Psychological stress impairs homeostasis in many aspects, including immune dysregulation with
important variability according to age and sex. Use of easily accessible biomarkers is of
importance to assess these changes in fragile subjects, as for example children, especially
in a context of exposure to childhood stress experience, when invasive sampling procedures
may increase the psychic stress.
Saliva is a promising tool which has been used both for acute and chronic stress Several
salivary immune biomarkers are now considered to be sensitive and reliable readouts of mental
stress in adult patients, among them free cortisol, alpha-amylase (sAA) and secretory
immunoglobulin IgA (sIgA), IgM, IgG and opiorphin (OPI).
These four biomarkers may be measured easily in saliva, but in variable amounts according to
age and sex, as well as in response to psychological stress. The main objective of this
exploratory study was therefore to compare salivary levels of opiorphin, cortisol, sAA, sIgA,
IgM, IgG in two groups of healthy children, 6-12 years old, a developmental age critical to
mental disorders and dental interventional treatment, with ELISA tests.
This study's aim is a measuring stress/immune biomarkers in saliva of healthy school-age
children and compare subgroups according to age, sex, stress perception in dental pain
related to symptomatic irreversible pulpitis (SIP) and symptomatic apical periodontitis
(SAP).
Material and methods: 50 children diagnosed with SIP and SAP aged from 6 to 12 years old will
be treated with root canal treatment. Dental examination using DMF score and oral hygiene
level will be performedby experienced dentists. Salivary samples will be collected three
times: before treatment in day of first dental visit (1), after two weeks (2), and after next
two weeks = 30 days (3). Additionally, pain and stress perception will be examined by VAS
scale and questionnaires dedicated for children anxiety: Frankl behavior rating scale,
Venham's anxiety and behavior rating scale. Salivary immunoglobullins A, G, M, opiorphin,
free cortisol and amylase will be measured using commercially available ELISA kits. Results
will assess which of the measured salivary biomarkers is related to stress and dental pain,
suggesting its use for evaluating in non-invasive way in childhood.
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