Correspondence to Antici et al. Salivary CRP predicts treatment response to virtual reality exposure therapy for social anxiety disorder.

The study by Antici et al. (2024) investigates the effects of virtual reality exposure therapy on social anxiety disorder (SAD), focusing on the relationship between C-reactive protein (CRP) levels in saliva and therapy outcomes. Findings indicate that this therapy not only reduces SAD symptoms and discomfort but also correlates with decreased systemic inflammation, as evidenced by lowered CRP levels. Remarkably, higher baseline CRP levels predicted a greater reduction in anxiety symptoms, suggesting a unique response pattern in SAD compared to other psychological disorders. This study highlights systemic inflammation's significance in SAD and the promise of non-invasive biomarkers like salivary CRP for managing psychological disorders. It calls for more research to understand the underlying mechanisms and validate these initial findings.

The diagnostic value of salivary C-reactive protein in neonatal infections: a meta-analysis.

PURPOSE: C-reactive protein (CRP), as an acute phase protein, is a sensitive indicator of neonatal bacterial infection. Some recent studies have shown that there is a correlation between CRP levels in serum and saliva, and using saliva to detect CRP levels is expected to be an ideal and non-invasive method to predict neonatal infection. The purpose of this Meta-analysis was to evaluate the diagnostic value of salivary CRP for neonatal infection. METHODS: We searched PubMed, Embase, Web of Science, and Scopus databases in October 2023 and included observational studies that examined salivary CRP in newborns with bacterial infections. Data was extracted regarding the methodology, participant characteristics, and outcome measures. RESULTS: Nine articles were included, with a total of 696 newborns. Salivary CRP levels are significantly higher in neonates with infections compared to non-infected group (SMD = 0.58, 95%CI [0.40-0.76], P < 0.001). The accuracy for salivary CRP to predict serum CRP abnormality is high (sensitivity 86%, specificity 88%, area under the curve = 0.94). CONCLUSIONS: Our meta-analysis suggested that salivary CRP can be used as an alternative biomarker to serum CRP for detecting neonatal infection.

Examining the Utility of Rapid Salivary C-Reactive Protein as a Predictor for Neonatal Sepsis: An Analytical Cross-Sectional Pilot Study.

This study aimed to compare the rapid bedside quantitative assessment of C-reactive protein (CRP) in saliva to serum CRP to predict blood culture-positive sepsis in neonates. The research was carried out over eight months at Fernandez Hospital in India (February 2021-September 2021). The study included 74 randomly selected neonates with clinical symptoms or risk factors of neonatal sepsis requiring blood culture evaluation. SpotSense rapid CRP test was conducted to estimate salivary CRP. In analysis, the area under the curve (AUC) on the receiver operating characteristics (ROC) curve was used. The study population's mean gestational age and median birth weight were 34.1 weeks (SD: ±4.8) and 2370 g (IQR: 1067-3182). The AUC on ROC curve analysis for predicting culture-positive sepsis was 0.72 (95% CI: 0.58 to 0.86, p-value: 0.002) for serum CRP and 0.83 (95% CI: 0.70 to 0.97, p-value: <0.0001) for salivary CRP. The Pearson correlation coefficient between salivary and serum CRP was moderate (r = 0.352, p-value: 0.002). Salivary CRP cut-off scores were comparable to serum CRP in terms of sensitivity, specificity, PPV, NPV, and accuracy in predicting culture-positive sepsis. The rapid bedside assessment of salivary CRP appears to be an easy and promising non-invasive tool in culture-positive sepsis prediction.

Salivary C-Reactive Protein and Mean Platelet Volume in the Diagnosis and Follow-Up of Community-Acquired Pneumonia in Infants.

Background: Community-acquired pneumonia (CAP) in infants is a major cause of morbidity and mortality, especially in developing countries. Increased salivary C-reactive protein (CRP) levels have been demonstrated in neonatal pneumonia and other diseases. We investigated the applicability of CRP and mean platelet volume (MPV) in the diagnosis and follow-up of CAP in infants. Methods: This prospective observational study included 45 infants admitted for CAP. We measured serum and salivary CRP levels via ELISA, while MPV was measured using an automated blood cell counter. Results: Both salivary and serum CRP values were significantly different in the studied population between admission and follow-up (P = 0.001 and P < 0.0001, respectively). The same was observed for MPV (P < 0.0001). We found significant positive correlations between serum and salivary CRP (r = 0.652, P < 0.0001) and between serum CRP and MPV (r = 0.495, P = 0.001), as well as between salivary CRP and MPV (r = 0.439, P = 0.003). Receiver operating curve analysis showed that salivary CRP at a cutoff value of 3.2 ng/L had a sensitivity of 97.2% and specificity of 90%, while MPV at a cutoff value of 8.4 fL showed 91% sensitivity and 90% specificity. Conclusions: The present study showed that both salivary CRP and MPV are reliable diagnostic markers of CAP in infants.

Evaluation of serum and salivary C-reactive protein for diagnosis of late-onset neonatal sepsis: A single center cross-sectional study.

OBJECTIVE: To evaluate the diagnostic utility of salivary C-reactive protein (CRP) and its potential correlation with serum CRP levels in full-term neonates with late-onset sepsis (LOS). METHODS: This cross-sectional study included 90 neonates assigned to three equal groups: culture proven LOS, clinical LOS and a control group. Clinical findings and routine laboratory data including complete blood pictures and blood culture results were documented. Highly sensitive serum CRP was measured according to hospital protocol, while salivary CRP levels were measured using enzyme-linked immunosorbent assay. RESULTS: The median serum CRP was significantly higher in septic neonates compared to controls (p < 0.001). For serum CRP, the optimum cut-off value for LOS diagnosis was found to be 7.2 mg/L with sensitivity, specificity, positive and negative predictive values of 91, 100, 100, and 85.7%, respectively. No significant difference was observed in levels of salivary CRP among the 3 study groups (p = 0.39). No correlation was found between the levels of salivary and serum CRP (r = 0.074, p = 0.49). CONCLUSION: Serum CRP, at a cut-off value of 7.2 mg/L, exhibited a high specificity and positive predictive value in LOS diagnosis, whereas salivary CRP levels weren't significantly different between the 3 study groups nor did they predict abnormal serum CRP thresholds in newborns with sepsis.

Salivary C-reactive protein and mean platelet volume in diagnosis of late-onset neonatal pneumonia.

BACKGROUND: Neonatal pneumonia is an important and major cause of neonatal morbidity and mortality worldwide therefore; its early detection plays a crucial role in successful therapy. Analysis of saliva as a non-invasive method for detection of neonatal diseases holds great promise for improving health care. Till now, salivary C-reactive protein (CRP), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR) and platelets/lymphocytes ratio (PLR) have not been studied as markers of diagnosis in neonatal pneumonia. OBJECTIVE: To assess the applicability of salivary CRP, MPV, NLR and PLR as diagnostic markers in late-onset neonatal pneumonia. METHODS: A prospective case control study of 70 full-term neonates, 35 with late-onset neonatal pneumonia and 35 healthy controls, was enrolled. Serum and salivary CRP concentrations were measured by ELISA, while MPV, NLR and PLR were measured by automated blood cell counter. RESULTS: This study showed a statistically significant difference between salivary CRP means in neonates with late-onset neonatal pneumonia vs control neonates (6.2 ± 4.6 and 2.8 ± 1.9 ng/L) respectively. At the cutoff point of 3.8 ng/L, salivary CRP showed 91.4% sensitivity and 80.9% specificity. Salivary CRP also showed accuracy in predicting elevated serum CRP in neonates with pneumonia. MPV showed a significant difference between pneumonia and controls (mean = 10.2 ± 0.7, 8 ± 0.5) respectively. At cutoff point 9.0, it has 80% sensitivity and specificity. CONCLUSIONS: The present study showed for the first time that both salivary CRP and MPV are suitable as diagnostic markers in late-onset neonatal pneumonia.

Salivary C-reactive protein, mean platelet volume and neutrophil lymphocyte ratio as diagnostic markers for neonatal sepsis.

OBJECTIVE: To assess the applicability of salivary C-reactive protein, mean platelet volume, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio in the diagnosis of neonatal sepsis. METHODS: Prospective case-control study of 70 full-term neonates, 35 with sepsis (20 with proven sepsis and 15 with clinical sepsis) and 35 healthy controls. Serum and salivary C-reactive protein concentrations were measured by enzyme-linked immunosorbent assay while mean platelet volume, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio were measured by automated blood cell counter. RESULTS: This study showed statistically significant difference of mean salivary C-reactive protein between septic neonates and controls (12.0±4.6ng/L vs. 2.8±1.2ng/L) respectively. At a cut-off point of 3.48ng/L, salivary C-reactive protein showed 94.3% sensitivity and 80% specificity. Salivary C-reactive protein also showed good predictive accuracy for predicting elevated serum C-reactive protein values in septic neonates. Mean platelet volume and neutrophil-lymphocyte ratio showed significant difference between septic neonates and controls (10.2±1.2fL vs.8.0±0.5fL; 2.9±1.7 vs. 1.6±0.4, respectively). At a cut-off point of 10.2fL, mean platelet volume presented 80% sensitivity and specificity. At a cut-off point of 2.7, neutrophil-lymphocyte ratio presented 80% sensitivity and 57.1% specificity. CONCLUSION: This study provides support for further studies on the usefulness of salivary C-reactive protein, mean platelet volume, and neutrophil-lymphocyte ratio as diagnostic markers for neonatal sepsis.

Evaluation of serum and salivary C-reactive protein for diagnosis of late-onset neonatal sepsis: A single center cross-sectional study

Abstract Objective: To evaluate the diagnostic utility of salivary C-reactive protein (CRP) and its potential correlation with serum CRP levels in full-term neonates with late-onset sepsis (LOS). Methods: This cross-sectional study included 90 neonates assigned to three equal groups: culture proven LOS, clinical LOS and a control group. Clinical findings and routine laboratory data including complete blood pictures and blood culture results were documented. Highly sensitive serum CRP was measured according to hospital protocol, while salivary CRP levels were measured using enzyme-linked immunosorbent assay. Results: The median serum CRP was significantly higher in septic neonates compared to controls (p < 0.001). For serum CRP, the optimum cut-off value for LOS diagnosis was found to be 7.2 mg/L with sensitivity, specificity, positive and negative predictive values of 91, 100, 100, and 85.7%, respectively. No significant difference was observed in levels of salivary CRP among the 3 study groups (p = 0.39). No correlation was found between the levels of salivary and serum CRP (r = 0.074, p = 0.49). Conclusion: Serum CRP, at a cut-off value of 7.2 mg/L, exhibited a high specificity and positive predictive value in LOS diagnosis, whereas salivary CRP levels weren't significantly different between the 3 study groups nor did they predict abnormal serum CRP thresholds in newborns with sepsis.

Salivary C-reactive protein, mean platelet volume and neutrophil lymphocyte ratio as diagnostic markers for neonatal sepsis / Proteína C reativa salivar, volume médio de plaquetas e proporção de neutrófilos/linfócitos como marcadores de diagnóstico de sepse neonatal

Abstract Objective: To assess the applicability of salivary C-reactive protein, mean platelet volume, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio in the diagnosis of neonatal sepsis. Methods: Prospective case-control study of 70 full-term neonates, 35 with sepsis (20 with proven sepsis and 15 with clinical sepsis) and 35 healthy controls. Serum and salivary C-reactive protein concentrations were measured by enzyme-linked immunosorbent assay while mean platelet volume, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio were measured by automated blood cell counter. Results: This study showed statistically significant difference of mean salivary C-reactive protein between septic neonates and controls (12.0 ± 4.6 ng/L vs. 2.8 ± 1.2 ng/L) respectively. At a cut-off point of 3.48 ng/L, salivary C-reactive protein showed 94.3% sensitivity and 80% specificity. Salivary C-reactive protein also showed good predictive accuracy for predicting elevated serum C-reactive protein values in septic neonates. Mean platelet volume and neutrophil-lymphocyte ratio showed significant difference between septic neonates and controls (10.2 ± 1.2 fL vs.8.0 ± 0.5 fL; 2.9 ± 1.7 vs. 1.6 ± 0.4, respectively). At a cut-off point of 10.2 fL, mean platelet volume presented 80% sensitivity and specificity. At a cut-off point of 2.7, neutrophil-lymphocyte ratio presented 80% sensitivity and 57.1% specificity. Conclusion: This study provides support for further studies on the usefulness of salivary C-reactive protein, mean platelet volume, and neutrophil-lymphocyte ratio as diagnostic markers for neonatal sepsis.

Resumo Objetivo: Avaliar a aplicabilidade da proteína C reativa salivar, do volume médio de plaquetas, a proporção de neutrófilos-linfócitos e a proporção de plaquetas/linfócitos no diagnóstico de sepse neonatal. Métodos: Estudo caso-controle prospectivo de 70 neonatos a termo, 35 com sepse (20 com sepse comprovada e 15 com sepse clínica) e 35 controles saudáveis. As concentrações de PCR no soro e salivar foram medidas por ensaio imunossorvente ligado a enzima (Elisa), ao passo que o VMP, PNL e PPL foram medidos por contador de células sanguíneas automatizado. Resultados: Este estudo mostrou uma diferença estatisticamente significativa da média de PCR salivar entre os neonatos com sepse e os controles (12,0 ± 4,6 ng/L em comparação com 2,8 ± 1,2 ng/L), respectivamente. Um ponto de corte 3,48 ng/L na PCR salivar mostrou sensibilidade de 94,3% e especificidade de 80%. A PCR salivar mostrou, ainda, boa precisão preditiva para prever altos valores de PCR no soro em neonatos com sepse. O VMP e a PNL mostraram diferença significativa entre os neonatos com sepse e os controles (10,2 ± 1,2 fL em comparação com 8,0 ± 0,5 fL), (2,9 ± 1,7 em comparação com 1,6 ± 0,4), respectivamente. O VMP no ponto de corte 10,2 fL apresentou 80% de sensibilidade e especificidade. A PNL no ponto de corte 2,7 fL apresentou 80% de sensibilidade e 57,1% de especificidade. Conclusão: Este estudo fornece uma base para outros estudos na utilidade da PCR salivar, VMP e PNL como marcadores de diagnóstico de sepse neonatal.