Abstract

IntroductionProspective evidence for herbal diet and nasopharyngeal carcinoma (NPC) development is absent. We therefore evaluated the associations of herbal soup and herbal tea with NPC in a prospective cohort study in southern China.MethodsBased on an NPC screening cohort established in 2008–2015, information on herbal diet consumption, potential confounding factors, and Epstein-Barr virus (EBV) antibody levels were collected from 10,179 individuals aged 30–69 years in Sihui city, southern China. Cox regression models were performed to examine herbal diet with NPC risk, and logistic regression models were used to examine herbal diet with EBV reactivation.ResultsDuring a median of 7.54 years of follow-up, 69 participants developed NPC. Herbal soup consumption was associated with decreased NPC risk, with HRs of 0.31 (95% confidence interval (CI): 0.15–0.62) for the highest intake frequency and 0.29 (95% CI: 0.16–0.51) for a longer duration. However, herbal tea was not significantly associated. Moreover, we identified herbal soup was inversely associated with EBV seropositivity among all the participants at baseline, with the adjusted ORs being 0.78 (95% CI: 0.65–0.93) for immunoglobulin A antibodies against EBV capsid antigens (VCA-IgA) and 0.76 (95% CI: 0.64–0.91) for nuclear antigen 1 (EBNA1-IgA) in those with the highest frequency and 0.70 (95% CI: 0.59–0.84) for VCA-IgA and 0.64 (95% CI: 0.54–0.77) for EBNA1-IgA in those with the longer duration. Inverse associations were also observed in non-NPC individuals.ConclusionsWith inhibition of EBV reactivation by plants, herbal soup could significantly decrease the risk of NPC in endemic areas.

Highlights

  • Prospective evidence for herbal diet and nasopharyngeal carcinoma (NPC) development is absent

  • Herbal soup consumption was associated with decreased NPC risk, with hazard ratios (HRs) of 0.31 (95% confidence interval (CI): 0.15–0.62) for the highest intake frequency and 0.29 for a longer duration

  • We identified herbal soup was inversely associated with Epstein-Barr virus (EBV) seropositivity among all the participants at baseline, with the adjusted odds ratios (ORs) being 0.78 for immunoglobulin A antibodies against EBV capsid antigens (VCA-IgA) and 0.76 for nuclear antigen 1 (EBNA1-IgA) in those with the highest frequency and 0.70 for VCA-IgA and 0.64 for EBNA1-IgA in those with the longer duration

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Summary

Introduction

Prospective evidence for herbal diet and nasopharyngeal carcinoma (NPC) development is absent. Nasopharyngeal carcinoma (NPC) is rare in most parts of the world but prevalent in southern China. The virus preferentially establishes latent infection in memory B cells after infection and can be reactivated into lytic phase by endogenous and exogenous factors [4,5,6]. Such virus reactivation, reflected by elevated levels of serological antibodies against multiple EBV antigens, has been suggested as a key step of NPC onset and development [7, 8]. The contradiction between ubiquitous EBV infection and distinctive geographic distribution of NPC suggests the involvement of other environmental factors, especially traditional diet, in the etiology of NPC [9,10,11,12]

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