SALIVA DIAGNOSTICS
Most analytes in saliva are also stable at ambient temperatures for up to a week, allowing samples to be collected and shipped without refrigeration
extensive array of commercially available assays. State-of-the-art luminescence and ELISA immunoassays – like those developed by Tecan – provide high analytical and functional sensitivity to allow quantification of the very low analyte concentrations in saliva, with no time-consuming extraction processes required.
While immunoassays are highly accurate and used to quantify many analytes across clinical research and diagnostics, they can sometimes lack specificity in certain hormone testing applications. Many clinical laboratories are considering the adoption of mass spectrometry (MS) in a bid to increase specificity, and liquid chromatography-mass spectrometry (LC-MS) in particular is increasingly being recognised as a reference method, offering deeper insights into sample composition by breaking down molecules and analysing them by weight and retention time. However, these testing methods
are unlikely to completely replace ELISAs and luminescence-based assays as the cost and complexity of MS instruments will likely be an issue for many laboratories and, instead, LC-MS can be used by manufacturers as a reference method to validate immunoassays and ensure reliable results.
Emerging markets
The uptake of saliva diagnostics in clinical applications is also reflected in occupational medicine, sports medicine, and the health and wellness industries. Fluids iQ, for example, is successfully using this methodology to develop a more personalised approach towards tackling issues with mood, energy, libido and stress. Dr Aron Gonshor, President and CEO of the Canadian wellness center, explained why saliva testing is so important in the diagnosis of these frequently overlooked disorders: “People often turn to wellness practitioners, naturopaths, nutritionists, chiropractors or physicians in functional or integrative medicine when conventional medicine has been unable to provide answers to their health issue, and saliva testing gives us a straightforward way to
obtain baseline hormone levels as a starting point for further investigations. It is one of the best ways of looking at many analytes and has wonderful potential, offering a non-invasive method of measuring the bioactive levels of hormones and other compounds. Today, almost any of the proteins that can be tested for in blood – for example, enzymes, cytokines and antibodies – can also be screened in saliva, at sensitivities that could only be dreamt of just a few years ago. Saliva-based detection levels are now into the low picogram range,
with new assays offering novel analytes and lower detection limits continually under development. Saliva testing has truly come of age.”
Keeping up with increasing demand
The booming popularity of saliva testing whatever the setting, is unsurprisingly putting pressure on laboratories to streamline their processes to keep up with the increase in demand. Fortunately, there are various dedicated immunoassay platforms available that can automate all common ELISA steps, including sample distribution and predilution, reagent pipetting, incubation, plate washing, optical density measurements and result generation. Employing automated solutions in the laboratory is not only efficient, it also helps to
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