Современный взгляд на клиническую ценность исследования ротовой жидкости в практике врача-педиатра

В настоящее время актуализировано внимание врачебного сообщества к неинвазивному методу лабораторной диагностики – исследованию ротовой жидкости (пероральной, слюны, салива-теста) в различных областях клинической медицины и преимущественно у взрослых пациентов. Тестирование слюны показало хорошие результаты, особенно в области геномики, микробиомики, протеомики, метаболомики и транскриптомики. В обзоре представлены возможности использования неинвазивного метода при инфекционных и неинфекционных заболеваниях у детей. Слюна содержит широкий спектр белковых ДНК- и РНК-биомаркеров, которые помогают в выявлении множества вирусных инфекций у детей. Анализы ротовой жидкости на вирус иммунодефицита человека, вирус гепатита В улучшили доступ к диагностике для младенцев. Как серологические, так и молекулярные анализы ротовой жидкости подходят для рутинного обследования и раннего выявления РНК вируса кори, полиомавирусов и др. В слюне детей с COVID-19 обнаружена экспрессия рецептора ангиотензинпревращающего фермента-2, что может использоваться для диагностики SARS-CoV-2. Тест со слюной столь же эффективен, как и стандартный тест при выявлении бессимптомных лиц при отслеживании контактов. Возможности саливадиагностики положительно оценены в трансплантологии. Выявлены новые биомаркеры в слюне для диагностики многих соматических заболеваний у детей. Показана роль ротовой жидкости в качестве альтернативы сыворотки крови у пациентов с терминальной почечной недостаточностью, хронической болезнью почек (определение креатинина, мочевины) как у взрослых, так и детей. Полученные данные могут повлиять на рекомендации по лечению больных. Как неинвазивный метод исследование ротовой жидкости перспективно для диагностики, прогноза, мониторинга заболеваний, масштабного типирования детей и поиска новых биомаркеров.

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