title: The Role of Salivary Neuropeptides in Pediatrics: Potential Biomarkers for Integrated Therapies.
abstract: BACKGROUND
  Objective measures of symptom response to integrated complementary approaches in pediatrics are evolving. The purpose of this study was to document the concentration range of salivary neuropeptides in healthy controls and in children with cancer, to explore correlations between serum and salivary measurements for Calcitonin Gene-Related Peptide (CGRP) and Vasoactive Intestinal Polypeptide (VIP), and to determine whether there is a change in these salivary neuropeptide levels in response to integrated mind-body therapies.
  
  
  METHODS
  A non-randomized pragmatic study with three phases: Phase 1- Healthy Control Saliva-10 healthy controls provided saliva samples; Phase 2- Cancer Diagnosis Serum-Saliva- 16 mixed-type cancer patients provided blood and saliva samples; Phase 3- Acute Lymphocytic Leukemia (ALL) Saliva Intervention- 12 patients with ALL provided pre- and post-complementary intervention saliva samples.
  
  
  METHODS
  20-minutes of structured touch or scripted relaxation breathing were administered to patients in Phase 3; Phase 1 and 2 patients did not receive this intervention.
  
  
  METHODS
  cortisol, CGRP, VIP, State/Trait Anxiety Scale, visual analogue scale, vital signs.
  
  
  RESULTS
  Salivary CGRP and VIP were similar for children in Phases 1 and 2. There was a correlation between serum and salivary VIP in the mixed cancer group, though not between serum and salivary CGRP. In Phase 3 children, following a complementary intervention, salivary CGRP, heart rate, and systolic blood pressure decreased.
  
  
  CONCLUSIONS
  These data provide evidence of a decrease in sympathetic output after integrative/complementary therapy intervention in children with cancer. The study underscores the potential role of salivary neuropeptides as non-invasive biomarkers for integrated therapies in pediatrics.
authors.affiliation: Department of Pediatrics, University of Utah Division of Pediatric Inpatient Medicine Primary Children's Hospital 100 N Mario Capecchi Drive Salt Lake City, UT 84113 United States ; Pediatric Integrative Medicine Service Primary Children's Hospital, 100 N Mario Capecchi Drive Salt Lake City, UT 84113 United States.
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Gershan
authors.affiliation: Missouri State University, Center for Biomedical and Life Sciences Jordan Valley Innovation Center 524 N. Boonville Springfield, MO 65806 United States.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Durham
authors.affiliation: University of Utah, Clinical Trials Office 295 Chipeta Way Salt Lake City, UT 84108 United States.
authors.forename: Jaci
authors.initials: J
authors.lastname: Skidmore
authors.affiliation: University of Utah, Clinical Trials Office 295 Chipeta Way Salt Lake City, UT 84108 United States.
authors.forename: Joshua
authors.initials: J
authors.lastname: Shimizu
authors.affiliation: Missouri State University, Center for Biomedical and Life Sciences Jordan Valley Innovation Center 524 N. Boonville Springfield, MO 65806 United States.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Cady
authors.affiliation: Department of Pediatrics, University of Utah Division of Pediatric Inpatient Medicine Primary Children's Hospital 100 N Mario Capecchi Drive Salt Lake City, UT 84113 United States.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sheng
authors.affiliation: Department of Pediatrics, University of Utah Division of Pediatric Inpatient Medicine Primary Children's Hospital 100 N Mario Capecchi Drive Salt Lake City, UT 84113 United States.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maloney
keywords: Salivary neuropeptide; autonomic nervous system; biomarker; complementary therapy; integrated therapy