The Implications of Salivary Exosomes as a Theranostic Secret of Human Cancers - With a Focus on Oral Cancer - Correspondence

Sep 24, 2026

Letter to the editor responding to a previously published correspondence on salivary exosomes as theranostic tools for oral cancer. The authors question claims that salivary exosomes were an unexplored area and argue that relevant studies existed earlier. They also highlight discrepancies regarding miRNA-365 localization, point out missing citations for proposed biomarkers such as multiple miRNAs and CD63, and note that current evidence including salivary exosomal proteins was insufficiently addressed. A compact review is presented, summarizing evidence from PubMed and Web of Science and discussing biomarker types, sample rationale, feasibility, and technical challenges.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Letter to the editor

Critique of the prior correspondence

Review of PubMed/Web of Science evidence

Biomarker types and rationale for saliva

Collection, processing, and analytical challenges

’Correspondence The implications of salivary exosomes as atheranostic secret of human cancers with a focus on oral cancer Wei Liu, MDa,d , Jinbing Wang, MDd,b,* , Xuemin Shen, DDSa,d,* , Huan Shi, MDd,c,* Dear Editor, We read with great interest a correspondence entitled ‘Salivary exosomes: a theranostics secret of oral cancer’ recently published in the International Journal of Surgery by Krishnan et al[1] . However, the interest is not sustained through the reading the text for potential concerned reasons. To begin with, the authors mentioned that ‘salivary exosomes remain an unexplored side of liquid biopsy for oral cancer screening’. In fact, this issue was explored earlier in the previous studies[2–7], before the time (06 September 2022) of the correspondence submitted by Krishnanand colleagues[1] . They also stated that salivary exosomal miRNA-365 serves as a biomarker in oral cancer[1], while miRNA-365 was reported to be not in salivary exosome but in theexosome of oral cancer cell lines[8] . Besides, they mentioned potential exosomal biomarkers including ten miRNAs and surface marker CD63, but did not cite a relevant reference[2] . They largely passed over the current evidence, including salivary exosomal proteins[2–7] and without appropriate description and discussion on this issue. Hence, the correspondence by Krishnanet al. [1], with all due respect, may be needless and tasteless. The current correspondence attempts to conduct a compact review of PubMed and Web of Science databases of studies on salivary exosomes in human cancers and present some comments for investigators’ consideration in further studies. As presented in aDepartment of Oral Mucosal Diseases, bDepartment of Oral and Maxillofacial-Head and Neck Oncology, cDepartment of Oral Surgery, Shanghai Ninth People ’s Hospital and dShanghai Key Laboratory ofStomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, College ofStomatology, Shanghai Jiao Tong University, Shanghai, China Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article. *Corresponding Author. Address: Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People ’s Hospital, Shanghai 200011, China. Tel.: +86 212 327 1699, Fax: +86 216 308 7037. E-mail address: [wangjinbing@aliyun.com](wangjinbing@aliyun.com) (J. Wang); Department of Oral Mucosal Diseases, Shanghai Ninth People ’s Hospital, Shanghai 200011, China. Tel.: +86 216 316 2851, Fax: +86 216 308 [7076. E-mail address: kiyoshen@hotmail.com](7076. E-mail address: kiyoshen@hotmail.com) (X. Shen); Department of Oral Surgery, Shanghai Ninth People ’s Hospital, Shanghai 200011, China. Tel.: +86 212 327 1699, Fax: +86 216 308 7052. E-mail address: [shihuan1312@163.com](shihuan1312@163.com) (H. Shi). Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. International Journal of Surgery (2023) 109:1072–1075 Received 6 March 2023; Accepted 9 March 2023 Published online 31 March 2023 [http://dx.doi.org/10.1097/JS9.0000000000000349](http://dx.doi.org/10.1097/JS9.0000000000000349) Table 1, proteins and miRNAs are the main types of biomarkers in salivary exosomes, also known as extracellular vesicles (EVs), which are mainly used for early diagnosis and prognosis evaluation of human cancers. We retrieve 18 studies on detection and validation of salivary exosomes, in several human cancers including esophageal carcinoma, lung cancer, pancreatic cancer, head and neck cancer, and particularly oral cancer. Saliva is in direct contact wit

FAQs

What is the main purpose of this correspondence?

To respond to and critique a previously published correspondence on salivary exosomes in oral cancer, while presenting additional comments and a compact review to guide further studies.

Why do the authors dispute the claim that salivary exosomes were unexplored for oral cancer screening?

They state the issue had been explored in earlier studies before the submitted correspondence date, and they reference prior work.

What technical challenges are emphasized for reliable exosome analysis?

Standardizing saliva collection and processing is essential, since collection can be unstimulated or stimulated and exosome isolation methods like ultracentrifugation can introduce contamination; methods must also rapidly isolate, subtype, quantify, and analyze exosome contents from small samples.

Sep 24, 2026

Uploaded by Riley West