Saliva as a diagnostic fluid in sports medicine: potential and limitations

Abstract

The use of saliva in the diagnosis of pathologies and/or monitoring of athletes in competitions or trainings is an attractive alternative due to the fact that samples are easily obtained and it is mostly a less invasive method in comparison with venous blood collection. The saliva is a hypotonic fluid in relation to plasma, containing compounds produced in the salivary glands (immunoglobulin A [IgA] and α-amylase) as well as compounds diffused in the plasma (water, electrolytes, proteins, metabolites and hormones). It plays a pivotal role in the protection of oral mucosa against microbes and in food digestion. Its production and composition depend on the sympathetic and parasympathetic nervous system activity, whose antagonistic action may result in different saliva volumes with distinct ionic and protein profiles. The aim of this review was to present a critical analysis of the potential and limitations of saliva as a diagnostic tool in sports medicine. Although there are studies that have deployed it to monitor athletes in training and doping, the standardization of some preanalytical variables are still required, among which the following ones are worth mentioning: the accurate choice of collection system, which allows the easy quantification of volume with adequate sample recovery; well-defined collection schedules in accordance with the circadian variations of the analyte; prevention of sample contamination with blood from oral mucosa lesions. Another key point for its application in sports is the establishment of reference intervals for analytes quantified in the saliva, collected from a population that comprises healthy individual that exercise regularly and systematically, with physical activity progression.

Effect of exercise on saliva flow, viscosity and ph

“…[15] There are various physiological variations in the saliva as observed in the study. Normally, the physiological alterations are overlooked, and research has been thriving only in the pathology of diseases.…”

Saliva for Assessing Vitamin A Status in Extremely Preterm Infants: A Diagnostic Study

“…The pharmacokinetics of vitamin A in preterm infants and the factors affecting vitamin A content of saliva have not been well studied. Molecules bound to transport proteins are not available for secretion into saliva [9]. More than 95% of vitamin A in plasma is bound to retinol-binding protein in adults during the fasting state, while vitamin A transport through chylomicrons predominates in the postprandial state [10].…”

Physiological Changes in Salivary Gland and Kidney that help the Diagnosis caused of Epstein-Barr virus: A Brief Review

“…Production and composition are dependent on the activity of the autonomic sympathetic and parasympathetic nervous system whose complementary action could result in different saliva volumes with protein and ionic distinct profiles [7].…”