Salivary biosensors for screening trauma-related psychopathology

Abstract

After facial trauma, a distinct subset of patients goes on to develop mental health problems including recalcitrant psychopathology. Early identification of maladaptive stress reactions provides opportunities for initiating preemptive mental health interventions and hinges on the surgeon's ability to differentiate between transient distress and precursors of recalcitrant psychiatric sequelae. The comprehensive care of injured patients will benefit greatly from objective adjuncts and decision-making tools to complement the clinical evaluation. This article addresses meeting the need for practical, standardized, and reliable screening strategies through promising developments in the use of stress response biomarkers and biosensing technology. The systematic interrogation of differentially expressed stress response biomarkers in saliva now permits rapid assessment of the psychopathogical response to the stressor. Quantitative, point-of-use measurements of the traumatic stress response will greatly improve the nosology of posttraumatic stress disorders and help advance the screening, diagnosis, treatment, and prevention of mental health consequences of violence and trauma.

Figure 1

Components of a typical biosensor.

Figure 2

Illustration of various biosensing approaches for the detection of salivary biomarkers. (a) Local Surface Plasmon Resonance; (b) Enzyme sensor; (c) Surface Plasmon Resonance; (d) DNA chip.

Figure 3

Saliva collection strip and prototype biosensor for point-of-use measurement of salivary alpha-amylase (sAA).

Figure 4

Concordance between sAA biosensors and Olympus analyzer.

Figure 5

Linear regression fit to mean biosensor values.

Figure 6

Reproducibility of sAA biosensor verified by repeat measurements of 5 saliva samples. Negligible variation from the “true value” (horizontal lines representing the Olympus AU400 readings) indicate minimal measurement drift.