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Chloride and sodium determination in saliva by direct ion selective electrode technique : a possible method for cystic fibrosis diagnosis

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Author(s):
Aline Cristina Gonçalves
Total Authors: 1
Document type: Doctoral Thesis
Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
Defense date:
Examining board members:
Edson Antunes; Fernanda Loureiro de Andrade Orsi; Jose Espin Neto; Giesela Fleischer Ferrari
Advisor: Carlos Emíio Levy; Antonio Fernando Ribeiro
Abstract

Background: Systemic diseases, such as cystic fibrosis (CF), influence both the amount of saliva produced and the quality of this fluid, as the chemical constituents and the physical properties. Several studies confirm the diagnostic value of saliva. CF is characterized by a defect in ionic transport through the cell membrane in epithelial cells of the airways, pancreas, salivary glands, sweat glands, intestine and reproductive system. There is scientific evidence that chloride and sodium concentrations in the saliva of CF patients are significantly higher when compared to the concentrations of these ions in non-CF subjects. This fact stimulated us to investigate the feasibility of chloride dosage in saliva as an alternative diagnostic method to the sweat test, because the saliva test is low cost and the equipment has easy access in the public health system. Objective: To evaluate the possibility use of saliva chloride dosage by the direct selective ion electrode technique as an alternative diagnostic method for cystic fibrosis. Patients and methods: A cross-sectional, prospective study with a group of patients with cystic fibrosis selected at CERFC Unicamp and a control group of individuals with no evidence of disease. The chloride and sodium concentrations of the saliva were analyzed by the direct selective ion electrode technique and the same sweat ions were measured respectively by titration and by flame photometry. Both groups (FC and Control) were composed of 125 participants since 2 months of age, regardless of gender or ethnicity. Results: The chloride and sodium concentrations in saliva were statistically higher in the CF patients when compared to the control group. With the application of the ROC curve we determined the cut-off of 14.5 mmol / L for chloride in saliva 1 (Sensitivity = 80.6%, specificity = 68.1%, positive predictive value = 71.6%, negative predictive value = 77.8%). Conclusions: Our results suggest a concordance of chloride and sodium concentrations in saliva and sweat, that means that both fluids have a physiologically similar behavior, evidencing the possibility of the use of the chloride and sodium dosage in the saliva by direct ion selective electrode technique as a screening and / or diagnostic complementary test (AU)

FAPESP's process: 14/00611-2 - Saliva as method diagnostic of the cystic fibrosis
Grantee:Aline Cristina Gonçalves
Support type: Scholarships in Brazil - Doctorate