Oral fluid as a diagnostic tool

Choo, Robin E.; Huestis, Marilyn A.

doi:10.1515/cclm.2004.248

Cited by 140 publications

(127 citation statements)

References 93 publications

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“…among suspected drugged drivers. Oral fluid (mixed saliva) may also be analysed to detect and monitor drug use, and the use for this purpose is increasing [1][2][3][4]. Oral fluid is an easily available medium that can be collected with noninvasive methods without the intrusion of privacy.…”

Section: Introductionmentioning

confidence: 99%

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Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine

Gjerde

Verstraete

2010

Forensic Science International

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A B S T R A C TAim: To study several methods for estimating the prevalence of high blood concentrations of tetrahydrocannabinol and amphetamine in a population of drug users by analysing oral fluid (saliva).Methods: Five methods were compared, including simple calculation procedures dividing the drug concentrations in oral fluid by average or median oral fluid/blood (OF/B) drug concentration ratios or regression coefficients and more complex Monte Carlo simulations.Populations of 311 cannabis users and 197 amphetamine users from the Rosita-2 Project were studied. Results:The results of a feasibility study suggested that the Monte Carlo simulations might give better accuracies than simple calculations if good data on OF/B ratios is available. If using only 20 randomly selected OF/B ratios, a Monte Carlo simulation gave the best accuracy but not the best precision. Dividing by the OF/B regression coefficient gave acceptable accuracy and precision, and was therefore the best method. None of the methods gave acceptable accuracy if the prevalence of high blood drug concentrations was less than 15%. Conclusion:Dividing the drug concentration in oral fluid by the OF/B regression coefficient gave an acceptable estimation of high blood drug concentrations in a population, and may therefore give valuable additional information on possible drug impairment, e.g. in roadside surveys of drugs and driving. If good data on the distribution of OF/B ratios are available, a Monte Carlo simulation may give better accuracy.

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Section: Introductionmentioning

confidence: 99%

“…There are, however, positive correlations between drug concentrations in oral fluid and blood, varying from one drug to another [9][10][11][12]. For alcohol, the concentration in oral fluid reflects very well the blood alcohol concentration [1,4].…”

Section: Introductionmentioning

confidence: 99%

Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine

Gjerde

Verstraete

2010

Forensic Science International

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“…However, stimulation may affect drug concentrations due to the dilution effect and an altered pH of the oral fluid. Other challenges associated with oral fluid analysis are adsorption of analytes to collection devices, interferences from food or drinks and contamination with orally ingested or inhaled drugs left in the mouth [70][71][72].…”

Section: Oral Fluidmentioning

confidence: 99%

Alternative Sampling Strategies for Cytochrome P450 Phenotyping

2015

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Interindividual variability in the expression and function of drug metabolizing cytochrome P (CYP) 450 enzymes, determined by a combination of genetic, non-genetic and environmental parameters, is a major source of variable drug response. Phenotyping by administration of a selective enzyme substrate, followed by the determination of a specific phenotyping metric, is an appropriate approach to assess the in vivo activity of CYP450 enzymes, as it takes into account all influencing factors. A phenotyping protocol should be as simple and convenient as possible. Typically, phenotyping metrics are determined in traditional matrices, such as blood, plasma or urine. Several sampling strategies have been proposed as an alternative for these traditional sampling techniques.In this review, we provide a comprehensive overview of available methods using dried blood spots, hair, oral fluid, exhaled breath and sweat for in vivo CYP450 phenotyping. We discuss the relation between phenotyping metrics measured in these samples and those in conventional matrices, along with the advantages and limitations of the alternative sampling techniques. Reliable phenotyping procedures for several clinically relevant CYP450 enzymes, including CYP1A2, CYP2C19 and CYP2D6, are currently available for oral fluid, breath or dried blood spots, while additional studies are needed for other CYP450 isoforms, such as CYP3A4. The role of hair analysis for this purpose remains to be established. Being non-or minimally invasive, these sampling strategies provide convenient and patient-friendly alternatives for classical phenotyping procedures, which may contribute to the implementation of CYP450 phenotyping in clinical practice. 4 Key Points Phenotyping by administration of a selective probe drug, followed by determination of a specific phenotyping metric, allows to assess the in vivo enzyme activity of CYP450 enzymes, taking into account genetic, non-genetic and environmental influencing factors. In addition to classical sampling techniques, such as blood or urine collection, reliable phenotyping procedures for several clinically relevant CYP450 enzymes are currently available for oral fluid, breath and dried blood spots.

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“…The use of saliva in a diagnostic setting has obvious advantages to blood based testing [1,2]. Oral fluid is a perfect medium offering a non-invasive, easy to obtain means for patient specimen collection.…”

Section: Background: History Of Saliva Molecular Analysismentioning

confidence: 99%

Salivary mRNA targets for cancer diagnostics

Zimmermann

Wong

2008

Oral Oncology

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Head and neck squamous cell carcinoma (HNSCC) affects almost 1 million people worldwide per year. Despite therapeutic advances the overall survival rate remains low because diagnosis often occurs only at advanced stages with poor prognosis. Like in most cancers, the implementation of an early detection scheme would have a positive impact on this disease. Similarly, as oral cancer has a very high recurrence rate, the early identification of recurrence or second primary tumors is an important challenge.HNSCC detection is currently based on expert clinical examination of the upper aerodigestive tract and histologic analysis of suspicious areas, but it may be undetectable in hidden sites, and unfortunately visual screening for oral lesions is an often neglected part of dental healthcare. Our group is actively pursuing the assembly of a toolbox for the molecular analysis of oral fluid. Here we present our current status utilizing the salivary transcriptome for oral cancer diagnostics.

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Oral fluid as a diagnostic tool

Cited by 140 publications

References 93 publications

Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine

Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine

Alternative Sampling Strategies for Cytochrome P450 Phenotyping

Salivary mRNA targets for cancer diagnostics

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