The analysis of antibody serum titer of Iga anti-viral capsid antigens and anti-epstein-Barr nuclear antigens in nasopharyngeal carcinoma patients

Calloselasma rhodostoma (Kuhl, 1824) is one species of Indonesian medically important snake that distributed in many Indonesia regions. With th Background: The serological test as an effort to diagnose early Nasopharyngeal Carcinoma (NPC) in several countries, especially China, has succeeded in finding cases of early NPC that remain asymptomatic. In Indonesia, the serological test is rarely used, causing the value of anti-viral capsid antigen IgA titer (VCA) and anti-Epstein-Barr nuclear antigen virus (EBNA) for NPC patients remain unknown. Purpose: This study aims to obtain the value of anti-VCA IgA and anti-EBNA IgA in NPC based on the type of histopathology and stage to determine the specificity value and sensitivity of the anti-VCA IgA titer and anti-EBNA IgA titer in NPC. Method: This study used a cross-sectional study with a case-control study design. A total of 35 patients who met both case and control samples were taken for venous blood in the median cubital vein using a 5 ml syringe for material inspection. Then, serological tests were carried out in the form of serum analysis of anti-VCA IgA and anti-EBNA IgA antibody titer using the Elisa Test method. Result: The sensitivity of anti-VCA IgA titer reached 91.14%, whereas its specificity amounted to 97.14%. On the other hand, the sensitivity of anti-EBNA IgA titer reached 91.14% whereas its specificity amounted to 94.30%. Conclusion: The examination of both types of titers is excellent for diagnosing hidden NPC and detecting disease recurrence after treatment. Recent snakebite cases of this snake and warrant of further improvement on anti-venin in Indonesia, the information on storage conditions for its venom is important for developing an anti-venin. The genetic identity that possibly holds a cryptic diversity that has not been resolved, could impact the future of anti-venin development of this species. We analyze the molecular data based on the ND4 gene to resolve the genetic relations of this snake from Java, Kangean, and Borneo population with the addition of the Thailand population by Bayesian Inference phylogenetic reconstruction. To evaluate the storage conditions, venom collection from six living specimens from the Java population was used to analyze the effect of svPLA2 activity under different storage conditions for 14 days long. The phylogenetic results show a polytomy tree, with a low p-distance value between populations. Only the storage at 37oC affects the performance of svPLA2 significantly. The phylogenetic indicating a single species even though divided by geographical barriers, more genes need to be compared to resolve the genetic relationship. More samples are needed to compare the venom properties throughout C. rhodostoma wide distribution, to enlight the anti-venin future development.