Detection of serum amyloid A in Saliva of patients with internal carotid artery stenosis: a pilot study.

OBJECTIVES

To determine whether serum amyloid A (SAA) is detectable in saliva of patients with internal carotid artery (ICA) stenosis and to investigate the relationship between salivary and serum SAA levels across the perioperative period of carotid endarterectomy (CEA).

MATERIALS AND

METHODS

Six patients with asymptomatic ICA stenosis (60-99%) undergoing CEA were enrolled. Periodontal status was assessed at enrolment and used to characterise the cohort and document potential oral inflammatory confounding of salivary SAA. Salivary and serum SAA, C-reactive protein (CRP), and lipid parameters were measured before CEA, on postoperative day 2, and 30-45 days postoperatively using enzyme-linked immunosorbent assay (ELISA) and standard laboratory methods.

RESULTS

SAA was detectable in all saliva samples. Serum SAA increased after surgery and did not decline at follow-up, whereas salivary SAA showed a progressive decline (repeated measures ANOVA: F(2,4) = 25.01, p = 0.005). A strong negative correlation was observed between changes in serum and salivary SAA (Pearson's r = - 0.976, p = 0.004).

CONCLUSIONS

In this small pilot cohort, SAA was detectable in all saliva samples, and salivary concentrations decreased across the perioperative time points while serum SAA did not show a parallel decline. The observed inverse serum-saliva association should be interpreted cautiously given the very small sample size, absence of a control group, and potential oral and sampling confounders. These findings support the feasibility of measuring salivary SAA in this clinical setting and warrant confirmation in larger controlled studies.