Objective: Despite advanced treatment options available, drug resistance develops in breast cancer (BC) patients requiring novel effective drugs. Stylissa carteri, a marine sponge predominantly living in Indonesia territories, has not been extensively studied as anti-cancer. Therefore, this study targeted to assess the anti-tumor activity of the ethanol extract of S. carteri in BC cells. Methods: S. carteri was collected from Pramuka Island, at Kepulauan Seribu National Park, Jakarta, Indonesia and extracted using ethanol. Different BC cells including MDA MB 231, MDA MB 468, SKBR3, HCC-1954 and MCF-7 cells were treated with this extract for cytotoxic analysis using MTT assay. Spheroid growth assay and apoptosis assay were conducted in HCC-1954 cells. In addition, cell migration analysis and synergistic activity with doxorubicin or paclitaxel were conducted in MDA MB 231 cells. This extract was subjected also for GC-MS analysis. Results: The results show that ethanol extract of S. carteri demonstrated a cytotoxic activity in BC cells. The IC 50 of this extract was lower 15 μg/ml in MDA MB 231, MDA MB 468, SKBR3, and HCC-1954 cells. Moreover, this extract inhibited spheroids growth and induced apoptosis in HCC-1954 cells. It inhibited cell migration and demonstrated a synergistic activity with doxorubicin or paclitaxel on triggering cell death in MDA MB 231 cells. Furthermore, GC-MS analysis indicated that this extract contained 1,2-Benzenediol, Dibutyl phthalate and 9,12-Octadecadienoic acid, ethyl ester. Conclusion: Our preliminary data indicate a potential anti-tumor activity of ethanol extract of S. carteri in breast cancer cells.

COVID-19 has been found to affect the cardiovascular system leading to myocardial damage. A study of 41 patients in Wuhan, China, found that 12% of COVID-19 patients experienced virus-related acute cardiac damage.Subsequent bigger Chinese studies also found acute cardiac damage in 7.2% to 27.8% of hospitalized patients. As a chronicsequela, this condition may result in cardiomyopathy. We report acase of an adolescent COVID-19 survivor with dilated cardiomyopathy with no underlying heart disease. A male patient aged 16 years old was admitted to our outpatient clinic with the primary symptom of exhaustion and had recovered frommild to moderate COVID-19 one month prior to the visit. No previous history of heart disease was documented. Physical examination showed no abnormalities. Laboratory results revealed substantially elevated NT-proBNP (7705 pg/mL) and D-dimer (1850 ng/mL). ECG presented normal sinus rhythm with poorR wave progression. Echocardiography revealed all chamber dilatation, eccentric left ventricular hypertrophy, globalhypokinetic, moderate mitral regurgitation, and reduced ejection fraction (22%). We diagnosed the patient with new-onset dilated cardiomyopathy and began treatment with candesartan, bisoprolol, furosemide, spironolactone, rivaroxaban, and trimetazidine. The recovery was steady at three-month follow-up visit. The emergence of new-onset cardiomyopathy in this previously healthy adolescent raisesthepossibility of COVID-19 acting asthe sole cause of myocardial injuryin the absence of underlying heart disease. To avoid further complications, comprehensive evaluation and effective therapy should be implemented during hospitalization and post-discharge. Additional tests such as cardiac magnetic resonance imaging and endomyocardial biopsies shouldbe performed to support final proof.