Associations between environmental factors and serological Epstein-Barr virus antibodies in patients with nasopharyngeal carcinoma in South China.

Epstein-Barr virus (EBV) reactivation, reflected by aberrantly increased levels of various serological antibodies, has been suggested to be an early indicator of nasopharyngeal carcinoma (NPC) onset and progression. We have previously suggested that certain lifestyle and dietary factors were associated with elevated serological levels of the antibody against various EBV antigens namely VCA, Zta, EBNA1, and oral EBV DNA loads among healthy population. It remains unclear whether these potential environmental factors would also influence EBV serological antibodies in NPC patients. We conducted an epidemiological study to evaluate the associations between such environmental factors and EBV antibody levels among 1701 NPC patients in South China. Pretreatment serums were collected and examined for VCA-IgA and EA-IgA by immunoenzymatic assays and antienzyme rate (AER) of EBV DNase-specific neutralizing antibody. We found that consumption of Canton-style herbal tea was significantly correlated with increased serological antibody levels of VCA-IgA and EA-IgA, with adjusted ORs of 1.35 (95% CI: 1.03-1.76) and 1.32 (95% CI: 1.01-1.73), respectively, in the weekly intake frequency stratum, while not related to AER of EBV DNase-specific neutralizing antibody. Smoking was found to be not only an apparent risk factor for higher antibody levels of AER in stage III-IV patients (OR = 1.60, 95% CI: 1.11-2.30), but also associated closely with NPC stage at diagnosis (OR = 2.17, 95% CI: 1.47-3.22), with dose-response effects. In conclusion, we found consumption of Canton-style herbal tea and cigarette smoking were in positive associations with elevated EBV antibodies in NPC patients, which may be of public health significance for the primary prevention of EBV-associated diseases especially NPC.

[Cancers associated with systemic sclerosis involving anti-RNA polymerase III antibodies]. / Néoplasies associées à une sclérodermie systémique avec anticorps anti-ARN polymérase III.

BACKGROUND: The incidence of cancer is increased in patients with systemic sclerosis (SSc). Further, recent studies have also shown that the presence of anti-RNA polymerase III antibodies is associated with a higher incidence of cancer in this population. PATIENTS AND METHODS: Herein we present the cases of two men aged 56 and 23 years presenting SSc without anti-Scl70 or anti-centromere antibodies but with anti-RNA polymerase III antibodies. Clinical symptoms led us to prescribe more laboratory exams and both patients were diagnosed with cancer of the nasopharyngeal area. DISCUSSION: Anti-RNA polymerase III antibodies are useful for SSc diagnosis in patients without anti-centromere or anti-Scl70 antibodies. Their presence must lead physicians to screen for associated cancer, even in the absence of clinical signs.

The efficacy of traditional Chinese Medicine as an adjunctive therapy in nasopharyngeal carcinoma: a systematic review and meta-analysis.

PURPOSE: The purpose of this systematic review was to assess the efficacy of traditional Chinese Medicine (TCM) as an adjunctive therapy to radiotherapy (RT) and/or chemotherapy (CT) for patients with nasopharyngeal carcinoma (NPC). METHODS: Randomized controlled trials (RCTs) with TCM to treat NPC were extensively searched in eight databases. Two researchers independently assessed the quality and validity of the included trials and extracted outcome data. Thirteen RCTs were included for analysis. RESULTS: Compared to using RT and/or CT, TCM combined with conventional cancer therapy had significantly improved Karnofsky performance status (KPS) [odds ratio (OR) 4.81, 95% confidence interval (CI) 3.06-7.56]. TCM as an adjunctive therapy significantly reduced the serious adverse effects of RT to the oral mucosa and skin so that grade I+II prevailed [OR 2.19, 95% CI 1.31-3.66; OR 8.63, 95% CI 3.28-22.70, respectively]. The combined therapy significantly enhanced immunoregulation, improving the levels of CD3, CD4 T cells (OR 10.08, 95% CI 1.38-18.78; OR 7.08, 95% CI 2.41-11.74, respectively). CONCLUSIONS: This systematic review suggests that TCM as a therapy adjunctive to RT and/or CT vs only RT and/ or CT has significant efficacy in terms of improvement of quality of life (QoL), alleviation of acute adverse effects, and enhancement of immunoregulation.

[Clinical study of bi yan qing du ke li and nasal care in treatment of patients with nasopharyngeal carcinoma after radiotherapy].

OBJECTIVE: To investigate the effect of bi yan qing du ke li combined with Nasal Care on the titers of EB virus VCA/IgA and nasopharyngeal symptoms in patients with nasopharyngeal carcinoma(NPC) after radiotherapy. METHOD: Sixty NPC patients underwent-radiotherapy were randomly divided into study group (bi yan qing du ke li combined with nasal care, n=30) and control group (bi yan qing du ke li group, n=30). RESULT: After treatment, the geometric mean titer of VCA/IgA was 20.5 in study group and 55.6 in control group, respectively (P < 0.05). Meanwhile, the nasopharyngeal symptoms after treatment in study group was improved significantly better than that of control group (P < 0.05). CONCLUSION: The application of bi yan qing du ke li combined with Nasal Care can significantly decrease the titers of VCA/IgA in NPC patients after-radiotherapy and improve the nasopharyngeal symptoms, which might be helpful to decrease the recurrence rate of NPC.

Antitumor and immunoregulatory effects of astragalus on nasopharyngeal carcinoma in vivo and in vitro.

This study was carried out to evaluate the effects of Astragalus on human nasopharyngeal carcinoma (NPC) viability and apoptosis and to investigate the mechanism of Astragalus in a NPC cell line (CNE2). Cell viability was measured using the MTT assay. CNE2 cells treated with Astragalus were stained with acridine orange/ethidium bromide and subjected to fluorescence microscopy. Bcl-2, Bax, caspase-3 and -8 were measured by western blotting. Rat NPC cells were used to establish a NPC model. Tumor weight, immune organ index and T lymphocyte subsets were employed to detect the immunoregulatory and antitumor effects of Astragalus after administration. Astragalus was effective in inducing apoptosis in CNE2 cells. Morphological changes associated with cell injury were found. Western analysis showed caspase-3, -8, and Bax protein levels were increased after Astragalus treatment, while the bcl-2 protein level was decreased. Astragalus increased the percentage of CD3(+) , CD4(+) T-lymphocytes, and the ratio of CD4(+) /CD8(+) . Astragalus also restored the immunological effects of DDP-induced immunosuppression. These findings suggest that the immunomodulatory and anticancer effects of DDP + Astragalus were better than those of DDP alone, and Astragalus could inhibit immunosuppression induced by DDP. The combination of CDDP + Astragalus could be developed as an effective chemotherapeutic regimen in the treatment of nasopharyngeal carcinoma.

Clinical efficacy of traditional Chinese medicine as a concomitant therapy for nasopharyngeal carcinoma: a systematic review and meta-analysis.

Many published studies have reported the use of traditional Chinese medicine (TCM) in combination with conventional cancer therapy for nasopharyngeal carcinoma (NPC). The purpose of this systematic review was to assess the efficacy of TCM as a concomitant therapy for NPC patients. A meta-analysis was conducted covering English- and Chinese-language studies published from 1966 to November 2007. Extensive searches were performed with the AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, Ovid EBM Review, and CNKI databases. Controlled trials comparing NPC patients treating by TCM combined with conventional cancer therapy (treatment group) versus patients using conventional cancer therapy alone (control group) were analyzed. Of the 178 potentially relevant publications, 18 controlled trials met the inclusion criteria. There were 18 studies (n = 1732) reported significant increase in the number of patients with survival more than 1, 3, or 5 years in the treatment group. Six studies (n = 464) reported enhancement of complete or partial immediate tumor responses with TCM combination treatment. Two studies (n = 135) reported stabilized or improved Karnofsky performance status with TCM combination treatment. Five studies (n = 439) significantly reduced the risk of adverse effects in the treatment group. Three studies (n = 182) reported significant immuno-stimulation in the treatment group. There were 16 Chinese herbs found to be commonly used across the studies. Published studies suggest that TCM is efficacious as a concomitant therapy for NPC patients. These results require confirmation with rigorously controlled trials.

[Prognostic value of changes of peripheral blood T cell subsets after thermoradiotherapy for nasopharyngeal carcinoma].

OBJECTIVE: To assess the prognostic value of changes of peripheral blood T cell subsets after thermoradiotherapy for nasopharyngeal carcinoma (NPC). METHODS: Peripheral blood T cell subsets in 20 normal subjects (control group), 30 NPC patients undergoing thermoradiotherapy, and 20 NPC patients undergoing radiotherapy were detected by flow cytometry. RESULTS: The percentages of CD3+CD4+ and CD8+CD28+ cells were decreased and the percentages of CD3+CD8+ and CD8+CD28- cells increased as compared with the measurements in normal persons. One month after thermoradiotherapy, the percentages of CD3+CD4+ and CD8+CD28+ cells further decreased and the percentages of CD3+CD8+ and CD8+CD28- cells further increased, which continued to worsen 3 months after the treatment and appeared to be related to the survival of the patients. CONCLUSION: T cell subsets of NPC patients are abnormal and their immune functions depressed in NPC patients within a long period after thermoradiotherapy. CD8+CD28+ and CD8+CD28- T cell subsets can be significant for prognostic assessment in these patients after thermoradiotherapy.

[Clinical observation on nasopharyngeal carcinoma treated with combined therapy of radiotherapy and ginseng polysaccharide injection].

OBJECTIVE: To observe the effect of radiotherapy (RT) combined with Ginseng polysaccharide (GSP) injection in treating nasopharyngeal carcinoma (NPC) and its influence on immune function. METHODS: One hundred and thirty-one NPC patients were randomly divided into two groups, 64 cases in the RT-GSP group treated with RT-GSP and 67 in the control group treated with conventional therapy, to observe the local cancer remission rate, 1-year total survival rate, no tumor survival rate and no remote metastasis survival rate. Moreover, the changes of T-lymphocyte subsets, natural killer (NK) cell activity and lymphocyte activated killer (LAK) cell activity before and after treatment were observed. RESULTS: Clinical examination conducted 3 months after treatment showed that the complete remission rete in the RT-GSP group was 96.6%, and in the control group 93.3%, the complete remission rate of cervical node metastatic tumor in the two groups was 85.7% and 78.0% respectively, and the NPC CT remission rate 60.3% and 51.7% respectively. Re-examination carried out 1 year after RT treatment showed that the total survival rate in the two groups was 100% and 96.5%, no tumor survival rate 84.4% and 74.6%, and no remote metastasis survival rate was 93.8% and 88.1% respectively. The activity of NK cell and LAK cell as well as T3, T4 value in peripheral blood increased significantly in the RT-GSP group (all P < 0.05) after treatment, while in the control group, activity of NK cell and LAK cell changed insignificantly after treatment, and T3, T4 value lowered significantly (P < 0.05). No toxic-adverse reaction of GSP was found. CONCLUSION: GSP has certain improving immune function effect in NPC patients during RT, it could also eliminate the occurred adverse reaction to RT and the general condition of patients.

Epstein-Barr virus early antigen induction in nasopharyngeal hybrid cells by Chinese medicinal herbs.

The effects of Chinese medicinal herbal drugs (CMH; Daphne genkwa, Wikstroemia indica, Croton oil) were studied for Epstein-Barr virus (EBV) early antigen (EA) induction in established nasopharyngeal hybrid cells. Both ether and water extracts of CMH were found to have inducing activity. However water extracts of the same herbs were not as strong as that of other extracts. The EA positive-cell rate was from 18.2 to 42.2% in ether extracts and 1.0 to 3.8% in water extracts at 10 microgram/ml of the concentration. N-Butyrate alone showed a 40.2% positive rate and in the both treatment of water extracts, a combination effects was seen in induction of the EBV-EA. This in vitro system for the induction of EBV-EA was thought to be useful to determine what is the causal factors for activation of EBV in vivo.

Benign and malignant disease caused by EBV.

Epstein-Barr virus (EBV) causes infectious mononucleosis as a primary disease. The virus infects more than 90% of the average population and persists lifelong in peripheral B-lymphocytes. The virus is produced in the parotid gland and spread via the oral route. Serology suggests that the Epstein-Barr virus might be involved in the causation of two neoplastic diseases of humans: African Burkitt's lymphoma and nasopharyngeal carcinoma. Whereas the development of the lymphoma has an even better linkage with chromosomal rearrangements, nasopharyngeal carcinoma shows a unique association with Epstein-Barr virus. Environmental factors, including traditional Chinese medicine, may be responsible for the enhanced risk of nasopharyngeal carcinoma in certain, predominantly Chinese, populations of southern Asia. Possible mechanisms leading to the establishment of the neoplastic manifestations will be discussed.

Inhibitory effect of retinoids on Epstein-Barr virus induction in Raji cells.

Induction of Epstein-Barr virus (EBV) early antigen after treatment with various combinations of croton oil and n-butyrate was markedly inhibited by retinoids 7901, 7902, Ro 10-9359 and Ro 11-1430. Possible administration of retinoids to virus capsid antigen IgA antibody-positive individuals in high-risk areas for nasopharyngeal carcinoma to prevent EBV activation and development of this cancer is discussed.