February 7, 2024 • 28 mins
Embark on a groundbreaking journey into the innovative realm of disease detection through saliva-based diagnostics. Join us as we welcome esteemed guest Dr. Paul Slowey, who will revolutionize your understanding of non-invasive testing. Discover how a mere drop of saliva is transforming personalized medicine and cancer screening. As a pioneer in oral fluid diagnostics, Dr. Slowey unveils remarkable progress in the field, highlighting the precision of current technologies in detecting diseases with unprecedented accuracy. Imagine a future where a simple saliva sample could replace a doctor's visit.
Our exploration extends beyond COVID-19, revealing the strides made in saliva testing against a wide array of diseases, including its potential in early cancer detection. We'll explore its applications beyond viral detection, such as identifying risk factors for heart disease and Alzheimer's. This episode pays tribute to the untapped power of saliva in unraveling the mysteries of our health and reshaping our approach to disease prevention and treatment.
Join Dr. Tiffany Montgomery as she engages in a thought-provoking discussion with Dr. Slowey about the potential of saliva-based testing. This non-invasive method stands on par with traditional diagnostic practices in cancer detection, supported by technological advancements in collection devices that streamline the diagnostic journey. By the end of this conversation, you'll gain insights into the significant role of DNA research and saliva testing in healthcare, inspired by a future where early detection and personalized treatment lead the way in medical innovation.
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Episode Transcript
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P23 Theme Music (00:00):
P23 Knowledge, access, power.
P23, wellness and Understandingat your fingertips P23.
And that's no cap.
Dr. Tiffany Montgomery (00:21):
Welcome back to another episode of
Demystifying DNA, for go-topodcasts, for unraveling the
mysteries of genetics and theirprofound influence on our lives.
I'm your host, Dr.
Tiffany Montgomery scientist,epidemiologist and just that
(00:42):
curious lady CEO of P23 Health,and today we are joined by a
distinguished expert in thefield, Dr.
Paul Slowey.
Dr.
Slowey is the founder and CEOof Oasis Diagnostics, a company
(01:03):
that specializes in non-invasivesaliva testing for a variety of
purposes, such as infectiousdiseases, genetics, nutrition
and more.
He is also the co-founder ofthe North American Salabas
Symposium, a member of theOregon Bioscience Association
(01:24):
and Life Science Washington andan honorary visiting professor
at Central South University inChina.
Dr Slowey has over 32 years ofexperience in clinical
diagnostics and pharmaceuticalindustries.
He has published 45 articles.
He has 15 patents, authoredseven chapters and has 12 patent
(01:49):
applications on various topicsrelated to saliva science.
He is widely recognized as apioneer and a leader in the
field of oral fluid diagnostics.
He has been instrumental indeveloping and commercializing
several saliva-based productsand technologies, such as the
(02:10):
ORQIC HIV test, the firstover-the-counter HIV test in the
US.
He is a husband, a father, agrandfather, a friend and a
mentor.
Dr Slowey is a dear, dearfriend, scientist in mind, who
has four children and almosteight grandchildren.
(02:33):
Dr Slowey, thank you forjoining us today.
Dr. Paul Slowey (02:37):
Well, thank you for having me.
I'm very, very honored toactually be part of this.
I wanted to do this for a longtime, so I'm really really
honored to be here.
Dr. Tiffany Montgomery (02:46):
We are thrilled to have you.
We love talking science and Ilove getting excited about
something that's so dear to me.
Not just science, not justgenetics, but saliva.
I love making it easy, so thisis going to be great.
In this episode, unraveling theSecrets Cancer and Genetics in
(03:07):
Salava-Based Testing, we willfocus on early detection through
saliva-based testing, wherewe'll delve into the fact of the
fascinating world ofnon-invasive diagnostic tools
and their transformative role inearly cancer detection.
From the power of saliva anddisease screening to the latest
(03:30):
breakthroughs in cancer genetics.
Buckle up for an excitingdiscussion that could alter your
perception of diseaseprevention.
Let's kick-start this rivetingconversation, dr Sloe.
So we talked about the power ofsaliva.
I want you.
You're basically like thegodfather of saliva.
Dr. Paul Slowey (03:50):
No, I'm not the godfather, I'm still a pupil.
I have lots of excellentmentors that are right there as
well, but I guess, as far as thecommercialization side and the
applications for saliva, I'mkind of synonymous with that, so
hopefully I can address some ofthe questions and point you to
some of the other leaders in thefield that could be on a future
(04:12):
one of these podcasts.
Dr. Tiffany Montgomery (04:15):
This is exciting.
So when we talk about the powerof saliva, why do you think
it's such a revolutionary toolfor disease detection?
Dr. Paul Slowey (04:23):
But you know we've been in this business or
myself have been in thisbusiness for 30 years with
Orishur saliva diagnosticsystems and then my own company
for the last 21 years.
And you know, if you look backin history, you know epitope
became Orishur in what I thinkwas 1999 or probably 2000, and
saliva at that time was prettymuch an upheld Push.
(04:44):
And I think the reasons that Ican look back on and say why
that's the case is that you knowSalivar is typically present in
either the biomarkers thatyou're looking for in saliva
whether they they be DNA,protein, rna they're usually
present in smaller quantities.
For, for instance, I think HIVis like 1400 times lower HIV
antibodies in saliva than inblood.
(05:05):
However, nowadays we have themuch more sensitive technologies
that can actually detect thosebiomarkers.
So you know, in proteins, forinstance, you got mass
spectrometry.
You know very, very highresolution mass spec.
You've got next generationsequence and you've got lateral
flow that can use fluorescencebased particles instead of
either colloidal gold, so youcan actually get down to much
(05:26):
lower levels and lower limits ofdetection.
So I think that and Puttogether that with the 23 and
me's of this world, the ancestrycomm, and then the advent of
COVID, where saliva became Kindof the mainstay, if you like,
for for sampling.
I think those things havereally pushed saliva forward and
it's really an exciting time tobe in the saliva world, to be
(05:49):
honest.
Dr. Tiffany Montgomery (05:50):
Now, when you think about what we're
able to detect in saliva, arethere any doubts in your mind
when it comes to the sensitivityor the accuracy of testing when
you compare, say, a nasal swabor blood sample to a saliva
sample?
Dr. Paul Slowey (06:07):
I think, if you take each one in turn, you know
there's there's cases for aswab test, there's cases for
saliva.
But I think, if you look backand use the COVID pandemic as an
example, when, when theshortage of swabs happened
randomly at March 2020 and Italked to a very large company,
a 25 billion dollar company atthe time, we, which shall remain
nameless, but they had a backorder of 37 million nasal swabs
(06:31):
on that nasal pharyngeal swabs.
We couldn't get swabs anywhereand that's kind of the time when
saliva became either the thatthe saliva was that tool of
choice, but it took a littlewhile.
The first publications thatcame out were kind of iffy.
But, over everything, if youlook back on the publications
from now Back to 2020, you'llsee that probably saliva is now
(06:52):
edged in front of nasalpharyngeal swabs.
And I can point to a study thatwas done in Europe on 11
different pathogens and on dayone, saliva and swab were
basically equivalent in terms ofsensitivity, but after day one,
the saliva basically took overin terms of being a better and
more sensitive tool for for thatparticular.
(07:13):
You know, and it was multiplepathogens, it wasn't just COVID,
it was RSV and flu A, flu B,etc.
So, yeah, I think it's it'sbecome a really really good tool
of choice and you know it's agood area to be in and I'm
really glad that you're in thisarea as well already.
Dr. Tiffany Montgomery (07:29):
Thank you.
It is exciting and I think thatinitially there were a lot of
doubts and one of the biggestproblems that we face Were that
the people who were doing thevalidations and you had the
ability to really convinceinstead of writing papers.
We were doing the work.
We were trying to get the EUAas we were trying to educate our
scientific community so morepeople could use the technology
(07:52):
so that we Be useful and helpful, especially with the shortage,
and I think, even Internallyinside of the scientific
community.
It took so convincing betweenscientists to even get
scientists to understand hey, wecan do this with something
other than a nasal swab.
Dr. Paul Slowey (08:09):
Right.
I think the thing that makes mereally excited and this
typically you mentioned in NorthAmerican saliva symposium we
haven't had one since COVIDstarted but I intend to have one
this year but the goal of thatwas literally to bring together
the commercial sector involvedin saliva, like 23andme,
ancestrycom, thermo Fisher, etcetera all these big companies
(08:30):
and then bring in theresearchers that are developing
the next biomarkers for diseasesall over the place At that
particular meeting.
As much as I'd love to talkabout what I do, I don't talk
very much.
I introduce the subject.
I spend 15 minutes introducingthe field and then I go out on
other meetings like that.
(08:50):
There was a meeting inAustralia recently called the
Salsa meeting, which was salivaliquid sampling Australia
meeting in May and I made a Ithink it was a 30 minute
presentation.
I didn't talk about anything wedid.
All I wanted to talk about wasthe new applications that are so
exciting.
You can determine yourbiological age.
You can detect pregnancy either.
(09:12):
There's a luminescence test forCOVID, I mean there's, just you
name it.
We're talking to people thatare developing tests for
congestive heart failure thatwill detect for risk biomarkers
for congestive heart failure andbe able to tell you in 30
minutes that, yeah, you have amuch higher risk.
We provide devices to theAlzheimer's associates for ApoE
(09:33):
genotyping.
That tells you whether you gota higher risk of having
Alzheimer's.
And you know, my wife's fatherdied of Alzheimer's so we were
very quick to have her tested.
Fortunately, she doesn't havethe ApoE4 gene, she's ApoE3.
So she's a much lower risk thanpeople who have the ApoE4 gene.
So there's not many things thatI can think of where you know
saliva is not going to play arole.
(09:54):
To be honest, and that'sexciting.
Dr. Tiffany Montgomery (09:56):
I think that you get something that was
key because we have to make surethat we continue that education
within our scientific communityas well.
I really push and forge thatinnovation, I think for sure.
We've talked about yoursymposium.
I'm excited P23 Labs and P23Health will be attending.
Dr. Paul Slowey (10:16):
Okay, good, good, good.
So I'm excited.
Dr. Tiffany Montgomery (10:18):
I want you to bring that back, so keep
us posted on that.
With saliva, we talk about it alot.
With infectious disease, we'vetalked about COVID and RSV.
You've mentioned briefly thebroad areas that it applies to,
but I want you to tell me alittle bit in particular how
saliva will play a role withearly cancer detection.
Dr. Paul Slowey (10:42):
I think this is the thing that I am so excited
about, and the reason is that Ithink we all know that when a
tumor forms, you knowcirculating tumor DNA is kind of
released into the blood streamvery quickly and a lot of
companies like FoundationMedicine, garden Health and
others have kind of picked up onthat and developed cancer-based
diagnostics based on a bloodliquid biopsy, which, by the way
(11:05):
, they like to call anon-invasive specimen which kind
of drives me up the wall,because blood, in my opinion,
was never a non-invasivespecimen, but that's a side
subject.
Companies like ours and othersdeveloped what we call saliva
liquid biopsy, if quantities.
So you may have to basicallyenrich the sample, but we have
(11:26):
one application that's reportedby the National Cancer Institute
for lung cancer particularly,and with one drop of saliva in
non-purified form you don't evenhave to purify the saliva, go
straight on a machine.
30 minutes later you candiagnose lung cancer.
Looking at a couple of mutationsin the EGFR gene, one of which
is the Exon 19 deletion, theother is the L858R, and to me
(11:49):
that's just kind of the proof ofconcept for multiple cancer
tests to be developed, providingthat the biomarkers are
available, and we're not abiomarker company, so we
literally provide tools that cancollect saliva.
We still need companies thathave the biomarkers to basically
partner with to bring these newapplications to market.
And I forgot to mention, inthis particular case, which is
(12:10):
reported widely it's been aroundfor about 10 years the
correlation that you get betweenthe saliva liquid biopsy
specimen is actually better.
With tissue, just tissue,obviously being the gold
standard.
The saliva sample is much morewell correlated to tissue than
blood or plasma.
So I mean, in this case you'resaying saliva is a better
(12:30):
specimen, it's not justequivalent, it's even better.
Dr. Tiffany Montgomery (12:33):
That's impressive, not just that it's a
viable specimen, but that it'sbetter because it correlates
closer to the tissue.
That is correct, and I thinkthat's because saliva circulates
right.
We have the proteins there, wehave the circulating tumor DNA
or CT DNA.
We have metabolites, we havemRNA and for us we are looking
(12:55):
at saliva to detect varioustypes of cancer like oral, lung,
breast, pancreatic and prostatecancer, all using saliva.
So I think it's important toeducate not just consultants,
not just health enthusiasts, butalso other scientists about the
possibilities and really helpto get that research out so that
(13:19):
it can be accepted, understoodand utilized.
Because when you think aboutsaliva-based testing and we go
into the future of truenoninvasive testing not
something that we're saying, oh,this is just a finger prick,
well, it's just a little bit ofblood.
So I'm not the false definition, but if we're truly thinking
about noninvasive diagnostics,where would you see the future
(13:43):
taking us?
Dr. Paul Slowey (13:44):
us.
Well, I'm really excited bywhat you said there, because
most of those tests that you'reworking on for breast and
prostate the tests that areavailable are reasonable, but
sometimes they're very poor.
I mean, in the case of prostatecancer, psa I get my PSA tested
twice a year.
I have biopsy once a year.
The tests are terrible and weneed something that's going to
(14:06):
be an early detection tool forthose people that currently
don't have cancer but may wellprogress to cancer.
So I think you're exactly inthe right realm and saliva will
play a big role in all of theseparticular cancers.
Dr. Tiffany Montgomery (14:20):
Not only that, but it gives us the
opportunity to take the productglobal.
Saliva can be inactivated.
It's not as infectious as bloodor tissue.
It can be stabilized for alonger amount of time.
We were looking at stabilitystudies up to 30 days, right
right.
It really puts us in a positionto break down those barriers,
(14:42):
which include access toscreening tools.
So when you're thinking that Iknow you work globally, tell me
how you think Saliva will playin that global market.
Dr. Paul Slowey (14:53):
One thing before we move on to that,
because I think another areathat we didn't mention is the
area of exosomes, becauseexosomes literally are the
carriers that carry everythingaround the system.
And yeah, saliva is rich inexosomes and we've done a lot of
work on EVs ourselves andcharacterize some of the
particle sizes that you get,size distribution, etc.
(15:14):
So that's something we shouldadd to our conversation.
As far as global is concerned,when I was with AuraShure, my
role was basically internationalmarket manager.
We launched AuraQuick intoSouth Africa in the year 2000,
and I spent a lot of time inUganda, kenya, egypt, in various
other countries in Africa.
Saliva you can collect itanywhere.
(15:35):
I mean that's the thing.
You collect it, you canstabilize it.
People, even in places likeAfrica where they consider blood
to be a taboo matrix, theydon't want to give blood because
it's considered to be part oftheir body, like Jehovah
Witnesses here.
They don't want to take a bloodsample either.
So in those cases saliva ispreferred specimen, and when you
(15:57):
show somebody, they have asaliva collection kit that's
going to collect saliva fromthem in a couple of minutes,
rather than sticking a needle intheir arm, I mean, they just
jump up and down.
It's wonderful Children as well.
I mean the devices that areavailable go down to.
You can collect from two yearolds and above.
So in maybe in Uganda, in thejungle areas and things like
(16:18):
that.
This is going to be ideal Anyday.
You don't have to actually dothe test there, as long as you
can collect the specimen andstabilize it at the point of
collection.
Then you get it back to the laband you can process it in some
of the main labs in the citieslike Kampala and all the cities
like that.
Dr. Tiffany Montgomery (16:34):
So when you were talking about saliva
collection devices another onethat I'm most familiar with is a
utom type device You're goingto ask a respirator to spit into
the tube and stabilize it.
Tell us about some differentthings you can do other than
just spitting in a tube.
How else can you collect saliva?
Dr. Paul Slowey (16:52):
Okay, I mean, yeah, we have devices like that
as well and they can.
They can a little bit like theyou know the origin device,
which is probably the marketleading product.
You spit in the cup and youcollect and stabilize it with a
stabilizer.
We have devices that collectDNA and proteins as well, but
they kind of meet you.
There's other products likethat, like that.
(17:12):
I think the thing thatdifferentiates certain
collections is that they have tobe what collects a purified
sample, and what I mean by thatis you use some sort of
absorbent material in the mouththat basically collects a sample
and purifies a sample duringthe collection process.
During that process as well,you've got sample indication,
you know.
That tells you look, I've gotenough saliva here so that I can
(17:34):
actually stop collecting andnow I can introduce it into a
test, or I can squeeze it into atube and then send it to a
laboratory for testing at alater time.
That's pretty critical whenyou're looking at things like
saliva antigen tests for COVIDand various other things.
Samples that are maybe passive,dual samples, are not really
amenable to what I'd calllateral flow tests or point of
(17:56):
care tests that look at eitherantigens or antibodies in bodily
fluids like saliva or urine orblood.
So if you can purify the sample, you're going to have a much
better chance of getting highsensitivity products from that,
and that's kind of part of ourrationale.
And one of the reasons thatwe're doing quite well right now
is that there are companiesthat are developing these types
(18:16):
of tests that require some sortof upfront you know, saliva
collection and purificationrather than just a sample
collection.
Dr. Tiffany Montgomery (18:24):
So what you're talking about is actually
purifying the sample right atpoint of collection.
Dr. Paul Slowey (18:32):
Yeah, and it could be what's considered a
size exclusion type principle,but the materials will literally
adhere to what I call themucinous material all the thick,
gooey stuff in your saliva thateverything that you want to
collect is still in the saliva.
And through publication we'veshown that these collection
tools will actually give you anequivalent sample.
(18:52):
All the proteins that you'relooking for are still there in
the same quantities that you'relooking for, but the the passive
joule sample is literally 45%lower in protein because they
get bound up.
The mucins get bound up on thecollection tools, so it's a very
neat way of cleaning up thesample and getting it ready for
for downstream analysis.
And that could apply to alldiagnostics cancer diagnostics
(19:14):
either, hormone testing, allthese types of things.
Dr. Tiffany Montgomery (19:18):
When you're talking about the future
and where we're going, thetechnology that's out, what we
can use it for, how we can takethese devices and put them in
the clinical setting.
It's no secret how we met, likehow we, how we really see the,
the vision going.
I mean it's exciting.
But I think that it's importantto help our audience understand
(19:40):
that the genetics of cancer andunderstanding the genetics of
cancer has led us to this pathof looking at the saliva, Help
us unravel the intricacies forbetter health outcomes.
I want to be very transparentthat using the saliva not only
gives us the ability for earlydiagnostic testing or early
(20:03):
diagnosis, because it's justright in line with that tissue.
This can help us and improveour health outcomes because it
can reduce the mortality andmore ability of cancer patients.
It can help improve quality oflife.
The fact that it's not invasivescreening really is exciting.
For different culture,religious, societal reasons,
(20:27):
some of us we may not have areligious reason or moral reason
or cultural reason that we'dalways love.
We just don't like it.
You might not be able to findthe vein, it's uncomfortable,
but you want to know.
We need people to get involvedwith knowing and be proactive in
their health, because knowingand the earlier that you can
(20:47):
detect cancer, the better chanceyou have of fighting it and
beating it Correct Right.
I'm excited about that part.
I just want to make sure thatwe are helping people understand
that this can increasecompliance and accessibility for
cancer screening.
Dr. Paul Slowey (21:05):
If we can reduce the number of biopsies
for lung or breast or prostate,just imagine how much we're
going to help people and,secondly, how much we're going
to save the healthcare system.
Because those things are notcheap, they're invasive and they
take time out of people's lives.
I had a small surgery done acouple of weeks back, but it's
put me out for a couple of weeks.
(21:26):
You don't really include thatas part of the process because
you lose work time as well ashaving to go in and get the
surgery done and that type ofthing.
If we can save people, thosetypes of things, then I think
we're going to save thehealthcare system a lot of money
.
My goal has always been to savelives and help people.
If we can do that and save justone life, it's very important.
Dr. Tiffany Montgomery (21:51):
It's worth it.
You mentioned something that iskey and it's something that P23
really focuses on.
It is using those salivarybiomarkers to provide
information about the molecularcharacteristics and the response
of cancer cells to differenttherapies such as chemotherapy,
(22:12):
radiotherapy, immunotherapy.
You can use the saliva to helptailor the treatment to the
specific needs and preference ofthe patient, optimizing the
efficacy and safety.
Right.
Right when you're looking atthe potential of Not just
detecting but helping tocustomize that treatment, reduce
(22:33):
the adverse drug reaction andhelping to drive the appropriate
outcome for care, you're nolonger Stabbing in the dark.
It gives you a very Directedroadmap to how this person will
respond with this type of cancer.
Dr. Paul Slowey (22:49):
It's true, and there are applications that are
already FDA approved whichbasically set the groundwork for
other ones to come through.
Pharmacogenomics is enough isvery.
Saliva's a plays a really,really big role in
pharmacogenomics.
So you got you look at sip tosee nine PGX, 5 fu, for instance
your five-flory urus cell.
I have a personal interest inthat.
My mother this is a really sadstory.
(23:10):
My mother was only 70 and shewas diagnosed with ovarian
cancer and they basically puther on 5f?
U but they didn't Test her forwhether she responded well or
badly to 5f?
U at the time and I was kind offurious.
But she responded extremelybadly and she went into a state
of dementia.
So they did.
(23:31):
The English doctors at the timesaid well, the only way we can
get her out of this dementia isto give her Electric shock
treatment.
So they give her a lot electricshock treatment which caused a
stroke and then a couple yearslater she died.
And you know, I think if they'djust done that test that would
have saved my mother's life.
I I swear that that that's thecase and it must be the same for
(23:53):
a lot of other people.
So the more testing we can doup front to verify and as you
said, to also, you know,determine what treatment
somebody should get, because 50%the people will respond well to
a treatment and the other 50%Will not.
You know we get, we have toknow which ones and, yeah,
you're at the forefront of this,dr Montgomery.
Dr. Tiffany Montgomery (24:11):
Oh, no, I'm doing behind you, I'm just a
grasshopper and I'm learningyour pupil.
I'm dead.
I'm a junior, junior people,honored to just be a part and
really be driving thisdiscussion.
Dr. Paul Slowey (24:24):
Do you know?
Would you know one thing wehaven't talked about and you
know, I'm kind of a consultantfor another company that's it's
working in the Alzheimer's fieldand I'm a co-chair of a
salivary working group which itwhich sits under the framework
of the Alzheimer's Associationand it's called a salivary
working group for Alzheimer'sdisease and it Constitutes about
50 people, global people thatare the experts in the saliva
(24:46):
world that are looking atsalivary biomarkers.
But the company I'm talkingabout they're called baseline
bioscience.
There they have intellectualproperty that we literally
brought to them.
We have some of it, they havethe others, but they're looking
to develop a point of careapplication for saliva for
Alzheimer's disease, looking at,you know, several biomarkers
which would be amazing.
(25:07):
You know, and you, we can dothe same thing with Parkinson's,
concussion and sleep disorders.
So we, you know, we haveintellectual property
surrounding those.
Dr. Tiffany Montgomery (25:15):
Well, probably we didn't get on that
because this episode is aboutcancer genetics, as some of your
Friends we might have.
Like a little, I don't know.
Panel discussion aboutAlzheimer's is such a complex
topic.
It's exciting, it's.
It's a part of where we are.
As we're living longer andwe're creating these longer
(25:38):
lives, more people areencountering it.
Dr. Paul Slowey (25:41):
I think that is a definite worthwhile
conversation to have but I thinkour job for cancer is to is to
Reach out to some of theselarger companies that are
completely blood-based and, youknow, I think they're very
Blinkered.
They think in one direction,which is blood testing, blood
testing, always blood testing,or tissue testing.
You know we need to get acrossthe fact that saliva is equally
(26:05):
applicable for you know, for thetests that they're developing
and you know, eventually, as wesaid, that's going to be cheaper
.
You know, because you don'thave to have a blood test, is
going to help more people.
We're going to get more peopleinto into treatment earlier.
So we just have to convincethem.
My voice is very small.
I mean, you know you, you giveme very nice compliments, but
you know, to be honest, you knowwe need people that have
(26:27):
high-power, strong voices thatcan basically advocate what
we're talking about here today.
Dr. Tiffany Montgomery (26:33):
We'll continue to build those voices,
for sure right.
I have enjoyed our conversationtoday.
Thank you for coming on.
We definitely have to continuethis conversation as we draw
this enlightening episode ofdemystifying DNA to a close.
Our episode today focused onunraveling the secrets cancer
(26:58):
and genetics in saliva-basedtesting.
Dr Paul Slowey and I, DrTiffany Montgomery, would like
to extend our gratitude for yourengagement.
Today we've uncovered thecritical role the saliva-based
testing plays in early cancerdetection and the incredible
(27:18):
potential it holds in the futureof disease prevention.
We hope we've broadened yourunderstanding of this
cutting-edge field and sparkedyour curiosity about the
incredible potential of geneticsto transform health care.
Remember, the world of geneticresearch never stands still
consistently unraveling newhorizons for our well-being.
(27:42):
Continue to explore, stayengaged and join us again on
demystifying DNA from moreenlightening journeys into the
fascinating realm of genetics.
Here's a friendly reminderwe're with you every step of the
way on this journey ofdiscovery.
Until next time.
P23 Theme Music (28:08):
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Knowledge, access, power.
P23.
Wellness and understanding atyour fingertips.
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And that's no cap.
P23 Knowledge, access, power.
P23, wellness and Understandingat your fingertips P23.
And that's no cap.
Dr. Tiffany Montgomery (00:21):
Welcome back to another episode of
Demystifying DNA, for go-topodcasts, for unraveling the
mysteries of genetics and theirprofound influence on our lives.
I'm your host, Dr.
Tiffany Montgomery scientist,epidemiologist and just that
(00:42):
curious lady CEO of P23 Health,and today we are joined by a
distinguished expert in thefield, Dr.
Paul Slowey.
Dr.
Slowey is the founder and CEOof Oasis Diagnostics, a company
(01:03):
that specializes in non-invasivesaliva testing for a variety of
purposes, such as infectiousdiseases, genetics, nutrition
and more.
He is also the co-founder ofthe North American Salabas
Symposium, a member of theOregon Bioscience Association
(01:24):
and Life Science Washington andan honorary visiting professor
at Central South University inChina.
Dr Slowey has over 32 years ofexperience in clinical
diagnostics and pharmaceuticalindustries.
He has published 45 articles.
He has 15 patents, authoredseven chapters and has 12 patent
(01:49):
applications on various topicsrelated to saliva science.
He is widely recognized as apioneer and a leader in the
field of oral fluid diagnostics.
He has been instrumental indeveloping and commercializing
several saliva-based productsand technologies, such as the
(02:10):
ORQIC HIV test, the firstover-the-counter HIV test in the
US.
He is a husband, a father, agrandfather, a friend and a
mentor.
Dr Slowey is a dear, dearfriend, scientist in mind, who
has four children and almosteight grandchildren.
(02:33):
Dr Slowey, thank you forjoining us today.
Dr. Paul Slowey (02:37):
Well, thank you for having me.
I'm very, very honored toactually be part of this.
I wanted to do this for a longtime, so I'm really really
honored to be here.
Dr. Tiffany Montgomery (02:46):
We are thrilled to have you.
We love talking science and Ilove getting excited about
something that's so dear to me.
Not just science, not justgenetics, but saliva.
I love making it easy, so thisis going to be great.
In this episode, unraveling theSecrets Cancer and Genetics in
(03:07):
Salava-Based Testing, we willfocus on early detection through
saliva-based testing, wherewe'll delve into the fact of the
fascinating world ofnon-invasive diagnostic tools
and their transformative role inearly cancer detection.
From the power of saliva anddisease screening to the latest
(03:30):
breakthroughs in cancer genetics.
Buckle up for an excitingdiscussion that could alter your
perception of diseaseprevention.
Let's kick-start this rivetingconversation, dr Sloe.
So we talked about the power ofsaliva.
I want you.
You're basically like thegodfather of saliva.
Dr. Paul Slowey (03:50):
No, I'm not the godfather, I'm still a pupil.
I have lots of excellentmentors that are right there as
well, but I guess, as far as thecommercialization side and the
applications for saliva, I'mkind of synonymous with that, so
hopefully I can address some ofthe questions and point you to
some of the other leaders in thefield that could be on a future
(04:12):
one of these podcasts.
Dr. Tiffany Montgomery (04:15):
This is exciting.
So when we talk about the powerof saliva, why do you think
it's such a revolutionary toolfor disease detection?
Dr. Paul Slowey (04:23):
But you know we've been in this business or
myself have been in thisbusiness for 30 years with
Orishur saliva diagnosticsystems and then my own company
for the last 21 years.
And you know, if you look backin history, you know epitope
became Orishur in what I thinkwas 1999 or probably 2000, and
saliva at that time was prettymuch an upheld Push.
(04:44):
And I think the reasons that Ican look back on and say why
that's the case is that you knowSalivar is typically present in
either the biomarkers thatyou're looking for in saliva
whether they they be DNA,protein, rna they're usually
present in smaller quantities.
For, for instance, I think HIVis like 1400 times lower HIV
antibodies in saliva than inblood.
(05:05):
However, nowadays we have themuch more sensitive technologies
that can actually detect thosebiomarkers.
So you know, in proteins, forinstance, you got mass
spectrometry.
You know very, very highresolution mass spec.
You've got next generationsequence and you've got lateral
flow that can use fluorescencebased particles instead of
either colloidal gold, so youcan actually get down to much
(05:26):
lower levels and lower limits ofdetection.
So I think that and Puttogether that with the 23 and
me's of this world, the ancestrycomm, and then the advent of
COVID, where saliva became Kindof the mainstay, if you like,
for for sampling.
I think those things havereally pushed saliva forward and
it's really an exciting time tobe in the saliva world, to be
(05:49):
honest.
Dr. Tiffany Montgomery (05:50):
Now, when you think about what we're
able to detect in saliva, arethere any doubts in your mind
when it comes to the sensitivityor the accuracy of testing when
you compare, say, a nasal swabor blood sample to a saliva
sample?
Dr. Paul Slowey (06:07):
I think, if you take each one in turn, you know
there's there's cases for aswab test, there's cases for
saliva.
But I think, if you look backand use the COVID pandemic as an
example, when, when theshortage of swabs happened
randomly at March 2020 and Italked to a very large company,
a 25 billion dollar company atthe time, we, which shall remain
nameless, but they had a backorder of 37 million nasal swabs
(06:31):
on that nasal pharyngeal swabs.
We couldn't get swabs anywhereand that's kind of the time when
saliva became either the thatthe saliva was that tool of
choice, but it took a littlewhile.
The first publications thatcame out were kind of iffy.
But, over everything, if youlook back on the publications
from now Back to 2020, you'llsee that probably saliva is now
(06:52):
edged in front of nasalpharyngeal swabs.
And I can point to a study thatwas done in Europe on 11
different pathogens and on dayone, saliva and swab were
basically equivalent in terms ofsensitivity, but after day one,
the saliva basically took overin terms of being a better and
more sensitive tool for for thatparticular.
(07:13):
You know, and it was multiplepathogens, it wasn't just COVID,
it was RSV and flu A, flu B,etc.
So, yeah, I think it's it'sbecome a really really good tool
of choice and you know it's agood area to be in and I'm
really glad that you're in thisarea as well already.
Dr. Tiffany Montgomery (07:29):
Thank you.
It is exciting and I think thatinitially there were a lot of
doubts and one of the biggestproblems that we face Were that
the people who were doing thevalidations and you had the
ability to really convinceinstead of writing papers.
We were doing the work.
We were trying to get the EUAas we were trying to educate our
scientific community so morepeople could use the technology
(07:52):
so that we Be useful and helpful, especially with the shortage,
and I think, even Internallyinside of the scientific
community.
It took so convincing betweenscientists to even get
scientists to understand hey, wecan do this with something
other than a nasal swab.
Dr. Paul Slowey (08:09):
Right.
I think the thing that makes mereally excited and this
typically you mentioned in NorthAmerican saliva symposium we
haven't had one since COVIDstarted but I intend to have one
this year but the goal of thatwas literally to bring together
the commercial sector involvedin saliva, like 23andme,
ancestrycom, thermo Fisher, etcetera all these big companies
(08:30):
and then bring in theresearchers that are developing
the next biomarkers for diseasesall over the place At that
particular meeting.
As much as I'd love to talkabout what I do, I don't talk
very much.
I introduce the subject.
I spend 15 minutes introducingthe field and then I go out on
other meetings like that.
(08:50):
There was a meeting inAustralia recently called the
Salsa meeting, which was salivaliquid sampling Australia
meeting in May and I made a Ithink it was a 30 minute
presentation.
I didn't talk about anything wedid.
All I wanted to talk about wasthe new applications that are so
exciting.
You can determine yourbiological age.
You can detect pregnancy either.
(09:12):
There's a luminescence test forCOVID, I mean there's, just you
name it.
We're talking to people thatare developing tests for
congestive heart failure thatwill detect for risk biomarkers
for congestive heart failure andbe able to tell you in 30
minutes that, yeah, you have amuch higher risk.
We provide devices to theAlzheimer's associates for ApoE
(09:33):
genotyping.
That tells you whether you gota higher risk of having
Alzheimer's.
And you know, my wife's fatherdied of Alzheimer's so we were
very quick to have her tested.
Fortunately, she doesn't havethe ApoE4 gene, she's ApoE3.
So she's a much lower risk thanpeople who have the ApoE4 gene.
So there's not many things thatI can think of where you know
saliva is not going to play arole.
(09:54):
To be honest, and that'sexciting.
Dr. Tiffany Montgomery (09:56):
I think that you get something that was
key because we have to make surethat we continue that education
within our scientific communityas well.
I really push and forge thatinnovation, I think for sure.
We've talked about yoursymposium.
I'm excited P23 Labs and P23Health will be attending.
Dr. Paul Slowey (10:16):
Okay, good, good, good.
So I'm excited.
Dr. Tiffany Montgomery (10:18):
I want you to bring that back, so keep
us posted on that.
With saliva, we talk about it alot.
With infectious disease, we'vetalked about COVID and RSV.
You've mentioned briefly thebroad areas that it applies to,
but I want you to tell me alittle bit in particular how
saliva will play a role withearly cancer detection.
Dr. Paul Slowey (10:42):
I think this is the thing that I am so excited
about, and the reason is that Ithink we all know that when a
tumor forms, you knowcirculating tumor DNA is kind of
released into the blood streamvery quickly and a lot of
companies like FoundationMedicine, garden Health and
others have kind of picked up onthat and developed cancer-based
diagnostics based on a bloodliquid biopsy, which, by the way
(11:05):
, they like to call anon-invasive specimen which kind
of drives me up the wall,because blood, in my opinion,
was never a non-invasivespecimen, but that's a side
subject.
Companies like ours and othersdeveloped what we call saliva
liquid biopsy, if quantities.
So you may have to basicallyenrich the sample, but we have
(11:26):
one application that's reportedby the National Cancer Institute
for lung cancer particularly,and with one drop of saliva in
non-purified form you don't evenhave to purify the saliva, go
straight on a machine.
30 minutes later you candiagnose lung cancer.
Looking at a couple of mutationsin the EGFR gene, one of which
is the Exon 19 deletion, theother is the L858R, and to me
(11:49):
that's just kind of the proof ofconcept for multiple cancer
tests to be developed, providingthat the biomarkers are
available, and we're not abiomarker company, so we
literally provide tools that cancollect saliva.
We still need companies thathave the biomarkers to basically
partner with to bring these newapplications to market.
And I forgot to mention, inthis particular case, which is
(12:10):
reported widely it's been aroundfor about 10 years the
correlation that you get betweenthe saliva liquid biopsy
specimen is actually better.
With tissue, just tissue,obviously being the gold
standard.
The saliva sample is much morewell correlated to tissue than
blood or plasma.
So I mean, in this case you'resaying saliva is a better
(12:30):
specimen, it's not justequivalent, it's even better.
Dr. Tiffany Montgomery (12:33):
That's impressive, not just that it's a
viable specimen, but that it'sbetter because it correlates
closer to the tissue.
That is correct, and I thinkthat's because saliva circulates
right.
We have the proteins there, wehave the circulating tumor DNA
or CT DNA.
We have metabolites, we havemRNA and for us we are looking
(12:55):
at saliva to detect varioustypes of cancer like oral, lung,
breast, pancreatic and prostatecancer, all using saliva.
So I think it's important toeducate not just consultants,
not just health enthusiasts, butalso other scientists about the
possibilities and really helpto get that research out so that
(13:19):
it can be accepted, understoodand utilized.
Because when you think aboutsaliva-based testing and we go
into the future of truenoninvasive testing not
something that we're saying, oh,this is just a finger prick,
well, it's just a little bit ofblood.
So I'm not the false definition, but if we're truly thinking
about noninvasive diagnostics,where would you see the future
(13:43):
taking us?
Dr. Paul Slowey (13:44):
us.
Well, I'm really excited bywhat you said there, because
most of those tests that you'reworking on for breast and
prostate the tests that areavailable are reasonable, but
sometimes they're very poor.
I mean, in the case of prostatecancer, psa I get my PSA tested
twice a year.
I have biopsy once a year.
The tests are terrible and weneed something that's going to
(14:06):
be an early detection tool forthose people that currently
don't have cancer but may wellprogress to cancer.
So I think you're exactly inthe right realm and saliva will
play a big role in all of theseparticular cancers.
Dr. Tiffany Montgomery (14:20):
Not only that, but it gives us the
opportunity to take the productglobal.
Saliva can be inactivated.
It's not as infectious as bloodor tissue.
It can be stabilized for alonger amount of time.
We were looking at stabilitystudies up to 30 days, right
right.
It really puts us in a positionto break down those barriers,
(14:42):
which include access toscreening tools.
So when you're thinking that Iknow you work globally, tell me
how you think Saliva will playin that global market.
Dr. Paul Slowey (14:53):
One thing before we move on to that,
because I think another areathat we didn't mention is the
area of exosomes, becauseexosomes literally are the
carriers that carry everythingaround the system.
And yeah, saliva is rich inexosomes and we've done a lot of
work on EVs ourselves andcharacterize some of the
particle sizes that you get,size distribution, etc.
(15:14):
So that's something we shouldadd to our conversation.
As far as global is concerned,when I was with AuraShure, my
role was basically internationalmarket manager.
We launched AuraQuick intoSouth Africa in the year 2000,
and I spent a lot of time inUganda, kenya, egypt, in various
other countries in Africa.
Saliva you can collect itanywhere.
(15:35):
I mean that's the thing.
You collect it, you canstabilize it.
People, even in places likeAfrica where they consider blood
to be a taboo matrix, theydon't want to give blood because
it's considered to be part oftheir body, like Jehovah
Witnesses here.
They don't want to take a bloodsample either.
So in those cases saliva ispreferred specimen, and when you
(15:57):
show somebody, they have asaliva collection kit that's
going to collect saliva fromthem in a couple of minutes,
rather than sticking a needle intheir arm, I mean, they just
jump up and down.
It's wonderful Children as well.
I mean the devices that areavailable go down to.
You can collect from two yearolds and above.
So in maybe in Uganda, in thejungle areas and things like
(16:18):
that.
This is going to be ideal Anyday.
You don't have to actually dothe test there, as long as you
can collect the specimen andstabilize it at the point of
collection.
Then you get it back to the laband you can process it in some
of the main labs in the citieslike Kampala and all the cities
like that.
Dr. Tiffany Montgomery (16:34):
So when you were talking about saliva
collection devices another onethat I'm most familiar with is a
utom type device You're goingto ask a respirator to spit into
the tube and stabilize it.
Tell us about some differentthings you can do other than
just spitting in a tube.
How else can you collect saliva?
Dr. Paul Slowey (16:52):
Okay, I mean, yeah, we have devices like that
as well and they can.
They can a little bit like theyou know the origin device,
which is probably the marketleading product.
You spit in the cup and youcollect and stabilize it with a
stabilizer.
We have devices that collectDNA and proteins as well, but
they kind of meet you.
There's other products likethat, like that.
(17:12):
I think the thing thatdifferentiates certain
collections is that they have tobe what collects a purified
sample, and what I mean by thatis you use some sort of
absorbent material in the mouththat basically collects a sample
and purifies a sample duringthe collection process.
During that process as well,you've got sample indication,
you know.
That tells you look, I've gotenough saliva here so that I can
(17:34):
actually stop collecting andnow I can introduce it into a
test, or I can squeeze it into atube and then send it to a
laboratory for testing at alater time.
That's pretty critical whenyou're looking at things like
saliva antigen tests for COVIDand various other things.
Samples that are maybe passive,dual samples, are not really
amenable to what I'd calllateral flow tests or point of
(17:56):
care tests that look at eitherantigens or antibodies in bodily
fluids like saliva or urine orblood.
So if you can purify the sample, you're going to have a much
better chance of getting highsensitivity products from that,
and that's kind of part of ourrationale.
And one of the reasons thatwe're doing quite well right now
is that there are companiesthat are developing these types
(18:16):
of tests that require some sortof upfront you know, saliva
collection and purificationrather than just a sample
collection.
Dr. Tiffany Montgomery (18:24):
So what you're talking about is actually
purifying the sample right atpoint of collection.
Dr. Paul Slowey (18:32):
Yeah, and it could be what's considered a
size exclusion type principle,but the materials will literally
adhere to what I call themucinous material all the thick,
gooey stuff in your saliva thateverything that you want to
collect is still in the saliva.
And through publication we'veshown that these collection
tools will actually give you anequivalent sample.
(18:52):
All the proteins that you'relooking for are still there in
the same quantities that you'relooking for, but the the passive
joule sample is literally 45%lower in protein because they
get bound up.
The mucins get bound up on thecollection tools, so it's a very
neat way of cleaning up thesample and getting it ready for
for downstream analysis.
And that could apply to alldiagnostics cancer diagnostics
(19:14):
either, hormone testing, allthese types of things.
Dr. Tiffany Montgomery (19:18):
When you're talking about the future
and where we're going, thetechnology that's out, what we
can use it for, how we can takethese devices and put them in
the clinical setting.
It's no secret how we met, likehow we, how we really see the,
the vision going.
I mean it's exciting.
But I think that it's importantto help our audience understand
(19:40):
that the genetics of cancer andunderstanding the genetics of
cancer has led us to this pathof looking at the saliva, Help
us unravel the intricacies forbetter health outcomes.
I want to be very transparentthat using the saliva not only
gives us the ability for earlydiagnostic testing or early
(20:03):
diagnosis, because it's justright in line with that tissue.
This can help us and improveour health outcomes because it
can reduce the mortality andmore ability of cancer patients.
It can help improve quality oflife.
The fact that it's not invasivescreening really is exciting.
For different culture,religious, societal reasons,
(20:27):
some of us we may not have areligious reason or moral reason
or cultural reason that we'dalways love.
We just don't like it.
You might not be able to findthe vein, it's uncomfortable,
but you want to know.
We need people to get involvedwith knowing and be proactive in
their health, because knowingand the earlier that you can
(20:47):
detect cancer, the better chanceyou have of fighting it and
beating it Correct Right.
I'm excited about that part.
I just want to make sure thatwe are helping people understand
that this can increasecompliance and accessibility for
cancer screening.
Dr. Paul Slowey (21:05):
If we can reduce the number of biopsies
for lung or breast or prostate,just imagine how much we're
going to help people and,secondly, how much we're going
to save the healthcare system.
Because those things are notcheap, they're invasive and they
take time out of people's lives.
I had a small surgery done acouple of weeks back, but it's
put me out for a couple of weeks.
(21:26):
You don't really include thatas part of the process because
you lose work time as well ashaving to go in and get the
surgery done and that type ofthing.
If we can save people, thosetypes of things, then I think
we're going to save thehealthcare system a lot of money
.
My goal has always been to savelives and help people.
If we can do that and save justone life, it's very important.
Dr. Tiffany Montgomery (21:51):
It's worth it.
You mentioned something that iskey and it's something that P23
really focuses on.
It is using those salivarybiomarkers to provide
information about the molecularcharacteristics and the response
of cancer cells to differenttherapies such as chemotherapy,
(22:12):
radiotherapy, immunotherapy.
You can use the saliva to helptailor the treatment to the
specific needs and preference ofthe patient, optimizing the
efficacy and safety.
Right.
Right when you're looking atthe potential of Not just
detecting but helping tocustomize that treatment, reduce
(22:33):
the adverse drug reaction andhelping to drive the appropriate
outcome for care, you're nolonger Stabbing in the dark.
It gives you a very Directedroadmap to how this person will
respond with this type of cancer.
Dr. Paul Slowey (22:49):
It's true, and there are applications that are
already FDA approved whichbasically set the groundwork for
other ones to come through.
Pharmacogenomics is enough isvery.
Saliva's a plays a really,really big role in
pharmacogenomics.
So you got you look at sip tosee nine PGX, 5 fu, for instance
your five-flory urus cell.
I have a personal interest inthat.
My mother this is a really sadstory.
(23:10):
My mother was only 70 and shewas diagnosed with ovarian
cancer and they basically puther on 5f?
U but they didn't Test her forwhether she responded well or
badly to 5f?
U at the time and I was kind offurious.
But she responded extremelybadly and she went into a state
of dementia.
So they did.
(23:31):
The English doctors at the timesaid well, the only way we can
get her out of this dementia isto give her Electric shock
treatment.
So they give her a lot electricshock treatment which caused a
stroke and then a couple yearslater she died.
And you know, I think if they'djust done that test that would
have saved my mother's life.
I I swear that that that's thecase and it must be the same for
(23:53):
a lot of other people.
So the more testing we can doup front to verify and as you
said, to also, you know,determine what treatment
somebody should get, because 50%the people will respond well to
a treatment and the other 50%Will not.
You know we get, we have toknow which ones and, yeah,
you're at the forefront of this,dr Montgomery.
Dr. Tiffany Montgomery (24:11):
Oh, no, I'm doing behind you, I'm just a
grasshopper and I'm learningyour pupil.
I'm dead.
I'm a junior, junior people,honored to just be a part and
really be driving thisdiscussion.
Dr. Paul Slowey (24:24):
Do you know?
Would you know one thing wehaven't talked about and you
know, I'm kind of a consultantfor another company that's it's
working in the Alzheimer's fieldand I'm a co-chair of a
salivary working group which itwhich sits under the framework
of the Alzheimer's Associationand it's called a salivary
working group for Alzheimer'sdisease and it Constitutes about
50 people, global people thatare the experts in the saliva
(24:46):
world that are looking atsalivary biomarkers.
But the company I'm talkingabout they're called baseline
bioscience.
There they have intellectualproperty that we literally
brought to them.
We have some of it, they havethe others, but they're looking
to develop a point of careapplication for saliva for
Alzheimer's disease, looking at,you know, several biomarkers
which would be amazing.
(25:07):
You know, and you, we can dothe same thing with Parkinson's,
concussion and sleep disorders.
So we, you know, we haveintellectual property
surrounding those.
Dr. Tiffany Montgomery (25:15):
Well, probably we didn't get on that
because this episode is aboutcancer genetics, as some of your
Friends we might have.
Like a little, I don't know.
Panel discussion aboutAlzheimer's is such a complex
topic.
It's exciting, it's.
It's a part of where we are.
As we're living longer andwe're creating these longer
(25:38):
lives, more people areencountering it.
Dr. Paul Slowey (25:41):
I think that is a definite worthwhile
conversation to have but I thinkour job for cancer is to is to
Reach out to some of theselarger companies that are
completely blood-based and, youknow, I think they're very
Blinkered.
They think in one direction,which is blood testing, blood
testing, always blood testing,or tissue testing.
You know we need to get acrossthe fact that saliva is equally
(26:05):
applicable for you know, for thetests that they're developing
and you know, eventually, as wesaid, that's going to be cheaper
.
You know, because you don'thave to have a blood test, is
going to help more people.
We're going to get more peopleinto into treatment earlier.
So we just have to convincethem.
My voice is very small.
I mean, you know you, you giveme very nice compliments, but
you know, to be honest, you knowwe need people that have
(26:27):
high-power, strong voices thatcan basically advocate what
we're talking about here today.
Dr. Tiffany Montgomery (26:33):
We'll continue to build those voices,
for sure right.
I have enjoyed our conversationtoday.
Thank you for coming on.
We definitely have to continuethis conversation as we draw
this enlightening episode ofdemystifying DNA to a close.
Our episode today focused onunraveling the secrets cancer
(26:58):
and genetics in saliva-basedtesting.
Dr Paul Slowey and I, DrTiffany Montgomery, would like
to extend our gratitude for yourengagement.
Today we've uncovered thecritical role the saliva-based
testing plays in early cancerdetection and the incredible
(27:18):
potential it holds in the futureof disease prevention.
We hope we've broadened yourunderstanding of this
cutting-edge field and sparkedyour curiosity about the
incredible potential of geneticsto transform health care.
Remember, the world of geneticresearch never stands still
consistently unraveling newhorizons for our well-being.
(27:42):
Continue to explore, stayengaged and join us again on
demystifying DNA from moreenlightening journeys into the
fascinating realm of genetics.
Here's a friendly reminderwe're with you every step of the
way on this journey ofdiscovery.
Until next time.
P23 Theme Music (28:08):
P23.
Knowledge, access, power.
P23.
Wellness and understanding atyour fingertips.
P23.
And that's no cap.
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