Ng Ted K S, Udeh-Momoh Chinedu, Lim Mei-Ann, Gleerup Helena Sophia, Leifert Wayne, Ajalo Catherine, Ashton Nicholas, Zetterberg Henrik, Rissman Robert A, Winston Charisse N, O' Bryant Sid, Jenkins Robert, Carro Eva, Orive Gorka, Tamburin Stefano, Olvera-Rojas Marcos, Solis-Urra Patricio, Esteban-Cornejo Irene, Santos Gustavo Alves Andrade Dos, Rajan Kumar B, Koh David, Simonsen Anja Hviid, Slowey Paul D
Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Edson College of Nursing and Health Education, Arizona State University, Phoenix, Arizona, USA.
Alzheimers Dement. 2025 Feb;21(2):e14420. doi: 10.1002/alz.14420. Epub 2024 Dec 30.
There is a pressing need for accessible biomarkers with high diagnostic accuracy for Alzheimer's disease (AD) diagnosis to facilitate widespread screening, particularly in underserved groups. Saliva is an emerging specimen for measuring AD biomarkers, with distinct contexts of use that could complement blood and cerebrospinal fluid and detect various analytes. An interdisciplinary, international group of AD and related dementias (ADRD) researchers convened and performed a narrative review of published studies on salivary AD biomarkers. We critically appraised the current state of the literature, examining both consistencies and discrepancies in existing pre-analytical variables and methodologies. We discussed how various pre-analytical variables could influence the detection and quantification of salivary biomarkers, showed technologies available to standardize collection procedures, and proposed a standardized pre-analytical protocol to guide future studies on salivary AD biomarker examinations. We identified potential contexts of use, gaps, and priorities and proposed future research directions. HIGHLIGHTS: Given its non-invasive nature, wider accessibility, and cultural acceptability, particularly in low-resourced settings, saliva is a biofluid complementary to blood and CSF. Current salivary AD biomarker studies do not control for many confounding pre-analytical variables during the sampling process, potentially leading to inaccurate salivary biomarker readings and conclusions, contributing to conflicting findings. Reviewing the current literature, including the consistencies and non-consistencies observed in the existing parameters and methodologies, discussing how they can affect salivary AD biomarker detection and quantification. Proposing a standardized salivary pre-analytical protocol, identifying the gaps and prioritizations needed to move this area forward, proposing future directions and potential contexts of use.
迫切需要具有高诊断准确性的可获取生物标志物用于阿尔茨海默病（AD）诊断，以促进广泛筛查，特别是在服务不足的人群中。唾液是一种新兴的用于测量AD生物标志物的样本，其独特的使用背景可以补充血液和脑脊液并检测各种分析物。一个跨学科的国际AD及相关痴呆症（ADRD）研究团队召集并对已发表的关于唾液AD生物标志物的研究进行了叙述性综述。我们批判性地评估了文献的现状，检查了现有分析前变量和方法中的一致性和差异。我们讨论了各种分析前变量如何影响唾液生物标志物的检测和定量，展示了可用于标准化采集程序的技术，并提出了一个标准化的分析前方案，以指导未来关于唾液AD生物标志物检测的研究。我们确定了潜在的使用背景、差距和优先事项，并提出了未来的研究方向。要点：鉴于其非侵入性、更广泛的可获取性和文化可接受性，特别是在资源匮乏的环境中，唾液是一种可补充血液和脑脊液的生物流体。目前的唾液AD生物标志物研究在采样过程中没有控制许多混杂的分析前变量，这可能导致唾液生物标志物读数和结论不准确，从而造成相互矛盾的结果。回顾当前的文献，包括在现有参数和方法中观察到的一致性和不一致性，讨论它们如何影响唾液AD生物标志物的检测和定量。提出一个标准化的唾液分析前方案，确定推动该领域发展所需的差距和优先事项，提出未来的方向和潜在的使用背景。
