Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA; Texas A&M College of Medicine, Bryan, TX, USA; Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA.
Department of Psychology, University of North Texas, Denton, TX, USA.
Brain Behav Immun. 2020 Aug;88:887-900. doi: 10.1016/j.bbi.2020.04.078. Epub 2020 May 1.
Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress.
The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [d]).
Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, d = 0.27), IL-10 (k = 11, d = 0.34), TNF-α (k = 10, d = 0.57), and IFN-γ (k = 6, d = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, d = 0.16) and IL-8 (k = 7, d = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations.
This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.
炎症的唾液生物标志物在应激研究中越来越多地被使用。本系统综述和荟萃分析定量总结了急性应激下唾液炎症标志物的变化。
综述纳入了 1558 名参与者（42 个独特样本，33 项研究），通过电子数据库（PubMed、PsycINFO、Embase）、参考文献树和 2015 年关于类似主题的综述中确定的文章获得。为了符合条件，文章必须是定量的，并评估至少一种唾液炎症生物标志物在成年人急性应激下的变化。主要结果是炎症生物标志物变化的幅度（重复测量的 Cohen's d [d]）。
唾液炎症的测量包括：C 反应蛋白（CRP）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素（IL）-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12p70、IL-13、IL-17A、IL-18、IL-21、干扰素（IFN）-α、IFN-γ 和肿瘤坏死因子（TNF）-α。细胞因子 IL-6（k=26，d=0.27）、IL-10（k=11，d=0.34）、TNF-α（k=10，d=0.57）和 IFN-γ（k=6，d=0.28）在应激反应中显著增加。事后敏感性分析表明，IL-1β（k=19，d=0.16）和 IL-8（k=7，d=0.30）也在应激前到应激后增加，但在去除一项异常值研究后，IFN-γ 的发现不再成立。对调节剂的检查表明，研究方法和样本人口统计学特征调节了一些关联。
本荟萃分析显示，某些唾液炎症细胞因子在急性应激下增加。结果存在显著的异质性和调节剂分析表明需要标准化研究方案。讨论了未来研究的方向。
