Saliva, a biological fluid, is a promising candidate for novel approaches
to prognosis, clinical diagnosis, monitoring and management of patients with
both oral and systemic diseases. However, to date, saliva has not been widely
investigated as a biomarker for radiation exposure. Since white blood cells are
also present in saliva, it should theoretically be possible to investigate the
transcriptional biomarkers of radiation exposure classically studied in whole
blood. Therefore, we collected whole blood and saliva samples from eight head
and neck cancer patients before the start of radiation treatment, at
mid-treatment and after treatment. We then used a panel of five genes: BAX,
BBC3, CDKN1A, DDB2 and MDM2, designated for assessing radiation dose in whole
blood to evaluate gene expression changes that can occur during radiotherapy.
The results revealed that the expression of the five genes did not change in
whole blood. However, in saliva, CDKN1A and DDB2 were significantly
overexpressed at the end, compared to the start, of radiotherapy, and MDM2 was
significantly underexpressed between mid-treatment and at the end of treatment.
Interestingly, CDKN1A and DDB2 expressions also showed an increasing monotonic
relationship with total radiation dose received during radiotherapy. To our
knowledge, these results show for the first time the ability to detect gene
expression changes in saliva after head and neck cancer radiotherapy, and pave
the way for further promising studies validating saliva as a minimally invasive
means of biofluid collection to directly measure radiation dose escalation
during treatment.