In response to the article; “Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer. J Lab Physicians. 2023;15(2):264-268”

We congratulate Chavan et al for their study that explored the significance of salivary immunoglobulin A (IgA)s levels in predicting microbial infections in patients with head and neck cancer (HNC) who underwent adjuvant chemoradiotherapy (CRT).[1] Their findings demonstrated a considerable rise in the prevalence of bacterial infections, mostly Klebsiella pneumoniae and Pseudomonas aeruginosa, in post-CRT patients. Furthermore, individuals with oral mucositis who acquired bacterial and fungal infections had significantly higher levels of salivary IgA (p = 0.003) than those who did not. The results of this study provide valuable insights into the relationship between radiation-induced toxicities and the mucosal immune response, specifically in the context of oral mucositis and concomitant infections. However, two issues need further discussion, which may contribute to the existing body of knowledge on this hot topic.