Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Lancet Microbe. 2023 Oct;4(10):e837-e850. doi: 10.1016/S2666-5247(23)00135-0. Epub 2023 Jul 26.
Despite its prominence in early scientific records, the usefulness of saliva as a respiratory specimen has been de-emphasised over the past century. However, due to its low cost and reliance on specific supply chains and the non-invasive nature of its collection, its benefits over swab-based specimens are again becoming increasingly recognised. These benefits were highlighted over the course of the COVID-19 pandemic, where saliva emerged as a more practical, clinically non-inferior sample type for the detection of SARS-CoV-2 and saw numerous saliva-based diagnostic tests approved for clinical use. Looking forward, as saliva uniquely contains both respiratory secretions and immunological components, it has potentially wide applications, ranging from clinical diagnostics to post-vaccine disease burden and immunity surveillance. This Personal View seeks to summarise the existing evidence for the use of saliva in detecting respiratory pathogens, beyond SARS-CoV-2, as well as detailing methodological factors that can influence sample quality and thus, clinical utility.
尽管唾液在早期科学记录中很突出，但在过去一个世纪中，其作为呼吸道标本的用途已经被淡化。然而，由于其成本低，并且依赖于特定的供应链，以及其采集的非侵入性，其相对于拭子标本的优势再次得到越来越多的认可。这些优势在 COVID-19 大流行期间得到了凸显，唾液作为一种更实用、临床非劣效的 SARS-CoV-2 检测样本类型脱颖而出，并且有许多基于唾液的诊断测试获得了临床使用的批准。展望未来，由于唾液中独特地包含呼吸道分泌物和免疫成分，因此它具有广泛的应用前景，从临床诊断到疫苗接种后疾病负担和免疫监测。本个人观点旨在总结除 SARS-CoV-2 之外，唾液在检测呼吸道病原体中的现有证据，并详细说明可能影响样本质量从而影响临床实用性的方法学因素。
