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The Rise of Salivary Diagnostics

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An interview with Dr. David Wong, Felix & Mildred Yip Professor and Director of the Center for Oral/Head & Neck Oncology Research at University of California Los Angeles. 

A pioneer in the field of salivary diagnostics, Dr. Wong tells us a little about his career and research. 

AM: What originally led you to become interested in studying oral biology?

DW: Research has been a passion since I was an undergraduate majoring in biochemistry. Going through dental school enhanced my interest in oral, dental and craniofacial biology. While at 3rd year of dental school I applied to a number of graduate programs and when Harvard accepted me, I went for my training in molecular biology and a residency in pathology. It has not only been a sustainable interest but has turned into a career path that is most gratifying. It has been a privilege.

AM: What have some of your most rewarding achievements been so far?

DW: Getting into dental school was a thrill. Matriculating from it was a joy. A defining moment was at the completion of my graduate training at Harvard, when I went to the Dean of School, Paul Goldhaber, asking him to give me a chance to stay at Harvard to start my career, fully expecting him to say no as I have no funding. Dr. Goldhaber gave me 2 years of support and a lab… my scientific journey started and it was a journey of no return.

As for the scientific goals, a very defining moment was when I moved to UCLA from Harvard in 2002. Two weeks after I arrived on campus NIH issued two initiatives to decipher the salivary proteome and develop point-of-care technologies for saliva diagnostics. I went after both of these RFAs and was funded to do both. That beginning sparked a journey of no return, moving towards clinical maturation and regulatory approval of impactful salivary diagnostic utilities. 

AM: Can you tell us more about your lab’s research directions?

DW: Currently the advancement of salivary diagnostics by scientific credentialing and translational/clinical validation are the focus research directions. Underpinning the scientific mechanisms of how systemic diseases e.g. pancreatic cancer can convey disease specific biomarkers from the organ of pathology to saliva, and the ability and discipline to achieve regulatory approval of salivary biomarkers are the key to advancing salivary diagnostics to clinical reality.

AM: Can you tell us more about the use of saliva as a diagnostic medium?

DW: Saliva as a discriminatory biofluid, offers biomarkers for early detection of human cancers (and diseases) and furthering scientific understanding. Then come the secondary advantages of being non-invasive, non-painful, and a fluid that we produce 3 bottles of water worth (1.5 liters): the holy grail of molecular diagnostics.  

AM: What is the Salivaomics Knowledge Base (SKB)?

DW: We coined the term Salivaomics in 2014 to reflect the presence of omics constituents in saliva. The SKB is an assembly of information to demonstrate to scientists and lay public the values and scientific aspects of saliva and its constituents. Saliva is a late comer but it has caught up.  

You can find out more here http://www.skb.ucla.edu/wonglab/

AM: Your lab is currently conducting research to detect EGFR lung cancer mutations in saliva using EFIRM. Can you tell us about some of the advantages this EFIRM Liquid Biopsy (eLB) offers over traditional methods? 

DW: The benefits of eLB include:

• Early detection of cancer
• Near 100% sensitivity
• Non/minimally invasive
• Minimal volume (40µl), real time, inexpensive
• Actionable mutations
• Secondary resistance mutations
• Personalized medicine
• Precision medicine
• Point-of-care
• High-throughput reference lab
• Know now
• Ready now

AM: What are some of the future implications of this work, and what barriers do you think there might be to widespread adoption of salivary diagnostics?

DW: The holy grail of molecular diagnostics. The barriers are almost entirely cultural, social and behavorial. Upon scientific credentialing, the table will turn… that is what I am looking forward to. 

You can find out more about Dr. Wong and the work being carried out in his lab here http://www.skb.ucla.edu/wonglab/