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Oral swab preferred for cytokine detection in children's allergic inflammation

Oral swab testing provided more precise concentrations and acceptable detection of cytokines related to allergic inflammation in children compared with passive drool collection, according to recent study results.

Researchers in Houston studied 20 children (median age, 14 years; 64% female). Eighty-five percent of the patients reported one or more allergic conditions, including eosinophilic esophagitis (n=9), allergic rhinitis (n=6), food allergy (n=2), asthma (n=2), oral allergy syndrome (n=1) and atopic dermatitis (n=1).

Patients consumed nothing for at least 4 hours, after which they rinsed their mouth with water. Passive drool (PD) was collected after a 10-minute period and was followed by saliva collection via oral swab (OS), used to minimize saliva’s effect on the flow rate and concentrations of cytokines in PD. Patients had their head tilted down and drooled into a 5.5-cm collection aid. OS was collected for approximately 60 to 90 seconds to saturate the swab and placed in a storage tube to allow for centrifuge. Two participants were unable to provide PD, while all children successfully used OS.

The children completed a questionnaire regarding knowledge of salivary diagnostics, and 23% were aware of saliva testing in health or disease surveillance. Eighty-two percent of the children preferred OS compared with PD sampling (18%; P<.05) because of its ease and speed of sample provision.

All PD and OS samples detected interleukin (IL)-4, IL-5 and IL-13. Three PD samples were unable to detect eotaxin 3 and thymic stromal lymphopoietin, which were detectable in all OS samples.

“The Wilcoxon rank sum test revealed that the median concentrations were similar between PD and OS samples; however, greater precision was noted in OS compared with PD concentrations,” the researchers wrote.

There was insufficient agreement between PD and OS in the Bland-Altman analysis, which suggested the two methods should not be used interchangeably.

Disclosure: The researchers report no relevant financial disclosures.