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Salivary Biomarkers Associated With Bone Deterioration in Patients With Medication-Related Osteonecrosis of the Jaws
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LETTER TO THE EDITOR J Oral Maxillofac Surg -:1, 2016
SALIVARY BIOMARKERS ASSOCIATED WITH BONE DETERIORATION IN PATIENTS WITH MEDICATION-RELATED OSTEONECROSIS OF THE JAWS
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for at least 6 hours before the collection of saliva samples. However, according to Navazesh and Li et al, saliva samples are collected 60 to 90 minutes after no eating or drinking. It is not obvious whether this difference in protocol could substantially affect the level of biomarkers and probably affect the results of the study. In addition, saliva alterations owing to the circadian rhythm necessitate collecting samples at a certain time of day, and the investigators did not make this clear.
To the Editor:—Kolokythas et al1 recently published an interesting article regarding the association of salivary biomarkers with bone deterioration. They suggested that using saliva, rather than serum or urine, could be an alternative for future studies of medication-related osteonecrosis of the jaw. Because it is the first report on the use of saliva for the detection of 2 bone turnover–related biomarkers (NTX and B-AP), a deeper look might be necessary: First, the exclusion criterion for the control group was the presence of active malignancy or active treatment with bisphosphonate or antiresorptive therapy. In this regard, the investigators did not mention excluding patients with other diseases, including brown tumor and Paget disease. In fact, patients with such diseases are routinely referred to the oral and maxillofacial surgery department, and their diseases affect B-AP level. Nevertheless, the investigators did not determine whether participants in the control group had any disease affecting B-AP level. Considering the small number of cases in this study, this issue might affect the results. Second, for the protocol of collecting and processing saliva samples, the investigators followed the protocols of Navazesh2 and Li et al.3 However, there seem to be some differences between the 2 protocols. In this study, participants were asked to avoid taking food or liquid
YASER FATHI ELHAM KEYKHA MAHDIEH-SADAT MOOSAVI Tehran, Iran
References 1. Kolokythas A, Karras M, Collins E, et al: Salivary biomarkers associated with bone deterioration in patients with medicationrelated osteonecrosis of the jaws. J Oral Maxillofac Surg 73: 1741, 2015 2. Navazesh M: Methods for collecting saliva. Ann N Y Acad Sci 694: 72, 1993 3. Li Y, St John MA, Zhou X, et al: Salivary transcriptome diagnostics for oral cancer detection. Clin Cancer Res 10:8442, 2004
http://dx.doi.org/10.1016/j.joms.2015.10.032
1 COR 5.4.0 DTD YJOMS57051_proof 16 December 2015 8:41 pm CE AH
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LETTER TO THE EDITOR J Oral Maxillofac Surg -:1, 2016
SALIVARY BIOMARKERS ASSOCIATED WITH BONE DETERIORATION IN PATIENTS WITH MEDICATION-RELATED OSTEONECROSIS OF THE JAWS
Q1
for at least 6 hours before the collection of saliva samples. However, according to Navazesh and Li et al, saliva samples are collected 60 to 90 minutes after no eating or drinking. It is not obvious whether this difference in protocol could substantially affect the level of biomarkers and probably affect the results of the study. In addition, saliva alterations owing to the circadian rhythm necessitate collecting samples at a certain time of day, and the investigators did not make this clear.
To the Editor:—Kolokythas et al1 recently published an interesting article regarding the association of salivary biomarkers with bone deterioration. They suggested that using saliva, rather than serum or urine, could be an alternative for future studies of medication-related osteonecrosis of the jaw. Because it is the first report on the use of saliva for the detection of 2 bone turnover–related biomarkers (NTX and B-AP), a deeper look might be necessary: First, the exclusion criterion for the control group was the presence of active malignancy or active treatment with bisphosphonate or antiresorptive therapy. In this regard, the investigators did not mention excluding patients with other diseases, including brown tumor and Paget disease. In fact, patients with such diseases are routinely referred to the oral and maxillofacial surgery department, and their diseases affect B-AP level. Nevertheless, the investigators did not determine whether participants in the control group had any disease affecting B-AP level. Considering the small number of cases in this study, this issue might affect the results. Second, for the protocol of collecting and processing saliva samples, the investigators followed the protocols of Navazesh2 and Li et al.3 However, there seem to be some differences between the 2 protocols. In this study, participants were asked to avoid taking food or liquid
YASER FATHI ELHAM KEYKHA MAHDIEH-SADAT MOOSAVI Tehran, Iran
References 1. Kolokythas A, Karras M, Collins E, et al: Salivary biomarkers associated with bone deterioration in patients with medicationrelated osteonecrosis of the jaws. J Oral Maxillofac Surg 73: 1741, 2015 2. Navazesh M: Methods for collecting saliva. Ann N Y Acad Sci 694: 72, 1993 3. Li Y, St John MA, Zhou X, et al: Salivary transcriptome diagnostics for oral cancer detection. Clin Cancer Res 10:8442, 2004
http://dx.doi.org/10.1016/j.joms.2015.10.032
1 COR 5.4.0 DTD YJOMS57051_proof 16 December 2015 8:41 pm CE AH
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