{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:40:13Z","timestamp":1786653613760,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Early childhood caries (ECC) is a prevalent, multifactorial disease influenced by microbial factors and host immune factors. Saliva serves as a noninvasive diagnostic medium with the potential to detect immune biomarkers such as human leukocyte antigen-DR (HLA-DR), a key class II molecule of the major histocompatibility complex involved in antigen presentation and the activation of adaptive immune responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To evaluate and compare salivary HLA-DR levels in preschool children with and without ECC and assess the relationship between HLA-DR levels and deft scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted among preschool children aged 3\u20136 years attending school dental screening camps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      Forty children aged 3\u20136 years were included and divided into ECC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20) and caries-free (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20) groups. Caries status was assessed using World Health Organization criteria and the Deft Index. Unstimulated saliva samples were collected and analyzed for HLA-DR concentrations using a commercially available sandwich enzyme-linked immunosorbent assay. Intergroup comparisons were performed using the Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      -test, and associations were evaluated using Spearman\u2019s correlation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Children with ECC showed significantly higher salivary HLA-DR levels (median 10.31 pg\/mL, interquartile range [IQR]: 7.65\u201317.98) than caries-free controls (median 6.28 pg\/mL, IQR: 3.14\u20139.32) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.023). A weak positive but nonsignificant correlation was found between HLA-DR levels and deft scores (\u03c1 =0.236,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.317).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Elevated salivary HLA-DR levels in ECC suggest enhanced local immune activation and may serve as a noninvasive biomarker for ECC presence, although not a direct indicator of lesion severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jisppd.jisppd_557_25","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:00:18Z","timestamp":1777568418000},"page":"142-146","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Association between salivary human leukocyte antigen-DR concentration and early childhood caries"],"prefix":"10.4103","volume":"44","author":[{"given":"Saravanan","family":"Gokul","sequence":"first","affiliation":[{"name":"Department of Pediatric, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rajendran Joy","family":"Daphny","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anantha Krishnan Chakravarthy Aravintha","family":"Sittharthan","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Baby","family":"John","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkataraman","family":"Subhalakshmi","sequence":"additional","affiliation":[{"name":"Central Research Laboratory, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S.","family":"Prathima","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Vinayaka Mission\u2019s Sankarachariyar Dental College, Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"R1-20260501","doi-asserted-by":"crossref","first-page":"157","DOI":"10.3389\/fped.2017.00157","article-title":"Early childhood caries: Prevalence, risk factors, and prevention","volume":"5","author":"Anil","year":"2017","journal-title":"Front Pediatr"},{"key":"R2-20260501","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12903-023-02722-8","article-title":"Salivary microbiome and metabolome analysis of severe early childhood caries","volume":"23","author":"Li","year":"2023","journal-title":"BMC Oral Health"},{"key":"R3-20260501","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1038\/ijos.2017.35","article-title":"Salivary proteins and microbiota as biomarkers for early childhood caries risk assessment","volume":"9","author":"Hemadi","year":"2017","journal-title":"Int J Oral Sci"},{"key":"R4-20260501","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1007\/s00784-003-0222-7","article-title":"Salivary antibodies, amylase and protein from children with early childhood caries","volume":"7","author":"de Farias","year":"2003","journal-title":"Clin Oral Investig"},{"key":"R5-20260501","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4103\/jisppd.jisppd_76_22","article-title":"Correlation of caries occurrence in primary teeth using human leukocyte antigen typing and maternal and physiochemical factors","volume":"40","author":"Saikia","year":"2022","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R6-20260501","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.5005\/jp-journals-10005-3011","article-title":"Estimation and correlation of human leukocyte antigen-dr and human leukocyte antigen-DQ in children with and without severe-early childhood caries: A randomized clinical trial","volume":"17","author":"Thimmegowda","year":"2024","journal-title":"Int J Clin Pediatr Dent"},{"key":"R7-20260501","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.5005\/jp-journals-10005-3295","article-title":"Caries risk assessment in children with early childhood caries and late childhood caries","volume":"18","author":"Vignesh","year":"2025","journal-title":"Int J Clin Pediatr Dent"},{"key":"R9-20260501","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s40368-022-00745-3","article-title":"Free sugars and early childhood caries development: A prospective cohort study","volume":"23","author":"Boustedt","year":"2022","journal-title":"Eur Arch Paediatr Dent"},{"key":"R10-20260501","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/omi.12152","article-title":"Advances in the microbial etiology and pathogenesis of early childhood caries","volume":"32","author":"Hajishengallis","year":"2017","journal-title":"Mol Oral Microbiol"},{"key":"R11-20260501","first-page":"1384","article-title":"Experience and prevalence of dental caries in migrant and nonmigrant low-SES families'children aged 3 to 5 years in Italy","volume":"9","author":"Ferrazzano","year":"2022","journal-title":"Children (Basel)"},{"key":"R12-20260501","doi-asserted-by":"crossref","first-page":"513","DOI":"10.4049\/jimmunol.1201891","article-title":"HLA class II molecules influence susceptibility versus protection in inflammatory diseases by determining the cytokine profile","volume":"190","author":"Mangalam","year":"2013","journal-title":"J Immunol"},{"key":"R13-20260501","doi-asserted-by":"crossref","first-page":"300060519893852","DOI":"10.1177\/0300060519893852","article-title":"Association between HLA-DRB1*allele polymorphism and caries susceptibility in Han Chinese children and adolescents in the Xinjiang Uygur Autonomous Region","volume":"48","author":"Wang","year":"2020","journal-title":"J Int Med Res"},{"key":"R14-20260501","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3390\/metabo13030356","article-title":"Identification of a biomarker panel for diagnosis of early childhood caries using salivary metabolic profile","volume":"13","author":"Kim","year":"2023","journal-title":"Metabolites"},{"key":"R15-20260501","doi-asserted-by":"crossref","first-page":"5011","DOI":"10.3390\/ijerph19095011","article-title":"Current status and trends in research on caries diagnosis: A bibliometric analysis","volume":"19","author":"Melo","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"R16-20260501","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1186\/s12903-025-06248-z","article-title":"HLA-DRB1 alleles and salivary Streptococcus mutans colonization in a group of Swedish children","volume":"25","author":"H\u00e4nel","year":"2025","journal-title":"BMC Oral Health"},{"key":"R17-20260501","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1375\/twin.10.6.821","article-title":"Heritability of oral microbial species in caries-active and caries-free twins","volume":"10","author":"Corby","year":"2007","journal-title":"Twin Res Hum Genet"}],"container-title":["Journal of Indian Society of Pedodontics and Preventive Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_557_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:40:00Z","timestamp":1786650000000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jisppd.jisppd_557_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jisppd.jisppd_557_25","relation":{},"ISSN":["0970-4388","1998-3905"],"issn-type":[{"value":"0970-4388","type":"print"},{"value":"1998-3905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-12-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}