Salivary Cytokines as Biomarker for Oral Health
Condition: Neoplasms
Study type: Observational

Summary: 
      Oral complications during and after cancer treatment are common. A key role in maintaining
      oral health plays saliva. In the last decade numerous studies have investigated immunological
      biomarkers such as cytokines in saliva samples. In children, the few studies have
      investigated salivary cytokines (sCK) suggesting that these are associated with oral health
      (sCK). One study investigating sCK in adult oncology patients showed an association between
      Interleukin-6 (IL-6) and severity of oral chronic graft-versus-host disease (GVHD) in
      survivors of hematopoietic stem cell transplantation. Therefore determination of sCK
      concentrations may also be helpful for assessment of GVHD activity and other inflammatory
      processes in cancer patients. In pediatric oncology patients, to the investigators'
      knowledge, no study has so far investigated sCK concentrations as markers for oral or
      systemic health.
    

Detailed description: 
      Oral complications are common during and after cancer treatment. Oral mucositis typically
      occurs during or immediately after chemotherapy and may lead to pain, oral and systemic
      infection, and nutritional compromise. Late effects of oral mucositis as a result of cancer
      treatment include an increased risk for dental caries, xerostomia and osteonecrosis. It has
      been recognised, that regular assessment of oral health, prevention and early treatment of
      oral mucositis decreases early and late complication rates.

      Saliva plays a key role in maintaining oral health and reduced salivary flow contributes to
      acute disorders and long-term sequelae in oral health. Saliva is a complex fluid secreted by
      the salivary glands and the gingiva. In the last decade numerous studies have investigated
      immunological biomarkers such as cytokines in saliva samples. These studies included
      individuals with various oral and systemic diseases including oral cancer, oral caries,
      autoimmune and endocrine diseases, metabolic syndrome, chronic kidney disease and psychiatric
      illnesses.

      In children, the few studies that have investigated salivary cytokines (sCK) suggest that
      these are associated with oral health (sCK). For example, one study in 114 healthy adolescent
      girls aged 11-17 years showed that sCK concentrations were generally not associated with
      levels in the serum . In addition this study also suggested that the sCK concentrations are
      age dependent.

      However, a number of other studies suggest that sCK may also reflect systemic diseases such
      as shown in a study including 20 children aged 9-17 with allergies (including asthma,
      allergic rhinitis and eosinophilic esophagitis) showing that Th-2 cytokines were detectable
      in sCK.

      One study investigating sCK in adult oncology patients showed an association between IL-6 and
      severity of oral chronic GVHD in survivors of a hematopoietic stem cell transplantation.
      Therefore determination of sCK concentrations may also be helpful for assessment of GVHD
      activity and other inflammatory processes in cancer patients. In paediatric oncology
      patients, to the investigators' knowledge, no study has so far investigated sCK
      concentrations as markers for oral or systemic health.
    

Intervention name(s): collection of salivary cytokines
Intervention type(s): Genetic
Intervention description(s): Collection of the saliva will be done following this procedure: The collection will be done prior to any other dental manipulation. The test person is sitting with its head tilted slightly forward. Initially, any saliva present in the mouth must be swallowed or spit out completely. Then, a paraffin gum is given to the test person. This paraffin gum must be chewed for minimally 2 and maximally up to 5 minutes. During the time period that the test person is chewing the paraffin gum, the saliva must be spitted into a cup repeatedly, or the saliva can also be let run passively into the cup. The amount of saliva is then weighted (1g equivalent to 1 ml) and a saliva flow rate (ml/min) is calculated and noted.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        -  Children with a new haematological/oncological diagnosis

          -  admitted to the paediatric oncology ward at the UKBB

          -  who will require radio- and/or chemotherapy.

        Healthy children who present at the Schulzahnklinik respectively Volkszahnklinik for a
        dental prophylaxis
      
Biospecimen description: 
      Saliva sample collection. Cytokines analysis in the saliva
    
Keywords: Oral health; Saliva; Biomarker; Cytokines; Cancer; children