Salivary Biomarkers for Diagnosis and Therapy Monitoring in Patients with Heart Failure. A Systematic Review

Abstract

The aim of this study was to perform a systematic review on the potential value of saliva biomarkers in the diagnosis, management and prognosis of heart failure (HF). The correlation between saliva and plasma values of these biomarkers was also studied. PubMed was searched to collect relevant literature, i.e., case-control, cross-sectional studies that either compared the values of salivary biomarkers among healthy subjects and HF patients, or investigated their role in risk stratification and prognosis in HF patients. No randomized control trials were included. The search ended on 31st of December 2020. A total of 15 studies met the inclusion criteria. 18 salivary biomarkers were analyzed and the levels of all biomarkers studied were found to be higher in HF patients compared to controls, except for amylase, sodium, and chloride that had smaller saliva concentrations in HF patients. Natriuretic peptides are the most commonly used plasma biomarkers in the management of HF. Their saliva levels show promising results, although the correlation of saliva to plasma values is weakened in higher plasma values. In most of the publications, differences in biomarker levels between HF patients and controls were found to be statistically significant. Due to the small number of patients included, larger studies need to be conducted in order to facilitate the use of saliva biomarkers in clinical practice.

A Novel IMFET Biosensor Strategy for Interleukin‐10 Quantification for Early Screening Heart Failure Disease in Saliva

“…Saliva analysis offers several advantages such as non-invasive sampling, which is suitable for the screening of a larger population, decreased psychological stress (especially if repeated sampling is needed) even from critical subjects (e. g. children, elder, and disabled people), and fewer health risks for patients and healthcare professionals who have to manage sample collection, analysis and disposal [14][15][16][17]. Moreover, salivary diagnostics are reaching sufficient levels of usability to be applied in the emerging field of Lab-on-Chip (LoC) and Point-of-Care (PoC) devices [18,19], and gaining importance as a promising approach for monitoring HF [20]. However, it is important to stress that the circulating level of TNF-α and IL-10 differ widely, even in nominally healthy subjects [14].…”

Estimation of GCF and Salivary Levels of NT-proBNP in Systemically Healthy Subjects with Severe Chronic Periodontitis Before and After Periodontal Flap Surgery

“…A systematic review analysed the potential value of saliva biomarkers in the diagnosis, management and prognosis of heart failure (HF). 18 They concluded that salivary BNP levels can be used for heart failure monitoring. This highlights the use of saliva to estimate the levels of biomarkers and hence salivary levels of NTpro-BNP was also evaluated.…”

The Potential Role of Salivary NT-proBNP in Heart Failure

“…Saliva, a body fluid containing several proteins that might be used as potential biomarkers, has the advantage of being easily collected in a non-invasive way, while it can be applied in various point-of-care (PoC) devices [ 3 , 4 ], as a tool to improve patient care by providing a rapid and actionable result near the patient [ 5 ]. Saliva has been mainly used in the detection of oral cancer and oral inflammation [ 6 , 7 ], while biomarkers associated with coronary artery disease such as CRP, CK-MB, sCD40 ligand, hs-cTnT, cTnI [ 8 , 9 , 10 , 11 , 12 , 13 ] and HF such as galectin-3 (Gal-3), cortisol, TNF, interleukins 6 and 10, CRP, BNP and NT-proBNP, have also been detected in saliva [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”