Is Salivary Exosome the Answer to Early Detection of Oral Cancer?

Muy-Teck Teh*

Is Salivary Exosome the Answer to Early Detection of Oral Cancer?

The presence of exosomes almost all bodily fluids including saliva
represents a promising surrogate approach to investigate tumour markers.

This has important clinical implications for developing non-invasive
salivary diagnostics and therapeutics. Human saliva is an ideal fluid for developing
non-invasive diagnostics and salivary biomarkers have been demonstrated in clinical
studies showing promising diagnostic potentials but lacking in sensitivity mostly
due to complexity of saliva.

Hence, this led to the emerging interests on exosomes which are membrane-bound
extracellular vesicles carrying specific membrane proteins with numerous
types of nucleic acids and protein cargos well protected from degradation
by extracellular enzymes.

Their size  is an advantage for purification and reducing the overall complexity of saliva.
Most of the salivary exosome studies to date have been restricted to characterization of normal healthy samples.

Emerging studies began looking at biochemical properties of disease-derived saliva exosomes.
So, it seems no brainer that salivary exosome serves as the perfect target for finding a biomarker that could enable early oral cancer detection by means of a simple saliva test.

Site of tumour may have profound impact on the route where cancer exosomes enter.
For example, comparing a patient with tonsillar tumour whereby its cancer
exosomes may not be detectable in the patient’s saliva compared to a patient with
buccal or tongue tumour.

Given the anatomical complexity of the oral compartment,
coupled with presumably very low abundance of cancer exosomes
at early stages of tumour development, and in a chemically fluctuating
salivary environment, the challenges researchers are facing would be
analogy to detecting an individual’s cells in the sewage system.

Dent Open J. 2015; 2(2): e3-e4. doi: 10.17140/DOJ-2-e002

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