Showing papers by "Gadjah Mada University published in 2014"

Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta‐analysis

Abstract: AIM: Systematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. MATERIAL AND METHODS: Literature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials, including also a non-intervention group. Data were extracted and meta-analyses were performed. RESULTS: From 3928 screened studies, 25 trials met the eligibility criteria. These trials enrolled 1748 periodontitis patients. Seven trials enrolled periodontitis patients that were otherwise healthy, 18 trials recruited periodontal patients with various co-morbidities, such as CVD or diabetes. None of the trials used hard clinical endpoints of CVD. However, improvement of endothelial function has been consistently reported. Meta-analyses demonstrated significant weighted mean difference (WMD) for hsCRP (-0.50 mg/l, 95% CI:-0.78; -0.22), IL-6 (-0.48 ng/l, 95% CI: -0.90; -0.06), TNF-α (-0.75 pg/ml, 95% CI: -1.34; -0.17), fibrinogen (-0.47 g/l, 95% CI: -0.76; -0.17), total cholesterol (-0.11 mmol/l, 95% CI: -0.21; -0.01) and HDL-C (0.04 mmol/l, 95% CI: 0.03; 0.06) favouring periodontal intervention. Importantly, periodontitis patients with co-morbidity benefitted most from periodontal therapy; significant WMD were observed for levels of hsCRP (-0.71 mg/l, 95% CI: -1.05; -0.36), IL-6 (-0.87 ng/l, 95% CI: -0.97; -0.78), triglycerides (-0.24 mmol/l, 95% CI: -0.26; -0.22), total cholesterol (-0.15 mmol/l, 95% CI: -0.29; -0.01), HDL-C (0.05 mmol/l, 95% CI: 0.03; 0.06) and HbA1c (-0.43%, 95% CI: -0.60; -0.25). CONCLUSIONS: This systematic review and meta-analyses demonstrate that periodontal treatment improves endothelial function and reduces biomarkers of atherosclerotic disease, especially in those already suffering from CVD and/or diabetes.

Fuel Production from LDPE Plastic Waste over Natural Zeolite Supported Ni, Ni-Mo, Co and Co-Mo Metals

Abstract: Hydrocracking of LDPE plastics into fuel over bi-functional catalysts was systematically studied. The natural zeolite from Sukabumi, Indonesia was refluxed in HCl 6N for 30 minutes and dried in an oven, then the activated natural zeolite (Z) was produced. This study found that natural zeolite obtained from Sukabumi which consists of the mordenite type crystalline. For bifunctional catalysts, Ni, Ni-Mo, Co and Co-Mo metals were loaded into the activated natural zeolite respectively to increase the activity and selectivity for hydrocracking process. The catalyst samples were heated in a microwave and done the reduction by hydrogen gas stream, produced Ni/Z, Ni-Mo/Z, Co/Z and Co-Mo/Z. Hydrocracking process was carried out effectively at 350 °

Carbon Footprint of Telemedicine Solutions - Unexplored Opportunity for Reducing Carbon Emissions in the Health Sector

Abstract: BACKGROUND: The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers.OBJECTIVES: To evaluate the potential o ...

Curcumin and its analogues (PGV-0 and PGV-1) enhance sensitivity of resistant MCF-7 cells to doxorubicin through inhibition of HER2 and NF-kB activation.

Abstract: Chemoresistance of breast cancer to doxorubicin is mediated mainly through activation of NF-kB and over expression of HER2. Curcumin and its analogues (PGV-0 and PGV-1) exert cytotoxic effects on T47D breast cancer cells. Suppression of NF-kB activation is suggested to contribute to this activity. The present study aimed to explore the effects of curcumin, PGV-0, and PGV-1 singly and in combination with doxorubicin on MCF-7/Dox cells featuring over-expression of HER2. In MTT assays, curcumin, PGV-0, and PGV-1 showed cytotoxicity effects against MCF-7/Dox with IC50 values of 80 µM, 21 µM, and 82 µM respectively. These compounds increased MCF-7/Dox sensitivity to doxorubicin. Cell cycle distribution analysis exhibited that the combination of curcumin and its analogues with Dox increased sub G-1 cell populations. Curcumin and PGV-1 but not PGV-0 decreased localization of p65 into the nucleus induced by Dox, indicating that activation of NFkB was inhibited. Molecular docking of curcumin, PGV-0, and PGV-1 demonstrated high affinity to HER2 at ATP binding site. This interaction were directly comparable with those of ATP and lapatinib. These findings suggested that curcumin, PGV-0 and PGV-1 enhance the Dox cytotoxicity to MCF-7 cells through inhibition of HER2 activity and NF-kB activation.

Antioxidative and antimicrobial activities of liquid smoke nanocapsules using chitosan and maltodextrin and its application on tuna fish preservation

Abstract: The aim of the study was to investigate the antioxidative and antimicrobial activities of liquid smoke (LS) nanocapsules from coconut shell using chitosan and maltodextrin as encapsulants and its application on tuna fish preservation. Nanocapsules were prepared by three variations of chitosan (CS)–maltodextrin (MD) i.e. CS (0.5% w/v) and MD (9.5% w/v) in acetic acid (1.0% v/v), only MD (10% w/v) in LS, and a mixture of CS (1.5% w/v) and MD (8.5% w/v) in LS. The experimental factor of varying nanocapsules concentration 0%; 2.5%; 5.0%; 7.5% and 10% w/w was used to evaluate the antioxidative and antimicrobial activities in fresh tuna fish stored at ambient temperature for 0, 12, 24, 36 and 48 h. Fresh tuna minced fish was observed for TVB-N, TPC and sensory evaluation. Results indicated that nanocapsules mixture of CS and MD in LS showed higher value in parameters evaluated i.e. total phenolic, total acid and radical scavenging activity. The addition of nanocapsules prepared of a mixture of CS (1.5% w/v) and MD (8.5% w/v) in LS higher than 5.0% could maintain the fish freshness until 48 h at room temperature and had the smallest particle size. Based on sensory evaluation, the score was neither like nor dislike for all nanocapsules concentrations. The results suggested that LS nanocapsule was an effective preservative agent for fresh tuna fish; therefore these nanocapsules are promising for food applications.

Mortality attributable to Plasmodium vivax malaria: a clinical audit from Papua, Indonesia

Abstract: Plasmodium vivax causes almost half of all malaria cases in Asia and is recognised as a significant cause of morbidity. In recent years it has been associated with severe and fatal disease. The extent to which P. vivax contributes to death is not known. To define the epidemiology of mortality attributable to vivax malaria in southern Papua, Indonesia, a retrospective clinical records-based audit was conducted of all deaths in patients with vivax malaria at a tertiary referral hospital. Between January 2004 and September 2009, hospital surveillance identified 3,495 inpatients with P. vivax monoinfection and 65 (1.9%) patients who subsequently died. Charts for 54 of these 65 patients could be reviewed, 40 (74%) of whom had pure P. vivax infections on cross-checking. Using pre-defined conservative criteria, vivax malaria was the primary cause of death in 6 cases, a major contributor in 17 cases and a minor contributor in a further 13 cases. Extreme anaemia was the most common primary cause of death. Malnutrition, sepsis with respiratory and gastrointestinal manifestations, and chronic diseases were the commonest attributed causes of death for patients in the latter two categories. There were an estimated 293,763 cases of pure P. vivax infection in the community during the study period giving an overall minimum case fatality of 0.12 per 1,000 infections. The corresponding case fatality in hospitalised patients was 10.3 per 1,000 infections. Although uncommonly directly fatal, vivax malaria is an important indirect cause of death in southern Papua in patients with malnutrition, sepsis syndrome and chronic diseases, including HIV infection.

Application of Vibrational Spectroscopy in Combination with Chemometrics Techniques for Authentication of Herbal Medicine

Abstract: One of the emerging issues in herbal medicine is its authenticity. The substitution of highly valuable materials in herbal medicine with lower ones is common practice in the herbal medicine industry. This practice can cause serious effects or be harmful to human health; therefore, the authentication of herbal medicine using analytical techniques is necessary. Due to its capability as fingerprint technique, vibrational spectroscopy (infrared and Raman), especially in combination with several chemometrics techniques, is the method of choice for authentication purposes. This review highlights the use of mid-infrared, near-infrared, and Raman spectroscopy for authentication of herbal medicine, either in raw materials or in final products.

Sensory improvement of leprosy peripheral neuropathy in patients treated with perineural injection of platelet-rich plasma.

Abstract: Background Leprosy (Hansen's disease) is a chronic granulomatous infection caused by Mycobacterium leprae with peripheral neuropathy as cutaneous and neurological manifestations. Peripheral nerve regeneration may be stimulated by vascular endothelial growth factor and other growth factors (GFs) that have important roles in extracellular matrix regeneration. All of those GFs can be found in platelet-rich plasma (PRP) preparation. The effect of PRP injection in leprosy peripheral neuropathy has never been reported. Materials and methods A double-blind, randomized, control clinical trial was conducted among 60 patients with leprosy peripheral neuropathy. They were randomized to receive either a 1-ml injection of PRP as treatment or a 1-ml injection of platelet-poor plasma (PPP) as control. Skin sensibilities were measured by two-point discrimination test (TPDT) and visual analog scale (VAS), which were taken before and two weeks after treatment. Results Perineural injection of PRP was shown to be significantly more effective than PPP (P < 0.05) either in VAS or TPDT measurements. In both groups, the patients had a tingling sensation at the time of injection that disappeared shortly after. Conclusion This study shows that perineural PRP injection could promote improvement of peripheral neuropathy sensibility in patients with leprosy. More research is needed to better determine the effects of PRP in nerve regeneration.

Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

Abstract: Background : Because most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. Objective : To build a large standardised mortality database from African and Asian sites, detailing the relevant methods, and use it to describe cause-specific mortality patterns. Design : Individual demographic and verbal autopsy (VA) data from 22 INDEPTH sites were collated into a standardised database. The INDEPTH 2013 population was used for standardisation. The WHO 2012 VA standard and the InterVA-4 model were used for assigning cause of death. Results : A total of 111,910 deaths occurring over 12,204,043 person-years (accumulated between 1992 and 2012) were registered across the 22 sites, and for 98,429 of these deaths (88.0%) verbal autopsies were successfully completed. There was considerable variation in all-cause mortality between sites, with most of the differences being accounted for by variations in infectious causes as a proportion of all deaths. Conclusions : This dataset documents individual deaths across Africa and Asia in a standardised way, and on an unprecedented scale. While INDEPTH sites are not constructed to constitute a representative sample, and VA may not be the ideal method of determining cause of death, nevertheless these findings represent detailed mortality patterns for parts of the world that are severely under-served in terms of measuring mortality. Further papers explore details of mortality patterns among children and specifically for NCDs, external causes, pregnancy-related mortality, malaria, and HIV/AIDS. Comparisons will also be made where possible with other findings on mortality in the same regions. Findings presented here and in accompanying papers support the need for continued work towards much wider implementation of universal civil registration of deaths by cause on a worldwide basis. Keywords : mortality; cause of death; Africa; Asia; verbal autopsy; INDEPTH Network (Published: 29 October 2014) Citation : Glob Health Action 2014, 7 : 25362 - http://dx.doi.org/10.3402/gha.v7.25362 SPECIAL ISSUE : This paper is part of the Special Issue: INDEPTH Network Cause-Specific Mortality . More papers from this issue can be found at http://www.globalhealthaction.net

DNA methylation, microRNAs, and their crosstalk as potential biomarkers in hepatocellular carcinoma.

Abstract: Epigenetic alterations have been identified as a major characteristic in human cancers. Advances in the field of epigenetics have contributed significantly in refining our knowledge of molecular mechanisms underlying malignant transformation. DNA methylation and microRNA expression are epigenetic mechanisms that are widely altered in human cancers including hepatocellular carcinoma (HCC), the third leading cause of cancer related mortality worldwide. Both DNA methylation and microRNA expression patterns are regulated in developmental stage specific-, cell type specific- and tissue-specific manner. The aberrations are inferred in the maintenance of cancer stem cells and in clonal cell evolution during carcinogenesis. The availability of genome-wide technologies for DNA methylation and microRNA profiling has revolutionized the field of epigenetics and led to the discovery of a number of epigenetically silenced microRNAs in cancerous cells and primary tissues. Dysregulation of these microRNAs affects several key signalling pathways in hepatocarcinogenesis suggesting that modulation of DNA methylation and/or microRNA expression can serve as new therapeutic targets for HCC. Accumulative evidence shows that aberrant DNA methylation of certain microRNA genes is an event specifically found in HCC which correlates with unfavorable outcomes. Therefore, it can potentially serve as a biomarker for detection as well as for prognosis, monitoring and predicting therapeutic responses in HCC.

The use of FTIR spectroscopy and chemometrics for rapid authentication of extra virgin olive oil

Abstract: The authenticity of high value edible fats and oils including extra virgin olive oil (EVOO) is an emerging issue, currently. The potential employment of Fourier transform infrared (FTIR) spectroscopy in combination with chemometrics of multivariate calibration and discriminant analysis has been exploited for rapid authentication of EVOO from canola oil (Ca-O). The optimization of two calibration models of partial least square (PLS) and principle component regression was performed in order to quantify the level of Ca-O in EVOO. The chemometrics of discriminant analysis (DA) was used for making the classification between pure EVOO and EVOO adulterated with Ca-O. The individual oils and their blends were scanned on good contact with ZnSe crystals in horizontal attenuated total reflectance, as a sampling technique. The wavenumbers of 3,028–2,985 and 1,200–987 cm−1 were used for quantification and classification of EVOO adulterated with Ca-O. The results showed that PLS with normal FTIR spectra was well suited for quantitative analysis of Ca-O with a value of the coefficient of determination (R2) > 0.99. The error, expressed as root mean square error of calibration obtained was relatively low, i.e. 0.108 % (v/v). DA can make the classification between pure EVOO and that adulterated with Ca-O with one misclassified reported.

Identification of plumericin as a potent new inhibitor of the NF-κB pathway with anti-inflammatory activity in vitro and in vivo.

Abstract: Background and Purpose The transcription factor NF-κB orchestrates many pro-inflammatory signals and its inhibition is considered a promising strategy to combat inflammation Here we report the characterization of the natural product plumericin as a highly potent inhibitor of the NF-κB pathway with a novel chemical scaffold, which was isolated via a bioactivity-guided approach, from extracts of Himatanthus sucuuba, an Amazonian plant traditionally used to treat inflammation-related disorders Experimental Approach A NF-κB luciferase reporter gene assay was used to identify NF-κB pathway inhibitors from H sucuuba extracts Monitoring of TNF-α-induced expression of the adhesion molecules VCAM-1, ICAM-1 and E-selectin by flow cytometry was used to confirm NF-κB inhibition in endothelial cells, and thioglycollate-induced peritonitis in mice to confirm effects in vivo Western blotting and transfection experiments were used to investigate the mechanism of action of plumericin Key Results Plumericin inhibited NF-κB-mediated transactivation of a luciferase reporter gene (IC50 1 μM), abolished TNF-α-induced expression of the adhesion molecules VCAM-1, ICAM-1 and E-selectin in endothelial cells and suppressed thioglycollate-induced peritonitis in mice Plumericin exerted its NF-κB pathway inhibitory effect by blocking IκB phosphorylation and degradation Plumericin also inhibited NF-κB activation induced by transfection with the constitutively active catalytic subunit of the IκB kinase (IKK-β), suggesting IKK involvement in the inhibitory action of this natural product Conclusion and Implications Plumericin is a potent inhibitor of NF-κB pathways with a new chemical scaffold It could be further explored as a novel anti-inflammatory lead compound

Application of powder suspended in dielectric fluid for fine finish micro-EDM of Inconel 718

Abstract: Inconel 718 is an extremely hard and difficult-to-cut material used extensively in manufacturing because of its superior wear and corrosion resistance. Microelectrical discharge machining (micro-EDM) is one of the effective methods of machining this extremely hard material. However, due to short circuiting and arcing, the surface of microholes produced by micro-EDM has black traces and cones. This study investigates the influence of molybdenum disulfide (MoS2) powder suspended in dielectric fluid on the performance of micro-EDM of Inconel 718 with focus in obtaining quality microholes. It was observed that MoS2 powder suspension with 50 nm of size and 5 g/l of concentration can produce better quality microholes in Inconel 718. Moreover, it was also found that 50 nm MoS2 powder was the best powder size to achieve the highest material removal rate.

The 21 February 2005, catastrophic waste avalanche at Leuwigajah dumpsite, Bandung, Indonesia

Abstract: On 21 February 2005 the Leuwigajah dumpsite, Bandung (Java, Indonesia) was affected by a large slide after heavy rainfalls. Second deadliest waste slide in history, it buried 71 houses and killed 143 people. Amongst the contemporary disastrous events of this type, only a few have been documented. We explored failure preconditions, triggering mechanisms and local context that conducted to this disaster. We carried on four field investigations on the site. A series of aerial photographs were acquired and completed by topographical measures on the ground. The morphology of the slide and its trajectory were reconstructed. To constrain the movement condition, we studied the internal structure of the source area and realized surveys among stakeholders of the dumpsite and citizen. 2.7 × 106 m3 of waste materials spread 1000 m from the source in a rice field with an average thickness of 10 m. The material displays a preferential fabric parallel to the previous topography. Numerous internal slip surfaces, underlined by plastic bags explain the low friction coefficient. The presence of methane within the waste dump was responsible for explosions prior to sliding and for the fire that affects whole sliding mass. Resulting of a combination of heavy rainfall and consecutive explosions due to biogas sudden release, this disaster was predictable in reason of i) a front slope of the dump of about 100% before the failure; ii) a poor dumpsite management; iii) the extreme vulnerability of the marginalized scavengers living at risk at the foot of the instable dump.

Fall detection system using accelerometer and gyroscope based on smartphone

Abstract: Most of people likes living independently at home. Some activity in our daily life is prone to have some accidents, such as falls. Falls can make people in fatal conditions, even death. A prototype of fall detection system using accelerometer and gyroscope based on smartphone is presented in this paper. Accelerometer and gyroscope sensors are embedded in smartphone to get the result of fall detection more accurately. Automatic call as an alert will be sent to family members if someone using this application in fatal condition and need some help. This research also can distinguish condition of people between falls and activity daily living. Several scenarios were used in these experiments. The result showed that the proposed system could successfully record level of accuracy of the fall detection system till 93.3% in activity daily living and error detected of fall was 2%.

Time-Dependent Analysis of Attacks

Abstract: The success of a security attack crucially depends on time: the more time available to the attacker, the higher the probability of a successful attack; when given enough time, any system can be compromised. Insight in time-dependent behaviors of attacks and the evolution of the attacker’s success as time progresses is therefore a key for effective countermeasures in securing systems. This paper presents an efficient technique to analyze attack times for an extension of the prominent formalism of attack trees. If each basic attack step, i.e., each leaf in an attack tree, is annotated with a probability distribution of the time needed for this step to be successful, we show how this information can be propagated to an analysis of the entire tree. In this way, we obtain the probability distribution for the entire system to be attacked successfully as time progresses. For our approach to be effective, we take great care to always work with the best possible compression of the representations of the probability distributions arising. This is achieved by an elegant calculus of acyclic phase type distributions, together with an effective compositional compression technique. We demonstrate the effectiveness of this approach on three case studies, exhibiting orders of magnitude of compression.

Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh

Abstract: Background: Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government’s post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis. Discussion: A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action. Summary: In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it could be adapted so that women and the poor are actively sought out and provided for. After training, these services could be run by Bangladesh’s pre-existing 50,000-strong Cyclone Preparedness Programme workforce, alongside the country’s extensive network of community-based health workers.

Hesperidin as a preventive resistance agent in MCF-7 breast cancer cells line resistance to doxorubicin.

Abstract: Objective To evaluate of hesperidin to overcome resistance of doxorubicin in MCF-7 resistant doxorubicin cells (MCF-7/Dox) in cytotoxicity apoptosis and P-glycoprotein (Pgp) expression in combination with doxorubicin.

Conducting a Grounded Theory Study in a Language Other Than English: Procedures for Ensuring the Integrity of Translation

Abstract: Translation can be a problem area for researchers conducting qualitative studies in languages other than English who intend to publish the results in an English-language journal. Analyzing the data is also complex when the research team consists of people from different language backgrounds. Translation must be considered as an issue in its own right to maintain the integrity of the research, especially in a grounded theory study. In this article, we offer guidelines for the process of translation for data analysis in a grounded theory study in which the research was conducted in a language other than English (Indonesian). We make recommendations about procedures to choose when, who, and how to translate data. The translation procedure is divided into four steps which are as follows: translation in the process of coding, translation in the process of team discussion, translation in the process of advanced coding, and ensuring the accuracy of translation.

Estimating reliability coefficient for multidimensional measures: A pedagogical illustration

Abstract: The literature has shown that the assumption of unidimensional measurement in psychology is difficult to fulfill, since measurement in psychology is usually a complex process that aims at providing information about constructs. As a consequence, factor analysis for psychological measurement tends to conceal several factors that underlie the items on the scale. Since applying a reliability coefficient (e.g., Cronbach’s alpha) based on a unidimensional assumption for a multidimensional measure will underestimate reliability, researchers should use an appropriate coefficient that matches the characteristics of the measure. There are several, albeit not frequently utilized reliability coefficients for multidimensional measures. The present article demonstrates the application of the stratified alpha, Mosier’s, Raykov’s, McDonald’s, and Hancock-Mueller’s coefficients for estimating the reliability of multidimen sional measures.

Therapeutic implications of Epstein-Barr virus infection for the treatment of nasopharyngeal carcinoma.

Abstract: Nasopharyngeal carcinoma (NPC) is highly endemic in certain regions including the People's Republic of China and Southeast Asia. Its etiology is unique and multifactorial, involving genetic background, epigenetic, and environment factors, including Epstein-Barr virus (EBV) infection. The presence of EBV in all tumor cells, aberrant pattern of antibodies against EBV antigens in patient sera, and elevated viral DNA in patient circulation as well as nasopharyngeal site underline the role of EBV during NPC development. In NPC tumors, EBV expresses latency type II, where three EBV-encoded proteins, Epstein-Barr nuclear antigen 1, latent membrane protein 1 and 2 (LMP1, 2), are expressed along with BamH1-A rightward reading frame 1, Epstein-Barr virus-encoded small nuclear RNAs, and BamH1-A rightward transcripts. Among all encoded proteins, LMP1 plays a central role in the propagation of NPC. Standard treatment of NPC consists of radiotherapy with or without chemotherapy for early stage, concurrent chemoradiotherapy in locally advanced tumors, and palliative systemic chemotherapy in metastatic disease. However, this standard care has limitations, allowing recurrences and disease progression in a certain proportion of cases. Although the pathophysiological link and molecular process of EBV-induced oncogenesis are not fully understood, therapeutic approaches targeting the virus may increase the cure rate and add clinical benefit. The promising results of early phase clinical trials on EBV-specific immunotherapy, epigenetic therapy, and treatment with viral lytic induction offer new options for treating NPC.