Perspect Nurs Sci.  2014 Oct;11(2):87-93. 10.16952/pns.2014.11.2.87.

State of the Science: Salivary Biomarker Utilization for Stress Research

Affiliations
  • 1School of Nursing, Virginia Commonwealth University, Richmond, USA. kan@vcu.edu
  • 2Virginia Commonwealth University, Richmond, USA.
  • 3University of Texas El Paso, Texas, USA.

Abstract

PURPOSE
The use of salivary biomarkers for stress research is increasing based on the convenience of collection, affordability and scientific merit. This short review provides an overview of the state of the science of salivary biomarkers utilized in research related to stress.
METHODS
An integrative review was conducted.
RESULTS
The trend of utilizing salivary biomarkers in stress research was reviewed, specifically, focusing on the use of endocrine and inflammatory biomarkers incorporated in previous stress research. Then, a review of sampling procedures for salivary biomarkers and the analytic methods is provided. Finally, a discussion on the strengths and areas for improvement in the use of salivary biomarkers in stress research is included.
CONCLUSION
Salivary biomarkers as an alternative to blood biomarkers are increasingly being recognized as a legitimate source for analyzing the stress response in humans.

Keyword

Stress; Saliva; Biological marker; Cortisol

MeSH Terms

Biomarkers
Humans
Hydrocortisone
Saliva
Hydrocortisone

Reference

1. Atkinson AJ, Colburn WA, DeGruttola VJ, DeMets DL, Downing GJ, Hoth DF, et al. Woodcock J, Zeger SL. Biomarker definition working group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001; 69(3):89–95. http://dx.doi.org/10.1067/mcp.2001.113989.
2. National Center for Biotechnology Information. Available from:. http://www.ncbi.nlm.nih.gov/pubmed/?term=salivary+biom. arkers+and+stress. Accessed 08/24/2014.
3. Aronson JK. Biomarkers and surrogate endpoints. Br J Clin Pharmacol. 2005; 59(5):491–94. http://dx.doi.org/10.1111/j.1365-2125.2005.02435.x.
Article
4. Poste G. Biospecimens, biomarkers, and burgeoning data: the imperative for more rigorous research standards. Trend Mol Med. 2012; 18(12):717–22. http://dx.doi.org/10.1016/j.molmed.2012.09.003.
Article
5. National Institute of Environmental Health Sciences. Available from:. http://www.niehs.nih.gov/health/topics/science/bio. markers. Accessed. 2014.
6. Cancer Research UK. Available from:. http://www.cancerresearchuk.org/funding-for-researchers/our-funding-schemes/biomarker-project-awards.Accessed8/31/2014.
7. Christodoulides N, Florian PN, Miller CS, Ebersole JL, Mohanty S, Dharshan P, et al. Lab-on-a-chip methods for point-of-care measurements of salivary biomarkers of periodontitis. Ann N Y Acad Sci. 2007 Mar; 1098:411–28.
Article
8. Srinivas PR, Kramer BS, Srivastava S. Trends in biomarker research for cancer detection. Lancet Oncol. 2001; 2(11):698–704. http://dx.doi.org/10.1016/S1470-2045(01)00560-5.
Article
9. Lee Y-H. Wong DT. Saliva: An emerging biofluid for early detection of diseases. Am J Dent. 2009; 22(4):241–8.
10. Granger DA, Kivlighan KT, Fortunato C, Harmon AG, Hibel LC, Schwartz EB, et al. Integration of salivary biomarkers into developmental and behaviorally-oriented research: Problems and solutions for collecting specimens. Physiol Behav. 2007; 92(4):583–90.
Article
11. Wong DTW. Salivary Diagnostics: Scientific and Clinical Frontiers. Advances in Dental Research. 2011; 23(4):350–2.
12. Cohen S, Schwartz JE, Epel E, Kirschbaum C, Sidney S, Seeman T. Socioeconomic status, race, and diurnal cortisol decline in the coronary artery risk development in young adults (CARDIA) study. Psychosomatic Med. 2006; 68(1):41–50. http://dx.doi.org/10.1097/01.psy.0000195967.51768.ea.
Article
13. Salimetrics. Available from:. https://www.salimetrics.com/col. lection-systems. Accessed 8/31/2014.
14. Floriano PN, Christodoulides N, Miller CS, Ebersole JL, Sper-tus J, Rose BG, et al. Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care: a feasibility study. Clin Chem. 2009; 55(8):1530–8. http://dx.doi.org/10.1373/clinchem.2008.117713. Epub 2009 Jun 25.
Article
15. Brailo V, Vucicevic-Boras V, Lukac J, Biocina-Lukenda D, Zilic-Alajbeg I, Milenovic A, et al. Salivary and serum interleukin 1 beta, interleukin 6 and tumor necrosis factor ⍺ in patients with leukoplakia and oral cancer. Medicina Oral, Pa-tología Oraly Cirugía Buccal. 2012; 17(1):): e10.
16. Goulart BHL, Clark JW, Pien HH, Roberts TG, Finkelstein SN, Chabner BA. Trends in the use and role of biomarkers in phase I oncology trials. Clin Cancer Res. 2007; 13:6719. http://dx.doi.org/10.1158/1078-0432.CCR-06-2860.
Article
17. Hu S, Arellano M, Boontheung P, Wang J, Zhou H, Jiang J, et al. Salivary proteomics for oral cancer biomarker discovery. Clin Cancer Res. 2008; 14(19):6246–52.
Article
18. Park NJ, Zhou H, Elashoff D, Henson BS, Kastratovic DA, Abemayor E, et al. Characterization, and Clinical Utility for Oral Cancer Detection. Clin Cancer Res. 2009; 15:5473–7. http://dx.doi.org/10.1158/1078-0432.CCR-09-0736.
19. Zhang L, Farrell JJ, Zhou H, Elashoff D, Akin D, Park NH, et al. Salivary transcriptomic biomarkers for detection of resectable pancreatic cancer. Gastroenterology. 2010; 138(3):949–57. e1-7.http://dx.doi.org/10.1053/j.gastro.2009.11.010. Epub 2009.
Article
20. Dekker MJ, Koper JW, van Aken MO, Pols HA, Hofman A, de Jong FH, et al. Salivary cortisol is related to atherosclerosis of carotid arteries. J Clin Endocrinol Metabolism. 2008; 93(10):3741–7. http://dx.doi.org/10.1210/jc.2008-0496;10.1210/jc.2008-0496.
Article
21. DeSantis AS, DiezRoux AV, Hajat A, Aiello AE, Golden SH, Jenny NS, et al. Associations of salivary cortisol levels with inflammatory markers: The multi-ethnic study of atherosclerosis. Psychoneuroendocrinology. 2012; 37(7):1009–18. http://dx.doi.org/10.1016/j.psyneuen.2011.11.009;10.1016/j.psyneuen.2011.11.009.
Article
22. Foley JD III, Sneed JD, Steinhubl SR. Oral fluids that detect cardiovascular disease biomarkers. Oral Surgery Oral Medi Oral Pathol Oral Radiol. 2012; 114(2):207–14.
23. Herr AE, Hatch AV, Throckmorton DJ, Tran HM, Brennan JS, Giannobile WV, Singh AK. Microfluidic immunoassays as rapid saliva-based clinical diagnostics. Proc Natl Acad Sci USA. 2007; 104(13):5268–73. Epub 2007 Mar 20.
Article
24. Hellhammer DH, Wüst S, Kudielka BM. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009; 34(2):163–71. http://dx.doi.org/10.1016/j.psyneuen.2008.10.026. Epub 2008 Dec 18.
Article
25. De Caro JA. Methodological considerations in the use of salivary ⍺-amylase as a stress marker in field research. Am J Hum Biol. 2008; 20(5):617–9.
26. Adam EK, Kumari M. Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology. 2009; 34(10):1423–36. http://dx.doi.org/10.1016/j.psyneuen.2009.06.011.
Article
27. Dhima M, Salinas TJ, Wermers RA, Weaver AL, Koka S. Patients preference(Preference changes of adult outpatients for giving saliva, urine and blood for clinical testing after actual sample collection. J Prosthodont Res. 2013 January; 57(1):): 51-6.http://dx.doi.org/10.1016/j.jpor.2012.09.004.
28. Eller NH, Netterstrom B, Allerup P. Progression in intima media thickness–the significance of hormonal biomarkers of chronic stress. Psychoneuroendocrinology. 2005; 30(8):715–23. http://dx.doi.org/10.1016/j.psyneuen.2005.01.005.
Article
29. Hajat A, Diez-Roux A, Franklin TG, Seeman T, Shrager S, Ranjit N, et al. Socioeconomic and race/ethnic differences in daily salivary cortisol profiles: The Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology. 2010; 35(6):932–43. http://dx.doi.org/10.1016/j.psyneuen.2009.12.009.
Article
30. Karmack T. Psychosocial stress and cardiovascular disease: An exposure science perspective Psychological Science Agen-da|April. 2012.
31. Takai N, Yamaguchi M, Aragaki T, Eto K, Uchihashi K, Nishikawa Y. Gender-specific differences in salivary biomarker responses to acute psychological stress. Ann N Y Acad Sci. 2007; 1098:510–5.
Article
32. Cohen S, Kessler RC, Underwood GL. Strategies for measuring stress in studies of psychiatric and physical disorders. Cohen S, Kessler RC, & Underwood Gordon L., editorsMeasuring Stress: A guide for health and social scientists. New York: Oxford University Press;1995.
33. Laudat MH, Cerdas S, Fournier C, Guiban D, Guilhaume B, Luton JP. Salivary cortisol measurement: a practical approach to assess pituitary-adrenal function. J Clin Endocrinol Metab. 1988; 66(2):343–8.
Article
34. Shirotsuki K, Izawa S, Sugaya N, Yamada KC, Ogawa N, Ouchi Y, et al. Salivary cortisol and DHEA reactivity to psychosocial stress in socially anxious males. Int J Psychophysiol. 2009; 72(2):198–203.
Article
35. Vitorino R, Lobo MJC, Ferrer-Correira AJ, Dubin JR, Tomer KB, Domingues PM, et al. Identification of human whole saliva protein components using proteomics. Proteomics. 2004; 4(4):1109–15.
Article
36. Weber-Hamann B, Kratzsch J, Kopf D, Lederbogen F, Gilles M, Heuser I, et al. Resistin and adiponectin in major depression: The association with free cortisol and effects of antidepressant treatment. J Psychiatr Res. 2007; 41(3-4):): 344-50.http://dx.doi.org/10.1016/j.jpsychires.2006.01.002.
Article
37. Mirzaii-Dizgah I, Hejazi SF, Riahi E, Salehi MM. Saliva-based creatine kinase MB measurement as a potential point-of-care testing for detection of myocardial infarction. Clin Oral Investig. 2012; 16(3):775–9.
Article
38. Mirzaii-Dizgah I, Jafari-Sabet M. Unstimulated whole saliva creatine phosphokinase in acute myocardial infarction. Oral Dis. 2011; 17(6):597–600. http://dx.doi.org/10.1111/j.1601-0825.2011.01817.x;10.1111/j.1601-0825.2011.01817.x.
Article
39. Matthews K, Schwartz J, Cohen S, Seeman T. Diurnal cortisol decline is related to coronary calcification: CARDIA study. Psychosomatic Med. 2006; 68(5):657–61. http://dx.doi.org/10.1097/01.psy.0000244071.42939.0e.
Article
40. Pariante CM, Papadopoulos AS, Poon L, Cleare AJ, Checkley SA, English J, et al. Four days of citalopram increase suppression of cortisol secretion by prednisolone in healthy volunteers. Psychopharmacology. 2004; 177(1-2):200–6.
Article
41. Tlili C, Myung NV, Shetty V, Mulchandani A. Label-free, che-miresistor immunosensor for stress biomarker cortisol in saliva. Biosens Bioelectron. 2011; 26(11):4382–6.
Article
42. Nater UM, Rohleder N. Salivary alpha amylase as a non-invasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology. 2009; 34(4):486–96.
43. van Stegeren A, Rohleder N, Everaerd W, Wolf OT. Salivary alpha amylase as marker for adrenergic activity during stress: effect of betablockade. Psychoneuroendocrinology. 2006; 31(1):137–41.
44. Rohleder N, Nater UM, Wolf JM, Ehlert U, Kirschbaum C. Psychosocial stress-induced activation of salivary alpha-amylase: an indicator of sympathetic activity? Ann N Y Acad Sci. 2004; 032:258–63.
Article
45. de Rooij SR. Blunted cardiovascular and cortisol reactivity to acute psychological stress: a summary of results from the Dutch Famine Birth Cohort Study. Int J Psychophysiol. 2013; 90(1):21–7. http://dx.doi.org/10.1016/j.ijpsycho.2012.09.011.
Article
46. SahebJamee M, Eslami M, Atarbashi Moghadam F, Sarafnejad A. Salivary concentration of TNF alpha, IL1 alpha, IL6, and IL8 in oral squamous cell carcinoma. Medicina Oral, Patología Oral Cirugía Bucal. 2008; 13(5):E292–5.
47. DeSantis AS, DiezRoux AV, Hajat A, Golden SH, Jenny NS, Sanchez BN, et al. Associations of salivary cortisol levels with metabolic syndrome and its components: The multi-ethnic study of atherosclerosis. J Clin Endocrinol Metab. 2011; 96(11):3483–92. http://dx.doi.org/10.1210/jc.2011-0483;10.1210/jc.2011-0483.
Article
48. Hibel LC, Granger DA, Cicchetti D, Rogosch F. Salivary Bio-marker Levels and Diurnal Variation: Associations With Medications Prescribed to Control Children's Problem Behavior. Child Dev. 2007 May/June; 78(3):): 927-37.http://dx.doi.org/10.1111/j.1467-8624.2007.01041.x.
Article
49. Do DP, Diez Roux AV, Hajat A, Auchincloss AH, Merkin SS, Ranjit N, et al. Circadian rhythm of cortisol and neighborhood characteristics in a population-based sample: The multi-ethnic study of atherosclerosis. Health Place. 2011; 17(2):625–32. http://dx.doi.org/10.1016/j.healthplace.2010.12.019.
Article
50. An K, Salyer J, Kao HF. Psychological strains, salivary biomarkers, and risks for coronary heart disease among hurricane survivors. Biol Res Nurs. 2014 Sep 18. pii: 109980041455 1164. [Epub ahead of print].
51. Bettendorf M, Albers N, Bauer J, Heinrich UE, Linderkamp O, Maser-Gluth C. Longitudinal evaluation of salivary cortisol levels in full-term and preterm neonates. Horm Res. 1998; 50:303–8.
Article
52. Hodgson N, Freedman VA, Granger DA, Erro A. Biobehavio-ral correlates of relocation in the frail elderly: salivary cortisol, affect, and cognitive function. J Am Geriatr Soc. 2004; 52:1856–62.
Article
53. Schrohl AS, Würtz S, Kohn E, Banks RE, Nielsen HJ, Sweep FC, et al. Banking of biological fluids for studies of disease-associated protein biomarkers. Mol Cell Proteomics. 2008; 10:2061–6. http://dx.doi.org/10.1074/mcp.R800010-MCP200.
Article
54. Li Y, Zhou X, St John MAR, Wong DT. RNA profiling of cell-free saliva using microarray technology. J Dent Res. 2004; 83:199–203.
55. National Institute of Dental and Craniofacial Research (NIDCR). Salivary Diagnostics, NIH fact sheets. Available from:. http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=65. Updated 2010. Accessed on 8/28/14.
56. Yoshizawa JM, Schafer CA, Schafer JJ, Paster BJ, Wong DTW. Salivary biomarkers: toward future clinical and diagnostic utilities. Clin Microbiol Rev. 2013; 26(4):781–91. http://dx.doi.org/10.1128/CMR.00021-13.
Article
Full Text Links
  • PNS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr