By Magali Fischer

A symptomatic menopausal woman may require periodic testing of her estrogen and progesterone levels to make necessary adjustments in the dosing of hormone replacement therapy. An athlete undergoes steroid hormone testing leading up to a major competition to assess his level of exercise-induced exertion and optimize his training routine.

Benefits of saliva hormone testing.

Benefits of saliva hormone testing.

In each of these scenarios, you and the patient have a choice. Extract a blood sample or collect a saliva sample for testing. With the robust saliva collection methods available today and highly sensitive immunoassays and automated workflows available from Tecan, saliva testing provides an accurate measure of circulating hormones. Importantly, the hormone concentrations measured in saliva, unlike in blood, represent the levels of free, biologically active hormones, which have greater clinical relevance than do measures of total hormone.

Tried and tested saliva testing methodology

From the first stages of pre-analytical sample processing to the final reporting of assay results, Tecan has developed a superior saliva testing methodology. No longer of concern are issues that limited the applicability of saliva testing during its early years back in the 1980s, when standardized, highly sensitive saliva diagnostics technology was not yet available.

Optimal saliva testing begins with an appropriate saliva sampling technique and container. The IBL International SaliCap from Tecan is a validated saliva sampling device made of ultra-pure polypropylene that minimizes interactions between the device surface and the salivary analyte being measured. This is especially important to achieve accurate results when measuring the very low levels of unbound, bioavailable hormones present in saliva - significantly lower than the concentrations of total analyte present in serum.

Proper methodology in the pre-analytical stage of the assay workflow is also essential. Tecan's analytical saliva processing method has been tried and tested for more than 15 years. We offer our own special-purpose saliva collection vials and years of experience to help you properly train your staff.

Exquisitely sensitive assays

Due to the extremely low levels of steroid hormones present in saliva, quantitative assays for salivary hormone assessment need to be highly sensitive. ELISA and luminescence immunoassays from IBL International are specially developed and validated for saliva samples, providing the very high sensitivity that is essential for saliva diagnostics.

Saliva testing: ELISA versus mass spectroscopy (MS)

Most labs today look to MS as the reference for hormone quantification. MS is, however, a large investment in capital and resources and as such is not available to all labs. The results provided by the IBL kit correlate closely with MS and are perfectly suited to the low sample volume typically offered with saliva. All IBL assays are calibrated against mass spectrometry (MS), the established reference method for hormone quantification.

Automated, multi-parameter analysis

IBL uses an enzymatic signal amplification system to develop salivary ELISA kits with good sensitivity. Tecan has adapted all of the ELISA methods to make them compatible with automation on the Freedom EVO® platform. These automated workflows make it possible to perform multiple assays and measure more than one analyte at a time, faster, more consistently, and with less risk of error. Saliva is a complex fluid that contains mucins - glycoproteins that are found in mucus. Automated pipetting of saliva on the Tecan system allows for more precise measurements than manual pipetting.

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