Elevated salivary protein in Parkinson's disease and salivary DJ-1 as a potential marker of disease severity

Introduction: There is an urgent need to identify robust biomarkers for Parkinson's disease (PD). Previous studies have shown changes in composition and secretion of saliva in patients with PD, including an increase in salivary DJ-1 concentration. Autonomic dysfunction is a known feature of PD and could contribute to abnormal salivary gland function. Methods: In this pilot cross-sectional study, characterisation of the saliva of 16 patients with PD and 22 age-matched controls was performed. Salivary DJ-1 concentration was measured with quantitative immunoblotting; total protein concentration with a BCA assay and spectrophotometry; amylase with an amylase activity assay; albumin with an ELISA and mucin concentration with periodic-acid Schiff staining of SDS-gels. Results: Patient saliva showed an increase in both total protein concentration (8.4 vs 5.0 mg/ml, p = 0.0002) and DJ-1 concentration (0.84 vs 0.42 mu g/ml, p = 0.001), but there was no difference in salivary DJ-1 after adjusting for total protein concentration. In patients, adjusted DJ-1 levels correlated with disease severity measured with the MDS-Unified Parkinson's Disease Rating Scale (p = 0.019). Patient saliva had elevated concentrations of amylase (127 vs 64 units/ml, p = 0.0005) and albumin (110 vs 474 mu/ml, p = 0.0003) but not mucins. Conclusions: This study suggests that the saliva of patients with PD is different in composition to that of healthy age-matched controls, supporting the notion that saliva may be a good candidate for biomarker discovery in PD. The specific differences suggest that major salivary glands and gingival crevicular fluid may both be sources of additional DJ-1 and protein in patient saliva. (C) 2015 Elsevier Ltd. All rights reserved.