This commentary summarizes the laboratory investigations and clinical trials published recently involving per-oral application of IgY supplemented food for specific orogastrointestinal disease prevention and control purposes. The prolonged use and misuse of conventional antibacterial drugs has spawned antibiotic resistant microbes prompting scientists to search for other germ-killing options. In particular, the use of IgY as a novel mode of immunotherapy using oral chicken immunoglobulin (IgY) to confer passive immunity has gained much interest as an inexpensive non-antibiotic alternative for the prophylaxis and treatment of a wide variety of infectious diseases. The stability of IgY in the orogastrointestinal tract and its safety profile has been well-documented. IgY has been used in the treatment or prevention of dental caries, periodontitis and gingivitis, gastritis and gastric ulcer, oral thrush and infant rotavirus diarrhea. The recent clinical trials on IgY with encouraging results has catapulted into the market novel nutraceutical or health supplements for therapeutic or prophylactic intervention based on the consumption of mono-specific or mixed IgY formulations. With recent trends in consumer preference for natural materials to alleviate health concerns, the increasing healthcare costs and the recent advances in drug delivery systems, IgY is likely to shift from its mainly functional food status toward pharmaceuticalization in the foreseeable future.

The rotavirus-induced diarrhea of human and animal neonates is a major public health concern worldwide. Until recently, no effective therapy is available to specifically inactivate the rotavirion particles within the gut. Passive immunotherapy by oral administration of chicken egg yolk antibody (IgY) has emerged of late as a fresh alternative strategy to control infectious diseases of the alimentary tract and has been applied in the treatment of diarrhea due to rotavirus infection. The purpose of this concise review is to evaluate evidence on the properties and performance of anti-rotavirus immunoglobulin Y (IgY) for prevention and treatment of rotavirus diarrhea in human and animal neonates. A survey of relevant anti-rotavirus IgY basic studies and clinical trials among neonatal animals (since 1994-2015) and humans (since 1982-2015) have been reviewed and briefly summarized. Our analysis of a number of rotavirus investigations involving animal and human clinical trials revealed that anti-rotavirus IgY significantly reduced the severity of clinical manifestation of diarrhea among IgY-treated subjects relative to a corresponding control or placebo group. The accumulated information as a whole depicts oral IgY to be a safe and efficacious option for treatment of rotavirus diarrhea in neonates. There is however a clear need for more randomized, placebo controlled and double-blind trials with bigger sample size to further solidify and confirm claims of efficacy and safety in controlling diarrhea caused by rotavirus infection especially among human infants with health issues such as low birth weights or compromised immunity in whom it is most needed.

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G12 rotaviruses are emerging rotavirus strains causing severe diarrhea in infants and young children worldwide. However, the whole genomes of only a few G12 strains have been fully sequenced and analyzed. In this study, we sequenced and characterized the complete genomes of six G12 strains (RVA/Human-tc/MMR/A14/2011/G12P[8], RVA/Human-tc/MMR/A23/2011/G12P[6], RVA/Human-tc/MMR/A25/2011/G12P[8], RVA/Human-tc/MMR/P02/2011/G12P[8], RVA/Human-tc/MMR/P39/2011/G12P[8], and RVA/Human-tc/MMR/P43/2011/G12P[8]) detected in six stool samples from children with acute gastroenteritis in Myanmar. On whole genomic analysis, all six Myanmarese G12 strains were found to have a Wa-like genetic backbone: G12-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strains A14, A25, P02, P39, and P43, and G12-P[6]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strain A23. Phylogenetic analysis showed that most genes of the six strains examined in this study were genetically related to globally circulating human G1, G3, G9, and G12 strains. Of note is that the NSP4 gene of strain A23 exhibited the closest relationship with the cognate genes of human-like bovine strains as well as human strains, suggesting the occurrence of reassortment between human and bovine strains. Furthermore, strains A14, A25, P02, P39, and P43 were very closely related to one another in all the 11 gene segments, indicating derivation of the five strains from a common origin. On the other hand, strain A23 consistently formed distinct clusters as to all the 11 gene segments, indicating a distinct origin of strain A23 from that of strains A14, A25, P02, P39, and P43. To our knowledge, this is the first report on whole genome-based characterization of G12 strains that have emerged in Myanmar. Our observations will provide important insights into the evolutionary dynamics of spreading G12 rotaviruses in Asia.

AbstrakKarsinoma nasofaring banyak terjadi di Cina dan Asia Tenggara, termasuk di Indonesia, sering didiagnosis pada keadaan lanjut dan memiliki prognosis yang buruk. Tujuan penelitian ini adalah untuk mengevaluasi epidemiologi, karakteristik klinis, dan tipe histopatologi pada pasien karsinoma nasofaring di Bagian THT-KL. Metodologi penelitian ini adalah deskriptif dengan menggunakan data rekam medik di RSUP Dr. M. Djamil Padang selama Juni 2010 sampai Juli 2013 dan data hasil pemeriksaan histopatologi sebagai konfirmasi.  Didapatkan sebanyak 44 kasus yang lengkap pada periode tersebut, yang mana 52,27% penderita adalah laki-laki dan 47,22% perempuan, perbandingan laki-laki dan perempuan adalah 1,2 : 1. Sebaran umur penderita dari 17 sampai 75 tahun dengan insiden puncak pada umur 41- 65 tahun. Gejala klinis terdiri atas massa di leher 93,17%, diikuti dengan obstruksi nasal 79,55%, dan gangguan pendengaran 79,55% sedangkan tanda klinis terdiri atas pembesaran kelenjar getah bening leher 90,91%, diikuti dengan tuli 79,55%, cranial nerve palsy  dan perluasan kelenjar getah bening ke fossa supraklavikula masing-masing 15,8%. Sebagian besar pasien berada pada stadium IV 83,16%, dengan derajat tumor terbanyak T4N2M0 15,91%. Tipe histopatologi yang terbanyak adalah nonkeratinizing carcinoma, undifferentiated type 75%, diikuti keratinizing SCC 13,64%, dan nonkeratinizing carcinoma - differentiated type 11,36%.Kata kunci: karsinoma nasofaring, karakteristik klinis, histopatologi, padang AbstractNasopharyngeal carcinoma  is more frequent in China and Southeast Asia, including Indonesia, commonly with advance stages at diagnosis and has a poor prognosis.  The objective of this study was to evaluate epidemiology, clinical characteristic and histopathology types of patients with nasopharyngeal carcinoma in the department of Otorhinolaryngology - Head and Neck Surgery.This is a descriptive study that used data from medical record of Dr. M. Djamil General Hospital in Padang during June 2010 to July 2013 and histopathology examination as confirmation. The result demonstrated 44 cases found on that period, of which 52,27% was male and 47,72% was female, hence the male and female ratio was 1,2 : 1.  The age-range from 17 to 75 years old with incidence peak between 41 - 65 years old. Clinical symptoms were neck mass 93,17%, followed by nasal obstruction 79,55 %, and audiological complaints 79,55% while clinical sign were cervical lymphadenopathy 90,91%, followed by hearing loss 79,55%, cranial nerve palsy and lymphadenopathy metastases to fossa supraclavicular each subject 15,8%. Most of patients were classified as stage IV 83,16%, with T4N2M0 15,91%.  The histopathology type were nonkeratinizing carcinoma, undifferentiated type had percentage 75%, followed by keratinizing SCC 13,64%, and nonkeratinizing carcinoma - differentiated type 11,36%. Keywords: nasopharyngeal carcinoma, clinical characteristic, histopathology types, padang

AbstrakLatar belakang: Karsinoma nasofaring adalah tumor ganas epitel nasofaring yang sampai saat ini penyebabnya belum diketahui, infeksi virus Epstein Barr dilaporkan sebagai faktor dominan terjadinya karsinoma nasofaring tetapi faktor non viral juga berperan untuk timbulnya keganasan nasofaring. Tujuan: Untuk mengetahui faktor non viral yang dapat meningkatkan kejadian karsinoma nasofaring sehingga dapat mencegah dan menghindari faktor-faktor non viral tersebut. Tinjauan Pustaka: Karsinoma nasofaring merupakan tumor ganas epitel nasofaring yang penyebabnya berhubungan dengan faktor viral dan non viral diantaranya asap rokok, ikan asin, formaldehid, genetik, asap kayu bakar , debu kayu, infeksi kronik telinga hidung tenggorok, alkohol dan obat tradisional. Kesimpulan: Pembuktian secara klinis dan ilmiah terhadap faktor non viral sebagai penyebab timbulnya karsinoma nasofaring masih belum dapat dijelaskan secara pasti. Faktor non viral merupakan salah satu faktor risiko yang dapat meningkatkan angka kejadian timbulnya keganasan nasofaring Kata kunci: karsinoma nasofaring, faktor risiko, non viral AbstractBackground: Nasopharyngeal carcinoma is a malignant epithelial nasopharyngeal tumor that until now the cause still unknown, Epstein barr virus infection had reported as predominant occurance of nasopharyngeal carcinoma but non viral factors may also contribute to the onset of the incidence of nasopharyngeal malignancy. Purpose: To find non viral factors that may increase the incidence of nasopharyngel carcinoma in order to prevent and avoid non-viral factors Literature: Nasopharyngeal carcinoma is a malignant tumor that causes nasopharyngeal epithelium associated with viral and non-viral factors such as cigarette smoke, salt fish, formaldehyde, genetic, wood smoke ,wood dust, ear nose throat chronic infections, alcohol, and traditional medicine. Conclusion: Clinically and scientifically proving the non-viral factors as the cause of nasopharyngeal carcinoma can not be explained with certainty. Non-viral factors only as one risk factor that can increase the incidence of the onset of nasopharyngeal carcinoma.

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