Seroprevalence of IgA anti Epstein-Barr virus is high among family members of nasopharyngeal cancer patients and individuals presenting with chronic complaints in head and neck area

Abstract

Epstein-Barr (EBV) infection and presence of a nasopharyngeal cancer (NPC) case in the family increases the risk of developing NPC. Aberrant anti-EBV immunoglobulin A (IgA) antibodies (EBV-IgA) may be present in the sera of non-cancer individuals and predict NPC. Limited studies report the presence of EBV-IgA antibodies within non-cancer individuals in Indonesia where the disease is prevalent. This study aimed at exploring whether EBV-IgA was found more frequently among first degree relatives of NPC patients and individuals presenting with chronic symptoms in the head and neck area compared to healthy controls. A total of 967 non-cancer subjects were recruited, including 509 family members of NPC cases, 196 individuals having chronic complaints in the head and neck region, and 262 healthy donors of the local blood bank. Sera were analyzed using a standardized peptide-based EBV-IgA ELISA. Overall, 61.6% of all individuals had anti-EBV IgA reactivity equal to or below cut off value (CoV). Seroreactivity above CoV was significantly higher in females (38.7%) compared to males (28.7%) (p = 0.001). Older individuals had more seroreactivity above CoV (42.5%) than the younger ones (26.4%) (p< 0.001). Seroprevalence was significantly higher in family members of NPC patients (41.7%), compared to 32.7% of individuals with chronic head and neck problems (p = 0.028) and 16.4% healthy blood donors (p< 0.001). As conclusion, this study showed a significant higher seroprevalence in healthy family members of NPC cases and subjects presenting with chronic symptoms in the head and neck area compared to healthy individuals from the general community. This finding indicates that both groups have elevated risk of developing NPC and may serve as targets for a regional NPC screening program.

The Serological Examination of Immunoglobulin A Anti-Early Antigen of Epstein–Barr Virus (Anti-EA EBV IgA) in the Nias Tribe Nasopharyngeal Cancer Patients

“…Serology tests of anti-EA EBV IgA in Nias tribal NPC patients found positive in 16 (55.2%). This result is smaller than previous studies that were found in 10 NPC patients in North Sumatra (66.7%) and 212 NPC patients in Yogyakarta (41.7%) [13], [15]. Serology tests Ig A anti-EA EBV of non-NPC Nias tribe found positive in 3 (10.3%).…”

“…The previous studies reported that IgA anti-EA EBV was significantly different between NPCs and controls [13], but other studies reported different results, where IgA anti-EA EBV was significantly different between NPCs and controls [14]. In addition, EBV anti-EA IgA was reported to differ by ethnicity [15]. Inconsistency of results required similar studies to confirm results.…”

Multilaboratory Assessment of Epstein-Barr Virus Serologic Assays: the Case for Standardization

“…responses) are at increased risk for the development of NPC (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). In areas of NPC endemicity, such as Southern China, EBV IgA antibody testing has been proposed for general population screening to triage individuals for further clinical evaluation aiming at the early detection and treatment of NPC (4,7,16,17).…”

Rapid nasopharyngeal brush-smear cytology with Epstein-Barr virus DNA load and viral marker analysis for detection of nasopharyngeal carcinoma

“…Further improvement of awareness about signs and symptoms of NPC in rural communities and local health care workers and improving readily available diagnostic options will improve recognition of NPC at earlier stages, ensuring proper referral and timely treatment initiation [11][12][13][14][15][16]19]. NP endoscopic examination and on-site NP-brush PAP-cytology is proposed as first-line diagnostic procedure for "at-risk" cases defined in population screening studies and for patients with undefined head and neck complaints suspected as having NPC, as was demonstrated in this study [1,17,55]. Further improvement in cyto-preservation technology may make NP brush cytology equally effective for NPC screening as classic PAP-smear cytology for the detection of cervical cancer [32,56].…”