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Fulltext Evoked response study among Malaysian multiple sclerosis patients

Tan CT, Leong S

Singapore Med J, 1992 Dec;33(6):575-80.
PMID: 1488664

A study of visual evoked potential (VEP), brainstem evoked potential (BAEP) and median nerve somatosensory evoked potential (SSEP) in 26 Malaysian patients with clinically definite Multiple Sclerosis (MS). This study showed an overall high rate of abnormality, with 85% of patients for VEP, 31% for BAEP and 65% for median nerve SSEP. The rate of abnormality was particularly high for patients who were symptomatic, reaching 100% of patients for VEP, 50% of patients in BAEP, 83% of nerves for median nerve SSEP. The rate of abnormality among those who were asymptomatic was lower, varying from 32% of eyes in VEP, 27% of patients in BAEP and 31% of nerves in median nerve SSEP. Three out of 10 patients with optic spinal form of MS have abnormal BAEP. These show the usefulness of the evoked potential studies in confirming the clinical lesions as well as demonstrating subclinical involvement. The rate of abnormal evoked responses for the asymptomatic patients in this study is generally lower than that published elsewhere.
Assessing the significance of first place and online third places in supporting Malaysian seniors' well-being during the pandemic

Tan TH, Idris I

Humanit Soc Sci Commun, 2023;10(1):149.
PMID: 37041889 DOI: 10.1057/s41599-023-01655-5

The enforced lockdowns and social distancing measures associated with COVID-19 may have influenced older adults' preferences towards their homes and neighborhoods as well as social spaces. One objective of this research is to determine whether home and neighborhood environments ("first place") affect how satisfied older adults are with their lives during the epidemic. This study also examined the extent to which social spaces that exist in the virtual world ("online third places") affect older adults' life satisfaction when they would have to practice risk-averse behaviors in times of pandemic. To collect data, this study analyzed the responses of 500 active older adults and conducted in-depth interviews with seven older adults who served as neighborhood leaders in Klang Valley, Malaysia. The study found that there is a direct relationship between older adults' satisfaction with their current housing and their overall life satisfaction during the pandemic. Similarly, having a quality neighborhood nearby increases the likelihood of living a satisfied life during the pandemic. Most online third parties, with the exception of instant messaging apps, do not appear to provide older adults with an adequate platform to interact with their friends, participate in social networking, and join communities for emotional support during the pandemic. The findings and recommendations of this study would be very useful in developing effective interventions to promote aging in place during the coronavirus outbreak.
Prevalence of haemosporidia in Asian Glossy Starling with discovery of misbinding of Haemoproteus-specific primer to Plasmodium genera in Sarawak, Malaysian Borneo

Noni V, Tan CS

BMC Vet Res, 2023 Apr 20;19(1):66.
PMID: 37081458 DOI: 10.1186/s12917-023-03619-y

BACKGROUND: Plasmodium, Haemoproteus and Leucocytozoon are three mainly studied blood parasites known to cause malarial and pseudomalarial infections in avian worldwide. Although Sarawak is a biodiversity hotspot, molecular data on blood parasite diversity in birds are absent. The objective of the study is to determine the prevalence of blood parasite in Asian Glossy Starlings (AGS), an urban bird with high population density in Sarawak and to elucidate the phylogenetic relationship with other blood parasite.
METHODS: Twenty-nine carcasses of juvenile AGS that were succumbed to death due to window collision were collected around the vicinity of Universiti Malaysia Sarawak. Nested-multiplex and nested PCR targeting the Cytochrome B gene were used to detect Plasmodium and Haemoproteus, and Leucocytozoon respectively. Two primer sets were used for Haemoproteus detection to increase detection sensitivity, with one being a genus-specific primer.
RESULTS: Fourteen samples (prevalence rate: 48.28%) were found positive for avian Plasmodium. Phylogenetic analysis divided our sequences into five lineages, pFANTAIL01, pCOLL4, pACCBAD01, pALPSIS01 and pALPSIS02, with two lineages being novel. No Haemoproteus and Leucocytozoon was found in this study. However, Haemoproteus-specific primer used amplified our Plasmodium samples, making the primer non-specific to Haemoproteus only.
CONCLUSION: This is the first blood parasite detection study on AGS using carcasses and blood clot as sample source in Sarawak. Due to the scarcity of longer sequences from regions with high genetic plasticity, usage of genus-specific primers should be validated with sequencing to ensure correct prevalence interpretation.
Fulltext When all else fails: supervised treatment in outpatient for schizophrenia (STOPS)

Tan HJR

BMJ Case Rep, 2017 Sep 23;2017.
PMID: 28942410 DOI: 10.1136/bcr-2017-221518

This was about a case of a patient requiring admission to psychiatry ward twice a year for relapse schizophrenia due to medication non-compliance. Medication adherence was previously monitored by her husband. However, following the death of her husband, she stopped treatment. The lack of insight and poor family support further contributed to her relapse. She presented with positive and negative symptoms of schizophrenia during her relapse, neglecting her hygiene and oral intake. She was also found to have anaemia as a result of poor diet when she was in relapse. Community psychiatry services had attempted to ensure compliance with postdischarge plan but failed as patient was not present every home visits. Supervised treatment in outpatient for schizophrenia (STOPS) provided an alternative method to ensure compliance in this patient. Patient has remained in remission for 1 year since the use of STOPS.
Fulltext Potential role of geranylgeraniol in managing statin-associated muscle symptoms: a COVID-19 related perspective

Tan B, Chin KY

Front Physiol, 2023;14:1246589.
PMID: 38046949 DOI: 10.3389/fphys.2023.1246589

Myopathy is the most common side effect of statins, but it has not been addressed effectively. In anticipation of its wider use as a small molecule to complement the current COVID-19 management, a pharmacological solution to statin-associated muscle symptoms (SAMS) is warranted. Statins act by suppressing the mevalonate pathway, which in turn affects the downstream synthesis of isoprenoids required for normal physiological functions. CoQ10 and geranylgeraniol (GG) syntheses are reduced by statin use. However, CoQ10 supplementation has not been shown to reverse SAMS. GG is an obligatory substrate for CoQ10 synthesis, an endogenous nutrient critical for skeletal muscle protein synthesis. Multiple studies showed GG supplementation is effective in reversing SAMS. This opinion paper proposes employing GG to prevent SAMS in pleiotropic statin use, including usage in the post-COVID-19 pandemic era.
Genetic polymorphisms as potential pharmacogenetic biomarkers for platinum-based chemotherapy in non-small cell lung cancer

Sito H, Tan SC

Mol Biol Rep, 2024 Jan 13;51(1):102.
PMID: 38217759 DOI: 10.1007/s11033-023-08915-2

Platinum-based chemotherapy (PBC) is a widely used treatment for various solid tumors, including non-small cell lung cancer (NSCLC). However, its efficacy is often compromised by the emergence of drug resistance in patients. There is growing evidence that genetic variations may influence the susceptibility of NSCLC patients to develop resistance to PBC. Here, we provide a comprehensive overview of the mechanisms underlying platinum drug resistance and highlight the important role that genetic polymorphisms play in this process. This paper discussed the genetic variants that regulate DNA repair, cellular movement, drug transport, metabolic processing, and immune response, with a focus on their effects on response to PBC. The potential applications of these genetic polymorphisms as predictive indicators in clinical practice are explored, as are the challenges associated with their implementation.
WITHDRAWN: Preliminary investigation on Mycoplasma maculosum isolated from chickens

Mohd-Zain Z, Tan LJ

Res Vet Sci, 2010 Nov 09.
PMID: 21067786

This article has been withdrawn at the request of the authors. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Fulltext Inhibition of NEDD8 and FAT10 ligase activities through the degrading enzyme NEDD8 ultimate buster 1: A potential anticancer approach

Tan KL, Pezzella F

Oncol Lett, 2016 Dec;12(6):4287-4296.
PMID: 28101194 DOI: 10.3892/ol.2016.5232

The capabilities of tumour cells to survive through deregulated cell cycles and evade apoptosis are hallmarks of cancer. The ubiquitin-like proteins (UBL) proteasome system is important in regulating cell cycles via signaling proteins. Deregulation of the proteasomal system can lead to uncontrolled cell proliferation. The Skp, Cullin, F-box containing complex (SCF complex) is the predominant E3 ubiquitin ligase, and has diverse substrates. The ubiquitin ligase activity of the SCF complexes requires the conjugation of neural precursor cell expressed, developmentally down-regulated 8 (NEDD8) to cullin proteins. A tumour suppressor and degrading enzyme named NEDD8 ultimate buster 1 (NUB1) is able to recruit HLA-F-adjacent transcript 10 (FAT10)- and NEDD8-conjugated proteins for proteasomal degradation. Ubiquitination is associated with neddylation and FAT10ylation. Although validating the targets of UBLs, including ubiquitin, NEDD8 and FAT10, is challenging, understanding the biological significance of such substrates is an exciting research prospect. This present review discusses the interplay of these UBLs, as well as highlighting their inhibition through NUB1. Knowledge of the mechanisms by which NUB1 is able to downregulate the ubiquitin cascade via NEDD8 conjugation and the FAT10 pathway is essential. This will provide insights into potential cancer therapy that could be used to selectively suppress cancer growth.
Is HIV Screening in the General Population Cost Effective?

Tan H, Koh K

Malays Fam Physician, 2008;3(2):96-7.
PMID: 25606125 MyJurnal
A review on natural phenylbutanoid attractants: Occurrence, distribution, and role in nature, especially in relation to Dacini fruit fly behavior and pollination

Tan KH, Nishida R

J Chem Ecol, 2024 Apr 22.
PMID: 38644437 DOI: 10.1007/s10886-024-01499-6

The natural occurrence, distribution (within a plant) and roles of four phenylbutanoid compounds (anisyl acetone, cue-lure, raspberry ketone and zingerone) are elucidated for the Asia-Pacific and Oceania regions. These phenylbutanoids may act individually or in combination to attract true fruit fly males belonging to a tribe Dacini of subfamily Dacinae (Diptera: Tepritidae). Of special interest are the mutualistic interactions between the Dacini fruit fly males and the tropical daciniphilous (attracting exclusively Dacini fruit flies) orchids - leading to cross pollination for the orchids and enchanced mating success for the flies. When offered to male flies, anisyl acetone and cue-lure are generally converted to raspberry ketone. Upon consumption, raspberry ketone and zingerone are individually sequestered in the male rectal (pheromonal) gland unchanged. Attracted male flies readily imbibe the phenylbutanoid(s) in the floral synomone to compliment the endogenously synthesized male sex pheromonal components - to enhance attraction of conspecific females during courtship as well as attract conspecific males to form 'leks'. The phenylbutanoid(s) may also act as an allomone to deter vertebrate predators, especially geckos, besides possessing antimicrobial and antioxidant activities. Cue-lure, raspberry ketone and zingerone are important attractants/lures used in pest surveillance and mass trapping under the integrated pest management (IPM) program against quarantine Dacini fruit fly pest species, particularly Bactrocera tryoni and Zeugodacus cucurbitae.
The Influence of Online Social and Physical Presence on User Consumption Decisions in TikTok Livestreaming: A Scoping Review

Bai K, Tan KH

Cyberpsychol Behav Soc Netw, 2024 Jul;27(7):452-466.
PMID: 38757705 DOI: 10.1089/cyber.2023.0526

This scoping review aimed to clarify and redefine the concepts of social and physical presence in the context of online livestreaming environments. Physical presence involves technical elements and nonhuman-to-human interaction, factors that inevitably influence social presence, which has human-to-human interactions at its core. Considering one type of presence to the exclusion of the other may not provide sufficiently informed decisions for user consumption. However, most previous studies have only studied either physical or social presence factors; few have systematically examined both to explain their influence. This review examined how the factors under these two presence influenced users' consumption decision-making process in TikTok live-stream retail purchases by synthesizing 60 studies conducted from 2019 to 2023 using Arksey and O'Malley's 5-step framework. Evidence of the specific attributes by which presence affects users' consumption decisions was elicited and reorganized. Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework for scoping review and guided by the joanna briggs institute (JBI) methodological guidelines, the results reveal that out of the 60 studies, 36 were influenced by social presence and 24 by physical presence. When livestreaming online, social presence tends to include the user and anchor perspectives, which prompts users to make consumption decisions. However, online physical presence includes products, technology, and scenes as its main dimensions, and users make consumption decisions through perceptual control. This review clarifies new media livestreaming communication and the key factors influencing users' consumption decision-making systems. It also suggests that integrating online social and physical presence in future research will yield a better understanding of livestreaming purchase decisions.
Fulltext Promising Acinetobacter baumannii Vaccine Candidates and Drug Targets in Recent Years

Tan YC, Lahiri C

Front Immunol, 2022;13:900509.
PMID: 35720310 DOI: 10.3389/fimmu.2022.900509

In parallel to the uncontrolled use of antibiotics, the emergence of multidrug-resistant bacteria, like Acinetobacter baumannii, has posed a severe threat. A. baumannii predominates in the nosocomial setting due to its ability to persist in hospitals and survive antibiotic treatment, thereby eventually leading to an increasing prevalence and mortality due to its infection. With the increasing spectra of drug resistance and the incessant collapse of newly discovered antibiotics, new therapeutic countermeasures have been in high demand. Hence, recent research has shown favouritism towards the long-term solution of designing vaccines. Therefore, being a realistic alternative strategy to combat this pathogen, anti-A. Baumannii vaccines research has continued unearthing various antigens with variable results over the last decade. Again, other approaches, including pan-genomics, subtractive proteomics, and reverse vaccination strategies, have shown promise for identifying promiscuous core vaccine candidates that resulted in chimeric vaccine constructs. In addition, the integration of basic knowledge of the pathobiology of this drug-resistant bacteria has also facilitated the development of effective multiantigen vaccines. As opposed to the conventional trial-and-error approach, incorporating the in silico methods in recent studies, particularly network analysis, has manifested a great promise in unearthing novel vaccine candidates from the A. baumannii proteome. Some studies have used multiple A. baumannii data sources to build the co-functional networks and analyze them by k-shell decomposition. Additionally, Whole Genomic Protein Interactome (GPIN) analysis has utilized a rational approach for identifying essential proteins and presenting them as vaccines effective enough to combat the deadly pathogenic threats posed by A. baumannii. Others have identified multiple immune nodes using network-based centrality measurements for synergistic antigen combinations for different vaccination strategies. Protein-protein interactions have also been inferenced utilizing structural approaches, such as molecular docking and molecular dynamics simulation. Similar workflows and technologies were employed to unveil novel A. baumannii drug targets, with a similar trend in the increasing influx of in silico techniques. This review integrates the latest knowledge on the development of A. baumannii vaccines while highlighting the in silico methods as the future of such exploratory research. In parallel, we also briefly summarize recent advancements in A. baumannii drug target research.
How I do it: novel use of a modified nasopharyngeal airway in laryngotracheal stenosis as a temporary stent

Ghauth S, Tan SH

J Laryngol Otol, 2024 Jun;138(6):696-698.
PMID: 37926907 DOI: 10.1017/S0022215123001858

BACKGROUND: This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the technique of endoscopic stent placement, and our experience in terms of the indications and suitability.
METHOD: The nasopharyngeal airway device was modified to use as an airway stent by trimming it to the desired length. Next, the stent was inserted endoscopically and anchored using a novel approach.
RESULTS: The surgery was performed successfully without complications. The patients had full use of their voice while the stent was in situ. No significant granulation tissue was observed.
CONCLUSION: This paper demonstrates the feasibility of using a nasopharyngeal airway device as a temporary stent to prevent restenosis in cases where the patients have a strong demand for phonation. The modified nasopharyngeal airway device is potentially very promising, but cases must be selected carefully to avoid compromising efficacy and safety.
Treatment of Intractable Aspiration - Combined Open Medialization Thyroplasty with Intraglandular Botulinum Toxin Injection

Ghauth S, Tan SH

J Laryngol Otol, 2024 Nov 11.
PMID: 39523292 DOI: 10.1017/S0022215124002214
The mTOR signalling pathway in cancer and the potential mTOR inhibitory activities of natural phytochemicals

Tan HK, Moad AI, Tan ML

Asian Pac J Cancer Prev, 2014;15(16):6463-75.
PMID: 25169472

The mammalian target of rapamycin (mTOR) kinase plays an important role in regulating cell growth and cell cycle progression in response to cellular signals. It is a key regulator of cell proliferation and many upstream activators and downstream effectors of mTOR are known to be deregulated in various types of cancers. Since the mTOR signalling pathway is commonly activated in human cancers, many researchers are actively developing inhibitors that target key components in the pathway and some of these drugs are already on the market. Numerous preclinical investigations have also suggested that some herbs and natural phytochemicals, such as curcumin, resveratrol, timosaponin III, gallic acid, diosgenin, pomegranate, epigallocatechin gallate (EGCC), genistein and 3,3'-diindolylmethane inhibit the mTOR pathway either directly or indirectly. Some of these natural compounds are also in the clinical trial stage. In this review, the potential anti-cancer and chemopreventive activities and the current status of clinical trials of these phytochemicals are discussed.
14-Deoxy-11,12-didehydroandrographolide induces DDIT3-dependent endoplasmic reticulum stress-mediated autophagy in T-47D breast carcinoma cells

Tan HK, Muhammad TST, Tan ML

Toxicol Appl Pharmacol, 2016 06 01;300:55-69.
PMID: 27049118 DOI: 10.1016/j.taap.2016.03.017

14-Deoxy-11,12-didehydroandrographolide (14-DDA), a major diterpenoid isolated from Andrographis paniculata (Burm.f.) Nees, is known to be cytotoxic and elicits a non-apoptotic cell death in T-47D breast carcinoma cells. In this study, the mechanistic toxicology properties of 14-DDA in T-47D cells were further investigated. 14-DDA is found to induce the formation of endoplasmic reticulum (ER) vacuoles and autophagosomes, with concurrent upregulation of LC3-II in the breast carcinoma cells. It stimulated an increase in cytosolic calcium concentration and caused a collapse in mitochondrial membrane potential in these cells. In addition, both DDIT3 and GADD45A, molecules implicated in ER stress pathway, were significantly upregulated. DDIT3 knockdown suppressed the formation of both ER vacuoles and autophagosomes, indicating that 14-DDA-induced ER stress and autophagy is dependent on this transcription factor. Collectively, it is possible that GADD45A/p38 MAPK/DDIT3 pathway is involved in the 14-DDA-induced ER-stress-mediated autophagy in T-47D cells.
Fulltext Venom and Purified Toxins of the Spectacled Cobra (Naja naja) from Pakistan: Insights into Toxicity and Antivenom Neutralization

Wong KY, Tan CH, Tan NH

Am J Trop Med Hyg, 2016 06 01;94(6):1392-9.
PMID: 27022154 DOI: 10.4269/ajtmh.15-0871

Geographical variations of snake venoms can result in suboptimal effectiveness of Indian antivenoms that are currently used in most South Asian countries. This study investigated the toxicity and neutralization profile of the venom and toxins from Pakistani spectacled cobra, Naja naja, using VINS polyvalent antivenom (VPAV, India), Naja kaouthia monovalent antivenom (NKMAV, Thailand), and neuro bivalent antivenom (NBAV, Taiwan). Cation-exchange and reverse-phase high-performance liquid chromatography fractionations followed by toxin identification through liquid chromatography-mass spectrometry (MS)/MS indicated that the venom comprised mainly of postsynaptic neurotoxins (NTXs) (long neurotoxins [LNTXs], 28.3%; short neurotoxins [SNTXs], 8%), cytotoxins (CTXs) (31.2%), and acidic phospholipases A2 (12.3%). NKMAV is the most effective in neutralizing the lethal effect of the venom (potency = 1.1 mg venom/mL) and its LNTX (potency = 0.5 mg toxin/mL), consistent with the high content of LNTX in N. kaouthia venom. VPAV was effective in neutralizing the CTX (potency = 0.4 mg toxin/mL), in agreement with the higher CTX abundance in Indian cobra venom. All the three antivenoms were weak in neutralizing the SNTX (potency = 0.03-0.04 mg toxin/mL), including NBAV that was raised from the SNTX-rich Taiwanese cobra venom. In a challenge-rescue experiment, envenomed mice were prevented from death by a maximal dose of VPAV (intravenous 200 μL) but the recovery from paralysis was slow, indicating the need for higher or repeated doses of VPAV. Our results suggest that optimal neutralization for Pakistani N. naja venom may be achieved by improving the formulation of antivenom production to enhance antivenom immunoreactivity against long and SNTXs.
Fulltext Evaluation of extraction kits and RT-qPCR systems adapted to high-throughput platform for circulating miRNAs

Tan GW, Khoo AS, Tan LP

Sci Rep, 2015;5:9430.
PMID: 25800946 DOI: 10.1038/srep09430

MicroRNAs regulate gene expression at the post-transcriptional level. Differential expression of miRNAs can potentially be used as biomarkers for early diagnosis and prediction for outcomes. Failure in validation of miRNA profiles is often caused by variations in experimental parameters. In this study, the performance of five extraction kits and three RT-qPCR systems were evaluated using BioMark high-throughput platform and the effects of different experimental parameters on circulating miRNA levels were determined. Differences in the performance of extraction kits as well as varying accuracy, sensitivity and reproducibility in qPCR systems were observed. Normalisation of RT-qPCR data to spike-in controls can reduce extraction bias. However, the extent of correlation for different qPCR systems varies in different assays. At different time points, there was no significant fold change in eight of the plasma miRNAs that we evaluated. Higher level of miRNAs was detected in plasma as compared to serum of the same cohort. In summary, we demonstrated that high-throughput RT-qPCR with pre-amplification step had increased sensitivity and can be achieved with accuracy and high reproducibility through stringent experimental controls. The information provided here is useful for planning biomarker validation studies involving circulating miRNAs.
A comparative study of the enzymatic and toxic properties of venoms of the Asian lance-headed pit viper (Genus Trimeresurus)

Tan NH, Armugam A, Tan CS

Comp. Biochem. Physiol., B, 1989;93(4):757-62.
PMID: 2553329

1. The lethalities, anticoagulant effects, hermorrhagic, thrombin-like enzyme, hyaluronidase, protease, arginine ester hydrolase, 5'-nucleotidase, L-amino acid oxidase, alkaline phosphomonoesterase, phosphodiesterase and phospholipase A activities of twenty-three samples of venoms from twelve species of Asian lance-headed pit vipers (genus Trimeresurus) were examined. 2. The results indicate that notwithstanding individual variations in venom properties, the differences in biological properties of the Trimeresurus venoms can be used for the differentiation of venoms from different species of Trimeresurus. 3. The results also suggest that differences in the biological properties of snake venoms are useful parameters in the classification of snake species. 4. Our results indicate that venoms from the species T. okinavensis exhibited biological properties markedly different from other Trimeresurus venoms examined. This observation supports the recently proposed reclassification of T. okinavensis as a member of the genus Ovophis, rather than the genus Trimeresurus.
Fulltext Cytotoxicity of Snake Venoms and Cytotoxins From Two Southeast Asian Cobras (Naja sumatrana, Naja kaouthia): Exploration of Anticancer Potential, Selectivity, and Cell Death Mechanism

Chong HP, Tan KY, Tan CH

Front Mol Biosci, 2020;7:583587.
PMID: 33263003 DOI: 10.3389/fmolb.2020.583587

Venoms of cobras (Naja spp.) contain high abundances of cytotoxins, which contribute to tissue necrosis in cobra envenomation. The tissue-necrotizing activity of cobra cytotoxins, nevertheless, indicates anticancer potentials. This study set to explore the anticancer properties of the venoms and cytotoxins from Naja sumatrana (equatorial spitting cobra) and Naja kaouthia (monocled cobra), two highly venomous species in Southeast Asia. The cytotoxicity, selectivity, and cell death mechanisms of their venoms and cytotoxins (NS-CTX from N. sumatrana: NS-CTX; N. kaouthia: NK-CTX) were elucidated in human lung (A549), prostate (PC-3), and breast (MCF-7) cancer cell lines. Cytotoxins were purified through a sequential fractionation approach using cation-exchange chromatography, followed by C18 reverse-phase high-performance liquid chromatography (HPLC) to homogeneity validated with sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and identified by liquid chromatography-tandem mass spectrometry (LCMS/MS). The cobra venoms and their respective cytotoxins exhibited concentration-dependent growth inhibitory effects in all cell lines tested, with the cytotoxins being more potent compared to the corresponding whole venoms. NS-CTX and NK-CTX are, respectively, P-type and S-type isoforms of cytotoxin, based on the amino acid sequences as per LCMS/MS analysis. Both cytotoxins exhibited differential cytotoxic effects in the cell lines tested, with NS-CTX (P-type cytotoxin) being significantly more potent in inhibiting the growth of the cancer cells. Both cytotoxins demonstrated promising selectivity only for the A549 lung cancer cell line (selectivity index = 2.17 and 2.26, respectively) but not in prostate (PC-3) and breast (MCF-7) cancer cell lines (selectivity index < 1). Flow cytometry revealed that the A549 lung cancer cells treated with NS-CTX and NK-CTX underwent necrosis predominantly. Meanwhile, the cytotoxins induced mainly caspase-independent late apoptosis in the prostate (PC-3) and breast (MCF-7) cancer cells lines but lacked selectivity. The findings revealed the limitations and challenges that could be faced during the development of new cancer therapy from cobra cytotoxins, notwithstanding their potent anticancer effects. Further studies should aim to overcome these impediments to unleash the anticancer potentials of the cytotoxins.

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