among its high-risk group of type-2 diabetes mellitus patients. The utility of salivary biomarkers will make the prediction of this cardiac event possible due to its reliability hence improve the quality of life of the patients. Current challenges in saliva collection are also addressed to improve the quality of saliva samples and produce robust biomarkers for future use in clinical applications.

No MeSH data available.


Related in: MedlinePlus