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Evaluating Novel Biomarkers for Personalized Medicine

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 16856

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Prof. Dr. Tudor Drugan

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Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania
Interests: medical research methodology; biostatistics; bioinformatics

Dr. Daniel Leucuta

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Special Issue Information

Dear Colleagues,

Standard and cutting-edge biomarkers for the diagnosis and evaluation of different illnesses will be covered in this Special Issue. The emphasis will be on personalized medicine, since this innovative strategy enables healthcare professionals to identify the most effective therapies for each patient by using diagnostic tests and biomarkers.

Evidence-based findings indicate that many medications are unsuccessful for some individuals, and hence this method is crucial. Healthcare professionals can create individual preventative and treatment plans by considering the patient's medical history as well as biomarkers throughout the diagnosis process. This strategy benefits patients and the healthcare system, according to several cost-effectiveness studies.

Treatments that are customized for each patient offer both medical and financial benefits, making them not only essential for patients and physicians, but also welcomed by regulatory agencies as well as insurance providers.

We encourage authors with expertise in a variety of medical areas to share their knowledge by submitting both original research and review articles. Authors from referral centers for cutting-edge therapy are especially encouraged to contribute.

Prof. Dr. Tudor Drugan
Dr. Daniel Leucuta
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

biomarkers
diagnostic tests
personalized medicine

Published Papers (12 papers)

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Editorial

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4 pages, 173 KiB

Open AccessEditorial

Evaluating Novel Biomarkers for Personalized Medicine

by Tudor Drugan and Daniel Leucuța

Diagnostics 2024, 14(6), 587; https://doi.org/10.3390/diagnostics14060587 - 11 Mar 2024

Viewed by 900

Abstract

Personalized medicine, sometimes referred to as precision medicine, is a paradigm shift in healthcare [...] Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

Research

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13 pages, 831 KiB

Open AccessArticle

Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index

by Efsun Somay, Erkan Topkan, Busra Yilmaz, Ali Ayberk Besen, Hüseyin Mertsoylu and Ugur Selek

Diagnostics 2023, 13(23), 3594; https://doi.org/10.3390/diagnostics13233594 - 4 Dec 2023

Cited by 1 | Viewed by 835

Abstract

To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as ′GLUCAR = (Fasting Glucose × CRP/Albumin Ratio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR ˂ 1.8 (N = 78) and GLUCAR ≥ 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR ≥ 31.8 (84.4% vs. 47.4% for GLUCAR ˂ 31.8; odds ratio (OR):1.82; p < 0.001). In the univariate analysis, the mean mandibular dose ≥ 38.5 Gy group (76.5% vs. 54.9% for <38.5 Gy; OR: 1.45; p = 0.008), mandibular V55.2 Gy group ≥ 40.5% (80.3 vs. 63.5 for <40.5%, p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis (p < 0.05 for each). Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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11 pages, 1785 KiB

Open AccessArticle

Inflammatory Status Assessment by Machine Learning Techniques to Predict Outcomes in Patients with Symptomatic Aortic Stenosis Treated by Transcatheter Aortic Valve Replacement

by Alexandru Stan, Paul-Adrian Călburean, Reka-Katalin Drinkal, Marius Harpa, Ayman Elkahlout, Viorel Constantin Nicolae, Flavius Tomșa, Laszlo Hadadi, Klara Brînzaniuc, Horațiu Suciu and Marius Mărușteri

Diagnostics 2023, 13(18), 2907; https://doi.org/10.3390/diagnostics13182907 - 11 Sep 2023

Viewed by 691

Abstract

(1) Background: Although transcatheter aortic valve replacement (TAVR) significantly improves long-term outcomes of symptomatic severe aortic stenosis (AS) patients, long-term mortality rates are still high. The aim of our study was to identify potential inflammatory biomarkers with predictive capacity for post-TAVR adverse events from a wide panel of routine biomarkers by employing ML techniques. (2) Methods: All patients diagnosed with symptomatic severe AS and treated by TAVR since January 2016 in a tertiary center were included in the present study. Three separate analyses were performed: (a) using only inflammatory biomarkers, (b) using inflammatory biomarkers, age, creatinine, and left ventricular ejection fraction (LVEF), and (c) using all collected parameters. (3) Results: A total of 338 patients were included in the study, of which 56 (16.5%) patients died during follow-up. Inflammatory biomarkers assessed using ML techniques have predictive value for adverse events post-TAVR with an AUC-ROC of 0.743 and an AUC-PR of 0.329; most important variables were CRP, WBC count and Neu/Lym ratio. When adding age, creatinine and LVEF to inflammatory panel, the ML performance increased to an AUC-ROC of 0.860 and an AUC-PR of 0.574; even though LVEF was the most important predictor, inflammatory parameters retained their value. When using the entire dataset (inflammatory parameters and complete patient characteristics), the ML performance was the highest with an AUC-ROC of 0.916 and an AUC-PR of 0.676; in this setting, the CRP and Neu/Lym ratio were also among the most important predictors of events. (4) Conclusions: ML models identified the CRP, Neu/Lym ratio, WBC count and fibrinogen as important variables for adverse events post-TAVR. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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13 pages, 579 KiB

Open AccessArticle

Serum Adropin Levels and Body Mass Composition in Kidney Transplant Recipients—Are There Sex Differences?

by Josipa Radić, Sanja Lovrić Kojundžić, Andrea Gelemanović, Marijana Vučković, Danijela Budimir Mršić, Daniela Šupe Domić, Maja Dodig Novaković and Mislav Radić

Diagnostics 2023, 13(17), 2768; https://doi.org/10.3390/diagnostics13172768 - 26 Aug 2023

Viewed by 791

Abstract

Adropin is a secretory peptide that regulates glucose, lipid, and protein metabolism, which is closely related to obesity, insulin resistance, dyslipidemia, and atherogenesis. The serum adropin level is related to sex and depends upon nutritional preferences. This study aims to determine the association between serum adropin levels and body composition parameters in kidney transplant recipients (KTRs), especially emphasizing sex differences. Our case–control study involved 59 KTRs (28 postmenopausal women and 31 men) who were divided into two groups according to sex, and each group of those KTRs was further divided into higher or lower adropin values than the mean value in each sex group. Univariate regression showed a negative association of adropin levels with most anthropometric and body composition parameters in men’s KTRs. Contrary to this, the serum adropin level was negatively associated only with phase angle in postmenopausal female KTRs. Multivariate regression showed that skeletal muscle mass and phase angle were the only negative predictors in women’s KTRs, whereas in men, negative predictors were BMI and body water. These findings imply that adropin could have a different impact on metabolic homeostasis in KTRs regarding sex and could be considered a negative predictor of body composition in KTRs. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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17 pages, 821 KiB

Open AccessArticle

Prognosis Predictive Markers in Patients with Chronic Obstructive Pulmonary Disease and COVID-19

by Nicoleta Ștefania Motoc, Iulia Făgărășan, Andrada Elena Urda-Cîmpean and Doina Adina Todea

Diagnostics 2023, 13(15), 2597; https://doi.org/10.3390/diagnostics13152597 - 4 Aug 2023

Cited by 4 | Viewed by 1093

Abstract

Some studies have reported that chronic respiratory illnesses in patients with COVID-19 result in an increase in hospitalization and death rates, while other studies reported to the contrary. The present research aims to determine if a predictive model (developed by combing different clinical, imaging, or blood markers) could be established for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19, in order to be able to foresee the outcomes of these patients. A prospective observational cohort of 165 patients with both diseases was analyzed in terms of clinical characteristics, blood tests, and chest computed tomography results. The beta-coefficients from the logistic regression were used to create a score based on the significant identified markers for poor outcomes (transfers to an intensive care unit (ICU) for mechanical ventilation, or death). The severity of COVID-19, renal failure, diabetes, smoking status (current or previous), the requirement for oxygen therapy upon admission, high lactate dehydrogenase (LDH) and C-reactive protein level (CRP readings), and low eosinophil and lymphocyte counts were all identified as being indicators of a poor prognosis. Higher mortality was linked to the occurrence of renal failure, the number of affected lobes, the need for oxygen therapy upon hospital admission, high LDH, and low lymphocyte levels. Patients had an 86.4% chance of dying if their mortality scores were −2.80 or lower, based on the predictive model. The factors that were linked to a poor prognosis in patients who had both COPD and COVID-19 were the same as those that were linked to a poor prognosis in patients who had only COVID-19. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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11 pages, 703 KiB

Open AccessArticle

Triiodothyronine and Protein Malnutrition Could Influence Pulse Wave Velocity in Pre-Dialysis Chronic Kidney Disease Patients

by Crina Claudia Rusu, Ina Kacso, Diana Moldovan, Alina Potra, Dacian Tirinescu, Maria Ticala, Ancuta M. Rotar, Remus Orasan, Cristian Budurea, Andrada Barar, Florin Anton, Ana Valea, Cosmina Ioana Bondor and Madalina Ticolea

Diagnostics 2023, 13(14), 2462; https://doi.org/10.3390/diagnostics13142462 - 24 Jul 2023

Cited by 1 | Viewed by 1117

Abstract

Cardiovascular diseases (CVD) are the first cause of chronic kidney disease (CKD) mortality. For personalized improved medicine, detecting correctable markers of CVD can be considered a priority. The aim of this study was the evaluation of the impact of nutritional, hormonal and inflammatory markers on brachial-ankle Pulse Wave Velocity (PWV) in pre-dialysis CKD patients. A cross-sectional observational study was conducted on 68 pre-dialysis CKD patients (median age of 69 years, 41.2% with diabetes mellitus, 52.9% male). Laboratory data were collected, including levels of prolactin, triiodothyronine, TGF α, IL-6, and IL-1β. The high values of brachial-ankle PWV were associated with reduced muscle mass (p = 0.001, r = −0.44), low levels of total cholesterol (p = 0.04, r = −0.26), triglycerides (p = 0.03, r = −0.31), triiodothyronine (p = 0.04, r = −0.24), and prolactin (p = 0.02, r = −0.27). High PWV was associated with advanced age (p < 0.001, r = 0.19). In the multivariate analysis, reduced muscle mass (p = 0.018), low levels of triiodothyronine (p = 0.002), and triglycerides (p = 0.049) were significant predictors of PWV, but age (p < 0.001) remained an important factor. In conclusion, reduced triiodothyronine together with markers of malnutrition and age were associated with PWV in pre-dialysis CKD patients. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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15 pages, 4179 KiB

Open AccessArticle

Identifying Optical Coherence Tomography Markers for Multiple Sclerosis Diagnosis and Management

by Larisa Cujba, Cristina Stan, Ovidiu Samoila, Tudor Drugan, Ancuta Benedec (Cutas) and Cristina Nicula

Diagnostics 2023, 13(12), 2077; https://doi.org/10.3390/diagnostics13122077 - 15 Jun 2023

Cited by 2 | Viewed by 1217

Abstract

Background: Multiple sclerosis (MS) is a common neurological disease affecting the optic nerve, directly or indirectly, through transsynaptic axonal degeneration along the visual pathway. New ophthalmological tools, arguably the most important being optical coherence tomography (OCT), could prove paramount in redefining MS diagnoses and shaping their follow-up protocols, even when the optic nerve is not involved. Methods: A prospective clinical study was conducted. In total, 158 eyes from patients previously diagnosed with relapsing remitting MS (RRMS)—with or without optic neuritis (ON), clinically isolated syndrome (CIS) with or without ON, and healthy controls were included. Each patient underwent an ophthalmologic exam and OCT evaluation for both eyes (a posterior pole analysis (PPA) and the optic nerve head radial circle protocol (ONH-RC)). Results: The macular retinal thickness (the 4 × 4, respectively, 2 × 2 grid) and thickness of the peripapillary retinal nerve fiber layer (pRNFL) were investigated. Various layers of the retina were also compared. Our study observed significant pRNFL thinning in the RRMS eyes compared to the control group, the pRNFL atrophy being more severe in the RRMS-ON eyes than the RRMS-NON eyes. In the ON group, the macular analysis showed statistically significant changes in the RRMS-ON eyes when compared only to the CIS-ON eyes, regarding decreases in the inner plexiform layer (IPL) thickness and inner nuclear layer (INL) on the central 2 × 2 macular grid. The neurodegenerative process affected both the inner retina and pRNFL, with clinical damage appearing for the latter in the following order: CIS-NON, CIS-ON, RRMS-NON, and RRMS-ON. In the presence of optic neuritis, SMRR patients presented an increase in their outer retina thickness compared to CIS patients. Conclusions: To differentiate the MS patients from the CIS patients, in the absence of optic neuritis, OCT Posterior Pole Analysis could be a useful tool when using a central 2 × 2 sectors macular grid. Retinal changes in MS seem to start from the fovea and spread to the posterior pole. Finally, MS could lead to alterations in both the inner and outer retina, along with pRNFL. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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14 pages, 1316 KiB

Open AccessArticle

Identification of Histopathological Biomarkers in Fatal Cases of Coronavirus Disease: A Study on Lung Tissue

by Ioana-Andreea Gheban-Roșca, Bogdan-Alexandru Gheban, Bogdan Pop, Daniela-Cristina Mironescu, Vasile Costel Siserman, Elena Mihaela Jianu, Tudor Drugan and Sorana D. Bolboacă

Diagnostics 2023, 13(12), 2039; https://doi.org/10.3390/diagnostics13122039 - 12 Jun 2023

Cited by 2 | Viewed by 1535

Abstract

We aimed to evaluate the primary lung postmortem macro- and microscopic biomarkers and factors associated with diffuse alveolar damage in patients with fatal coronavirus (COVID-19). We retrospectively analyzed lung tissue collected from autopsies performed in Cluj-Napoca, Romania, between April 2020 and April 2021 on patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We examined 79 patients with confirmed SARS-CoV-2 infection, ages 34 to 96 years, split into two groups using the cut-off value of 70 years. Arterial hypertension (38%) and type 2 diabetes mellitus (19%) were the most common comorbidities with similar distribution between groups (p-values > 0.14). Macroscopically, bloody exudate was more frequently observed among patients < 70 years (33/36 vs. 29/43, p-value = 0.0091). Diffuse alveolar damage (53.1%) was similarly observed among the evaluated groups (p-value = 0.1354). Histopathological biomarkers of alveolar edema in 83.5% of patients, interstitial pneumonia in 74.7%, and microthrombi in 39.2% of cases were most frequently observed. Half of the evaluated lungs had an Ashcroft score of up to 2 and an alveolar air capacity of up to 12.5%. Bronchopneumonia (11/43 vs. 3/36, p-value = 0.0456) and interstitial edema (9/43 vs. 2/36, p-value = 0.0493) were significantly more frequent in older patients. Age (median: 67.5 vs. 77 years, p-value = 0.023) and infection with the beta variant of the virus (p-value = 0.0071) proved to be significant factors associated with diffuse alveolar damage. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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13 pages, 1332 KiB

Open AccessArticle

The Role of Immunohistochemistry in the Differential Diagnosis between Intrahepatic Cholangiocarcinoma, Hepatocellular Carcinoma and Liver Metastasis, as Well as Its Prognostic Value

by Lavinia Patricia Mocan, Ioana Rusu, Carmen Stanca Melincovici, Bianca Adina Boșca, Tudor Mocan, Rareș Crăciun, Zeno Spârchez, Maria Iacobescu and Carmen Mihaela Mihu

Diagnostics 2023, 13(9), 1542; https://doi.org/10.3390/diagnostics13091542 - 25 Apr 2023

Cited by 5 | Viewed by 3407

Abstract

Intrahepatic cholangiocarcinoma (iCCA) is the second most frequent primary hepatic malignant tumor, after hepatocellular carcinoma (HCC). Its incidence has risen worldwide, yet the only potentially curative treatment, surgical resection, is seldom applicable, and the median overall survival remains extremely low. So far, there are no personalized therapy regimens. This study investigated whether routine immunohistochemical stains have diagnostic and/or prognostic value in iCCA. Clinical, imaging, and pathology data were retrospectively gathered for patients diagnosed with iCCA, HCC, or liver metastases assessed using liver needle biopsies. Three study groups with an equal number of cases (n = 65) were formed. In the iCCA group, CK19, CA19-9, CK7, and CEA demonstrated the highest sensitivities (100%, 100%, 93.7%, and 82.6%, respectively). The most relevant stains used for diagnosing HCCs were Glypican 3, CD34 (sinusoidal pattern), and Hep Par 1, with corresponding sensitivities of 100%, 100%, and 98.2%. The immunohistochemical panels for diagnosing metastatic tumors were chosen after correlating the clinical data and morphologic H&E aspects. Moderate/intensely positive CK7 expression and absent/low amount of intratumoral immune cells were favorable prognostic factors and correlated with increased overall survival in both the univariate analysis and the multivariate regression adjusted for age, existence of cirrhosis, number of tumors, and tumor differentiation. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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10 pages, 440 KiB

Open AccessArticle

Chitotriosidase and Neopterin as Two Novel Potential Biomarkers for Advanced Stage and Survival Prediction in Gastric Cancer—A Pilot Study

by Vlad-Ionuţ Nechita, Nadim Al Hajjar, Cristina Drugan, Cristina-Sorina Cătană, Emil Moiş, Mihaela-Ancuţa Nechita and Florin Graur

Diagnostics 2023, 13(7), 1362; https://doi.org/10.3390/diagnostics13071362 - 6 Apr 2023

Cited by 1 | Viewed by 1282

Abstract

Gastric cancer is the fifth type of neoplasia most frequently diagnosed and the fourth cause of death among other cancers. Prevalence is around two times higher for males than females. Chitotriosidase and neopterin are two molecular biomarkers with potential diagnostic and prognostic use in malignant pathology. We conducted a longitudinal prospective cohort study on thirty-nine patients with gastric adenocarcinoma, with a male-to-female ratio of 1.78 and an average age of 64.3 ± 9.97 years. No statistically significant differences in biomarker levels at presentation were observed between curative-intent surgery (28 patients) and advanced cases, suited only for palliative procedures (11 patients). Biomarker values were not significantly different for the advanced T stage and the presence of metastasis (p > 0.05—Mann Whitney test). The patients that died in the first 30 days after surgery did not present significantly different values at baseline, in comparison with those that had longer survival times, though a significant cut-off value was observed for chitotriosidase activity at 310 nmol/mL/h [AUC (area under the curve) = 0.78; 95% CI (0.61–0.92)]. The cut-off values corresponding to death after the first year, tumor invasion, and metastasis were not statistically significant. In the COX multivariate model, neopterin did not validate itself as a prognostic biomarker, however, chitotriosidase activity before surgery was significantly associated with overall survival (HR = 1.0038, p = 0.03). We conclude that chitotriosidase may have the potential to improve the prognostic model for gastric adenocarcinoma. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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16 pages, 3009 KiB

Open AccessArticle

Relationship between Systemic Inflammatory Markers, GLUT1 Expression, and Maximum 18F-Fluorodeoxyglucose Uptake in Non-Small Cell Lung Carcinoma and Their Prognostic Significance

by Sonya Youngju Park, Deog-Gon Cho, Byoung-Yong Shim and Uiju Cho

Diagnostics 2023, 13(6), 1013; https://doi.org/10.3390/diagnostics13061013 - 7 Mar 2023

Cited by 1 | Viewed by 1389

Abstract

Background: Factors involved in inflammation and cancer interact in various ways with each other, and biomarkers of systemic inflammation may have a prognostic value in cancer. Glucose transporter 1 (GLUT1) plays a pivotal role in glucose transport and metabolism and it is aberrantly expressed in various cancer types. We evaluated the differential expression of GLUT1, along with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in non-small-cell lung cancer (NSCLC), and then analyzed their prognostic significance. Methods: A total of 163 patients with resectable NSCLC were included in this study. Tumor sections were immunohistochemically stained for GLUT1 and GLUT3. Maximum standardized uptake value (SUV_max) was measured by preoperative FDG-PET, and neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) were derived from pretreatment blood count. Results: GLUT1 and GLUT3 was positively expressed in 74.8% and 6.1% of the NSCLC tissues, respectively. GLUT1 expression was significantly correlated with squamous cell carcinoma histology, poor differentiation, high pathologic stage, old age, male, smoking, and high SUV_max (>7) (all p < 0.05). The squamous cell carcinoma and smoker group also showed significantly higher SUV_max (both p < 0.001). Systemic inflammation markers, including NLR, PLR, and LMR, were positively correlated with high SUV_max (all p < 0.05). High GLUT1 expression, high SUV_max, high NLR, and low LMR, were significantly associated with poor overall survival in patients with NSCLC. However, in the multivariate survival analysis, LMR was an independent prognostic factor overall (HR 1.86, 95% CI 1.05–3.3) and for the stage I/II cohort (HR 2.3, 95% CI 1.24–4.3) (all p < 0.05). Conclusions: Systemic inflammatory markers—NLR, PLR, and LMR are strongly correlated with the SUV_max and are indicators of aggressive tumor behavior. Specifically, LMR is a promising prognostic biomarker in NSCLC patients. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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Review

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23 pages, 402 KiB

Open AccessReview

Salivary Biomarkers of Anti-Epileptic Drugs: A Narrative Review

by Ioana-Andreea Chiș, Vlad Andrei, Alexandrina Muntean, Marioara Moldovan, Anca Ștefania Mesaroș, Mircea Cristian Dudescu and Aranka Ilea

Diagnostics 2023, 13(11), 1962; https://doi.org/10.3390/diagnostics13111962 - 4 Jun 2023

Cited by 2 | Viewed by 1658

Abstract

Saliva is a biofluid that reflects general health and that can be collected in order to evaluate and determine various pathologies and treatments. Biomarker analysis through saliva sampling is an emerging method of accurately screening and diagnosing diseases. Anti-epileptic drugs (AEDs) are prescribed generally in seizure treatment. The dose–response relationship of AEDs is influenced by numerous factors and varies from patient to patient, hence the need for the careful supervision of drug intake. The therapeutic drug monitoring (TDM) of AEDs was traditionally performed through repeated blood withdrawals. Saliva sampling in order to determine and monitor AEDs is a novel, fast, low-cost and non-invasive approach. This narrative review focuses on the characteristics of various AEDs and the possibility of determining active plasma concentrations from saliva samples. Additionally, this study aims to highlight the significant correlations between AED blood, urine and oral fluid levels and the applicability of saliva TDM for AEDs. The study also focuses on emphasizing the applicability of saliva sampling for epileptic patients. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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