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Martins RARC, Costa FWG, Silva SM, Silva PGDB, Carvalho FSR, Fonteles CSR, Ribeiro TR. Salivary immunoglobulins (A, G, and M) in type 1 diabetes mellitus patients: A PROSPERO-registered systematic review and meta-analysis. Arch Oral Biol 2020; 122:105025. [PMID: 33341591 DOI: 10.1016/j.archoralbio.2020.105025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the difference in the salivary levels of immunoglobulins between patients with type 1 diabetes mellitus (DM1) and healthy controls. DESIGN This systematic review was registered on the PROSPERO (CRD42020159198) database. All references were cross-checked and the risk of bias assessment was conducted using the Newcastle-Ottawa Scale. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to appraise the quality of evidence. The standardized mean difference and Cohen's d as the effect size were used in the meta-analysis. I-square statistics was used to estimate heterogeneity. Analysis was performed using the RevMan® software (p < 0.05) with a 95 % confidence interval. RESULTS Of the total 92 articles, 9 were selected for this study. The meta-analysis included 333 DM1 patients and 325 healthy controls. DM1 patients showed a significant reduction in salivary flow (p = 0.0008; Cohen's d= -0.19, CI 95 %= -0.33, -0.05), although not significant enough to modify the IgA concentration (p = 0.120; Cohen's d = 0.58, CI 95 %= -0.15, 1.32). However, DM1 increased IgA concentration by reducing salivary flow (Cohen's d = 0.84; CI 95 % = 0.36, 1.32), with a strong estimate of effect (p = 0.0006). Regarding IgG, no significant change was noted with DM1 in the patient's saliva (p = 0.420). Furthermore, there was no significant variation in the salivary IgM levels (p = 0.300). CONCLUSIONS The data suggest that the salivary levels of the evaluated immunoglobulins do not seem to be altered in DM1 patients when compared to that in healthy controls. However, the increase in IgA salivary concentration was dependent on total protein estimation.
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Affiliation(s)
- Renata Asfor Rocha Carvalho Martins
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Sara Maria Silva
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | | | - Francisco Samuel Rodrigues Carvalho
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Ceará CampusSobral, Rua Conselheiro José Júlio, S/N, Centro, CEP: 62010-820, Sobral, Ceará, Brazil.
| | - Cristiane Sá Roriz Fonteles
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Thyciana Rodrigues Ribeiro
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
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Nunes MPO, van Tilburg MF, Tramontina Florean EOP, Guedes MIF. Detection of serum and salivary IgE and IgG1 immunoglobulins specific for diagnosis of food allergy. PLoS One 2019; 14:e0214745. [PMID: 30995240 PMCID: PMC6469776 DOI: 10.1371/journal.pone.0214745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/19/2019] [Indexed: 02/06/2023] Open
Abstract
Given the growing incidence and prevalence of life-threatening food allergies, health concerns have raised new perspectives for in vivo and in vitro diagnostic methodologies, pointing to saliva as a promising material, already used to diagnose other pathologies. Based on the above considerations, this study aimed to verify the possible use of saliva for the detection of IgE and IgG1 in the diagnosis of food allergy. This was a randomized, cross-sectional clinical study with a quantitative approach, developed at a hospital referral center in allergy in the state of Ceará, from January to July 2015. The sample consisted of 36 children of both sexes, aged between 1 and 60 months, with a diagnosis of cow's milk protein allergy (CMPA) by the RAST test. Children hospitalized or under immunosuppressive drugs were excluded from the study. Serum and saliva samples of the participants were collected and subsequently subjected to the indirect immunoenzymatic assay (ELISA) for the detection of specific serum and salivary immunoglobulins for food: corn, papaya, cow's milk, egg white, wheat, soybeans, peanuts, nuts, kiwi, cacao, fish, shrimp, bananas and tomatoes. For comparison of serum and saliva results, the T-test of independent samples and Mann-Whitney were adopted, for samples with normal and non-normal distribution respectively. A confidence interval of 95% was adopted for significant results. It was observed that 100% (n = 36) of the participants presented cow's milk allergy through the indirect ELISA, detecting IgE or IgG1 in serum and saliva. When serum IgE and IgG1 concentrations were compared, there was no statistical difference (p > 0.05) in 12 of the 14 foods evaluated. The same amount (n = 12) of non-significant differences (p > 0.05) was observed in the comparison of the 14 foods under IgE and IgG1 contractions in saliva. In the verification of the average values of IgE present in the serum and saliva of the foods, only cow's milk, fish and papaya showed statistically significant differences (p < 0.05). Of the total food evaluated, only the average levels of IgG1 present in serum and saliva showed a significant value (p < 0.05) in banana and tomato. These findings indicate that the detection of IgE and IgG1 in saliva proves to be as efficient as in the serum. The use of the salivary technique for use in the diagnosis of food allergy is suggested.
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