Public Health of Indonesia E-ISSN: 2477-1570 | P-ISSN: 2528-1542 Original Research The Cytotoxicity of Endophytic Fungi Isolated from Kelakai (Stenochlaena palustri. Against MCF-7 and Vero Cells Dali*1. Harlyanti MuthmaAoinnah Mashar2. Sukmawati Ahmad Damiti3. Ysrafil Ysrafil4 1Department of Nursing. Health Polytechnic of Kendari. Southeast Sulawesi. Indonesia 2Department of Nutrition. Health Polytechnic of Palangka Raya. Central Kalimantan. Indonesia 3Department of Midwifery. Health Polytechnic of Palangka Raya. Central Kalimantan. Indonesia 4Department of Pharmacotherapy. Faculty of Medicine. Universitas Palangka Raya. Central Kalimantan. Indonesia *Corresponding author Dali Department of Nursing. Health Polytechnic of Kendari. Southeast Sulawesi. Indonesia Email: dalid0458@gmail. DOI: https://doi. org/10. 36685/phi. Copyright: A 2025 the Author. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited. Article History: Received 5 December 2024 Revised 9 May 2025 Accepted July 2025 Abstract Background: The high prevalence of cancer has a direct impact on the quality of life and nutritional status of sufferers, mainly due to decreased appetite, metabolic disorders, and side effects of conventional therapies such as surgery, mastectomy, chemotherapy, hormonal therapy, or radiation therapy. These therapies, although aimed at inhibiting the growth and metastasis of cancer cells, often cause severe side effects that worsen the patient's condition. Therefore, it is important to explore alternative treatments that are effective and have minimal side effects. this regard, biological sources, such as endophytic fungi kelakai, contain various active secondary metabolites that can inhibit cancer cell proliferation so that they can be part of a more public health-friendly supportive therapy approach. Objective: This study aims to prove the cytotoxic activity of the extract of endophytic fungi in kelakai against MCF-7 and Vero cells. Methods: Isolation, purification, and extraction process of secondary metabolites from the endophytic fungi isolates were carried out in the same manner as our previous research. The ethyl acetate extract of kelakai was obtained by extractive fermentation from pure isolates of the endophytic fungi in kelakai. Extraction was carried out by the fractionation method using the ethyl acetate solvent at a ratio of 1:1. Identification of chemical contents, including tannins, alkaloids, flavonoids, saponins, and steroids/terpenoids, was conducted qualitatively. Cytotoxic activity was tested by the MTT method. Results: From the isolate extraction, 2. 4 g of ethyl acetate extract was produced. The identification of chemical contents showed positive results, meaning that the extract did contain tannins, flavonoids, alkaloids, steroids, and saponins. The extract cytotoxicity test against MCF-7 and Vero cells yielded IC50 values of 517. 3015 AAg/ml and 1,074. 9152 AAg/ml, respectively. Conclusion: Based on these results, the extract of kelakai was not toxic to Vero cells, but it was toxic to MCF-7 cells. These findings suggest that the kelakai can be the basis for exploring local plants as a source of natural medicine while supporting the conservation of endemic plants to provide safer alternative therapies and improve public health. Keywords: Stenochlaena palustris. Endophytic Fungi. MTT. MCF-7. Vero cell Volume 11. Issue 3. July Ae September 2025 Background Today, cancer is still a serious problem and ranked as the top cause of death worldwide and is a growing global health problem. According to the World Health Organization (WHO) in 2020, there were 19 million new cases of cancer, and nearly 10 million of them ended up in death. For the first time in 2020, breast cancer in women was expected to be the most common cancer worldwide (Sung et al. , 2. The prevalence of cancer is expected to continue to increase due to risk factors such as population ageing, lifestyle changes, and exposure to carcinogenic substances (Li et al. , 2. Indonesia itself, cancer ranks second as the highest cause of death . 4%), after heart disease . 2%) (IHME, 2. Globocan . data reports that breast cancer is one of the most common types of cancer found in Indonesian women, with an incidence rate that continues to increase every year. There were around 396,914 new cancer cases and almost 234,511 deaths from cancer in Indonesia in 2020. Cancer treatment in Indonesia still faces serious challenges. One of the main obstacles is limited access to oncology health services, especially in remote areas far from referral hospitals. In addition, although partly covered by the National Health Insurance, high treatment costs remain a burden for many patients. The lack of specialist medical personnel, uneven facilities, and limited availability of medicines also exacerbate this condition (Bourgeois et al. , 2024. Oluwasanu et al. , 2. On the other hand, many patients are diagnosed at an advanced stage due to low public awareness of early cancer symptoms and the lack of effective early detection programs (Icanervilia et al. , 2. Side effects of conventional treatments such as chemotherapy also often reduce the quality of life of patients. Chemotherapy side effects can be acute or prolonged and require monitoring. Certain patients may be at higher risk for complications. Some of the effects that arise include hypersensitivity reactions, nausea and vomiting, mucositis, fatigue, diarrhea, constipation, and They can even cause serious effects on various organs, including the lungs, liver and kidneys (Amjad et al. Kousar et al. , 2. Endophytes, a new category of microbial sources that can produce various potential compounds, have essential value to study and broader development prospects. Endophytic fungi have received much attention as a source of new bioactive compounds. Various active compounds produced by endophytic fungi are due to the close biological relationship between endophytes and their host plants. Bioactive compounds separated from endophytes include alkaloids, phenol derivatives, terpenoids, and steroids (Hashem et al. , 2. Compounds successfully isolated and purified from endophytic fungi are used to fight various cancers, such as prostate, lung, ovarian, and breast (Kousar et al. , 2. These potential compounds work through apoptosis induction and suppress cancer development (Dos Santos et al. , 2022. Tiwari & Bae. In addition, endophytic fungi also possess a large number of fungicidal metabolites and bactericidal and cytotoxic activities (Ababutain et al. , 2. One of the plants that has the potential to be developed as a traditional medicine is kelakai (S. Kelakai is an endemic fern plant widely found in Central Kalimantan and is commonly consumed by the local community in everyday life as a vegetable or processed into snacks in the form of chips. Kelakai can grow and survive in various environmental conditions and is resistant to pests and diseases, so the community can easily obtain it without having to buy it in a particular place (Fahruni, 2018. Santoso et al. , 2. Apart from being used as a food ingredient, people also consume kelakai to treat various diseases such as anemia and, due to its high iron content, to increase and facilitate breast milk production for breastfeeding mothers (Fahruni, 2018. Irawan et al. , 2. In addition, kelakai is also reported to have antidiabetic properties through inhibition of -glucosidase so that it can reduce blood sugar levels (Chai et al. , 2. and has the potential to be an anti-cancer (Mashar & Annah, 2020. Safitri et al. , 2. Kelakai contains various secondary metabolites, such as the flavonoid quercetins, phenols, alkaloids, and steroids (Chabib et al. , 2018. Fatmawati et al. , 2. Flavonoids have been reported to induce apoptosis by inhibiting DNA topoisomerase I/II activity, modulation of signaling pathways, decreased expression of Bcl-2 and Bcl-XL genes, increased expression of Bax and Bak genes, and endonuclease activity (Ren et al. , 2. Quercetin, a flavonoid derivative, can prevent the development of tumor cells by inducing phase II conjugation enzymes, thereby preventing the depletion of reduced glutathione (Ramos, 2. The results of the study by Mashar et al. eported that the results of the isolation of endophytic fungi from the leaves and stems of kelakai contained 3 fungi identified, namely Aspergillus sp. Paecilomyces sp. , and Arthrocristula , which showed quite good antimicrobial activity. The IC50 value of the fractionated ethyl acetate extract from the kelakai endophytic fungal isolate was obtained at 24. 29 AAg/ml, indicating potent antioxidant activity (Mashar et al. , 2. Endophytic fungi kelakai are known to produce secondary metabolite compounds that have the potential as However, the biological activity of this fungal isolate against MCF-7 breast cancer cells and normal Vero cells is not fully understood. To study this potential, a scientific test is needed to prove the resulting compound's cytotoxic Therefore, testing was carried out using the MTT assay method, which can measure cell viability based on the activity of mitochondrial enzymes in living cells. In this study, the variables to be measured include the concentration of the extract against the percentage of cell viability by calculating the ICCICA value as an indicator of cytotoxic potential against MCF-7 cells and selectivity against Vero cells. MCF-7 breast cancer cells are the most widely used in in vitro cytotoxic activity testing, while Vero cells are used to compare selectivity against MCF-7 cells. The results of this test are expected Volume 11. Issue 3. July Ae September 2025 to provide quantitative evidence regarding the cytotoxic ability of endophytic fungi kelakai isolates and evaluate their safety against normal cells, and can be part of a more public health-friendly supportive therapy approach. Methods Study design This research design is experimental research in the laboratory. Materials Fresh leaves from which endophytic fungi were to be isolated were obtained from Palangka Raya city. Central Kalimantan. Indonesia. The sampling method is Accidental Sampling, namely by taking kelakai leaves in areas with abundant kelakai availability and easy access. The part of the leaf used is a fresh and intact young leaf located in the third order from the shoot or growing point of the kelakai plant. The number of leaves used for each petri dish is 2 sheets. The samples obtained were put in a clean and sterile container and then transported to the laboratory for surface The samples stored in sterile containers are then put into an ice box, where the temperature is maintained at 25 Oc. Sample transportation from the collection location to the laboratory takes 15 minutes. Isolation. Purification, and Extraction The surface-sterilized samples were cut to a size of A1cm and then inoculated on Potato Dextrose Agar (PDA) and chloramphenicol media that had previously been compacted. Then the samples were incubated at 30 oC for 5 days. Observe for 5 days until the fungus grows. After that, the growing fungus was isolated and purified on new PDA media and incubated at 30 oC for 5 days to obtain pure isolates. In order to obtain secondary metabolites, pure isolates were fermented in Potato Dextrose Yeast (PDY) media for 14 days at 30 oC. The fermentate was separated from the mycelium for extraction. In the extraction process, 100 ml of fermentate was fractionated using ethyl acetate solvent in a ratio of 1:1. This process is carried out until a clear ethyl acetate fraction is obtained. The ethyl acetate fraction is separated and evaporated until a thick extract is obtained (Handayani et al. , 2017. Ismail et al. , 2. Identification of Chemical Contents Chemical content is identified qualitatively to determine the presence of secondary metabolites. Each test was performed with 2 replications. Tannins: Three mililiters of extract was added with ferric chloride solution. The blue-black precipitate or greenish-black precipitate would indicate positive for containing tannins (Mughal et al. , 2018. Vanimakhal & Ezhilarasi, 2. Alkaloids: The test extract was divided into 3 tubes. The first tube was added with 1 ml of hydrochloric acid 2 N and 2 ml of extract as blank. The second tube was added with 1 ml of Dragendorff and 2 ml of extract. The third tube was added with few drops of Mayer and 1 ml of extract. An orange precipitate in the second tube and yellowish or white in the third tube would indicate positive for containing alkaloids (Kancherla et al. , 2019. Sasikala & Sundaraganapathy, 2. Flavonoids: Five mililiters of extract was heated for approximately 5 minutes. After heating, the solution was added a few amount of Mg powder and some drops of concentrated hydrochloric acid. If the solution formed a yellow-orange color, then it was said to be positive for containing flavonoids (Parbuntari et al. , 2. Saponins: The test extract was added with 10 mL of hot water, cooled, and shaken vigorously for five minutes. foam forming for about 5 minutes and on the addition of HCl 2 N the foam would not disappear indicated the presence of saponins (Kancherla et al. , 2019. Parbuntari et al. , 2. Steroids: The extract was added with concentrated HCl and concentrated H2SO4. If the solution formed a green color, then it would be said to be positive for steroids (Kancherla et al. , 2. Cytotoxic Activity Assay Toxicity assays on MCF-7 cells . uman breast adenocarcinoma cell. and Vero cells . ormal cell. were carried out using the MTT method. All cell lines were obtained from the Cell Culture and Cytogenics Laboratory of the Faculty of Medicine. Universitas Padjadjaran. MCF-7 cells were cultured in complete RPMI, while Vero cells were cultured in complete DMEM. Both types of cells were sub-cultured after mild trypsinization with trypsin-EDTA (Sigma-Aldrich. USA). The cell number and viability were then determined. The cells were seeded in 96-well plates at a density of 10,000 cells/well in 200 AAl of medium and incubated for 24 hours. All media were supplemented with 10% fetal bovine serum (Gibc. , streptomycin, and penicillin . Sigma-Aldrich. USA). The cell line was kept at 37 oC and 98% relative humidity with 5% CO2 atmosphere. Volume 11. Issue 3. July Ae September 2025 The extract was prepared with several concentration variations: 2,000 AAg/ml. 1,000 AAg/ml. 500 AAg/ml. AAg/ml. 125 AAg/ml. 5 AAg/ml. 5 AAg/ml. 625 AAg/ml. This concentration variation is intended to measure the sample's ability to kill cells. The higher the concentration, the more active compounds are contained in the sample and the greater its ability to kill cells. Each concentration was performed with 3 replications. Cells that had been incubated were then divided into several groups, namely, treatment, positive control . , cell control, and medium control . The medium was then removed and washed using sterile PBS Then, 200 AAl of extract . ased on concentratio. was added to each well. Doxorubicin was used as positive control. Incubation was carried out for 72 hours in an incubator at 37 oC, 5% CO2. The cells that had been treated and incubated were later dumped throughout the medium and washed using sterile PBS. Then, each well was added 100 AAl of MTT, followed by 4 hours of incubation in an incubator at 37 oC, 5% CO2, until formazan crystals formed. After that, 100 AAl of 10% SDS was added to each well as a stopper to dissolve the formazan crystals formed. The plates were then read by an ELISA reader at 550 nm. Data analysis The cytotoxic test was analyzed by looking at the absorbance results that had been read with an ELISA reader at a wavelength of 550 nm. Cell viability (%) was calculated using the formula: Cell viability (%) = ((Absorbance of cells with treatment-Absorbance of control medi. /(Absorbance of control with media-Absorbance of control medi. ) *100% Furthermore, to obtain the IC50 value, it was analyzed using a linear regression equation. The IC50 value is the concentration that causes the death of 50% of the cell population. The IC50 value is used as a cytotoxic parameter. Cytotoxicity criteria are grouped into potential cytotoxic categories if IC50 <100 AAg/mL, moderate cytotoxic if IC50 ranges from 100 to 1000 AAg/mL, and non-toxic if IC50 >1000 AAg/mL (Caballero-Gallardo et al. , 2022. Widyananda et al. , 2. Ethical consideration This research has received ethical approval recommendations from the Health Research Ethics Committee of the Poltekkes Kemenkes Palangka Raya Number 568/XII/KE. PE/2022. Results Phytochemical screening was conducted using the color reagent method, which is a straightforward qualitative analysis technique designed to identify the presence of specific compounds in a sample. The results of the phytochemical screening indicated the presence of tannins, flavonoids, and saponins in the ethyl acetate extract of the endophytic fungi isolate from kelakai (Table . Table 1. Identification of the Chemical Contents of the Kelakai Extract Chemical Contents Results Conclusion Tannins Greenish black precipitate Alkaloids Green precipitate Flavonoids Orange-yellow solution Steroids Black precipitate Saponins Stable foam was formed The condition of the MCF-7 cells after treatment with the ethyl acetate extract of kelakai is shown in Figure 1. When compared with the condition of the cells before treatment (Figure 1. ), many cells became no longer intact or died after treatment. The test on MCF-7 cells yielded an IC50 value of ethyl acetate extract of 517. 3015 ug/mL. After treatment with the ethyl acetate extract kelakai, many of the Vero cells were still intact or not dead (Figure 2. ), similar to the condition of the cells before treatment (Figure 2. ) with cells being intact. The test on Vero cells yielded an IC50 value of ethyl acetate extract of 1,074. 9152 ug/mL. Volume 11. Issue 3. July Ae September 2025 Figure 1. Growth of MCF-7 cells: . before treatment with the ethyl acetate extract. after treatment with the ethyl acetate extract. treatment with doxorubicin Figure 2. Growth of Vero Cells: . before treatment with the ethyl acetate extract. after treatment with the ethyl acetate extract. treatment with doxorubicin Discussion Endophytic fungi can be found in most plants. Endophytic fungi spend part or all of their life cycle in a healthy host plant without causing symptoms of disease or disorder. Almost every plant contains one or more endophytic fungi (Baron & Rigobelo, 2022. Julia et al. , 2. Endophytic fungi make a positive contribution to plant growth, increase plant defense against environmental and biological conditions, increase nutrient absorption for their host plants, and modulate plant hormonal balance (Morales-Vargas et al. , 2024. Syamsia et al. , 2. In addition, these microorganisms facilitate Volume 11. Issue 3. July Ae September 2025 the synthesis of secondary metabolite compounds (Wang et al. , 2. Secondary metabolite compounds produced by endophytic fungi have been widely developed and used in the fields of agriculture, the pharmaceutical industry, and food industry development (Julia et al. , 2. Endophytic fungi groups have been identified to have various secondary metabolites obtained through isolation, purification, and characterization procedures. Endophytes have been reported to contain potential compounds of interest with biomedical importance in the form of cytotoxic, antiviral, and antituberculosis agents, including potential in anticancer treatment (Kaliaperumal et al. , 2023. Varghese et al. , 2. Compounds in endophytic fungi have been reported to induce apoptosis and suppress the development of cancer, such as Kaposi's disease, prostate, lung, ovarian, and breast cancer (Kousar et al. , 2. In this study, the compound content and cytotoxic activity assay in the ethyl acetate extract of the endophytic fungi isolated from kelakai were tested in vitro. The extract cytotoxicity test against MCF-7 and Vero cells. The IC50 value is used as a cytotoxic parameter. The IC50 value is the concentration that causes the death of 50% of the cell population. MCF-7 cells are human breast cancer cells that mostly express estrogen receptors. MCF-7 cells are often used to study breast cancer estrogen receptors in vitro (Holliday & Speirs, 2011. Vantangoli et al. , 2. Meanwhile. Vero cells are a type of cells widely used for antiviral and vaccine testing. These cells were obtained from the kidneys of the African green monkey (Cercopithecus ethiop. and were the first cells approved by WHO for testing the effectiveness of a vaccine for human use. Vero cells are considered non-tumorigenic with limited availability. they are also considered safe to use as substrates for vaccines (Kiesslich & Kamen, 2020. Shen et al. , 2. The cytotoxicity assay results against MCF-7 cells indicates that the activity of the sample was very weak because the IC50 value obtained was > 200 AAg/ml (Rahman et al. , 2. Meanwhile, the IC50 value for doxorubicin was 0. ug/mL, which showed high activity as practically all MCF-7 cells were destroyed. The IC50 value can be used as a parameter to assess the toxicity of an extract. If the IC50 value is < 1,000 AAg/ml, the extract is considered toxic. However, if the IC50 value is > 1,000 AAg/ml, the extract is not toxic (Jelita et al. , 2. Based on the results of cytotoxicity assay on Vero cells, the extract of kelakai was not considered toxic. The level of toxicity indicated the potential of the extract of kelakai as an natural-based anticancer agents. The IC50 value of Vero cells after 72 hours of treatment with doxorubicin was not measurable because the percentage of death at the highest concentration of doxorubicin . ug/mL) was in the range of 31Ae37%. Figure 2. shows the very strong activity of doxorubicin, which was able to kill almost all Vero cells. The compounds contained in plants are the main factor indicating their capacity to be developed as potential cytotoxic agents. Flavonoids are proven therapeutic agents that inhibit cancer cell proliferation (Sahu et al. , 2. They have also been shown to limit cell proliferation via modulating cyclin-dependent kinase and cyclin B, indicators of the transition from G2 to M phase, and by regulating tumor suppressor genes that play a key role in stopping cancer cells, including breast cancer cells. MCF-7 (Arullappan et al. , 2. The cytotoxicity test on the ethyl acetate fraction of kelakai on HeLa cells yielded the lowest IC50 value of 8. 60 AAg/ml (IC50 <200 AAg/m. (Arullappan et al. , 2017. El Ouadi et al. , 2. The ethyl acetate fraction also showed cytotoxic activity against liver cancer cells (HepG. with an IC50 value of 224. 12 AAg/ml (Yanti et al. , 2. The ethanol extract of kelakai showed a cytotoxic effect on MCF-7 cells with an IC50 value of 493. 57 AAg/ml (Mashar & Annah, 2. Characterization of potential compounds is needed to obtain Conclusion The results showed that ethyl acetate extract contains tannin, flavonoid, and saponin compounds with potential biological activity, including cytotoxic activity against cancer cells. The cytotoxicity test against MCF7 breast cancer cells showed that the extract activity was relatively weak, with an IC50 value of 517. 30 AAg/mL. However, the ICCICA value against Vero cells was 1,074. 92 AAg/mL, indicating that this extract was not toxic to normal cells. Thus, a conceptual model linking the content of bioactive compounds in plants with cytotoxic potential can be sufficient as an initial guide, although its effectiveness in cancer therapy still requires further strengthening. These findings have implications for the development of a primary anticancer candidate. Although the ethyl acetate extract of kelakai is not yet strong enough, its potential safety for normal cells makes it a promising base material. The development of safe, natural-based anticancer agents can be part of a preventive and curative approach that is more friendly to cancer patients' conditions, including their nutritional Conventional therapies that often cause disorders in patients can be strengthened or combined with natural agents that have minimal side effects so that in addition to supporting the healing process, they also serve as an effort to maintain the intake and nutritional status of cancer patients, which is very crucial in the healing process. These results emphasize the importance of selecting the correct dosage and extraction method for natural medicine. For further research, it is recommended to isolate and identify specific active compounds with the potential for higher activity. These results can also be the basis for exploring local plants as a source of natural medicine while supporting the conservation of endemic plants to provide safer alternative therapies and improve public health. Volume 11. Issue 3. July Ae September 2025 Declaration of conflicting interest The authors declare no potential conflict of interest. Funding This research was funded by DIPA funds from Poltekkes Kemenkes Palangka Raya on Decree Number HK. 03/I/0391/2022. Acknowledgment: The author would like to thank Poltekkes Kemenkes Palangka Raya for the research funds given for the research, the Microbiology and Chemistry Laboratory of the Nutrition Department of Poltekkes Kemenkes Palangka Raya, especially Putri Ayu Lestari and Puteri Elok Laluyangan, who have assisted in this research, and the owner of the MCF-7 cells. Ahmad Faried, dr. Sp. BS(K). Ph. D from Neurosurgery. Faculty of Medicine. Universitas Padjadjaran. The cytotoxicity test for MCF-7 and Vero cells was conducted at the Cell Culture and Cytogenetics Laboratory. Faculty of Medicine. Universitas Padjadjaran. Author contributions Dali led the study's concept and design, supervised the study's implementation, and contributed to the writing and revision of the Harlyanti Muthma'innah Mashar Designed the study, coordinated with the Cell Culture and Cytogenetics Laboratory. Faculty of Medicine. Universitas Padjadjaran, played an essential role in the Literature review, and drafted the manuscript. Teguh Supriyono provided expertise in methodology, ensured the rigor of the experimental procedures, and assisted in data interpretation. Sukmawati Ahmad Damiti played a role in data analysis and interpretation of results. Ysrafil Ysrafil was responsible for researching ethics, conducting data analysis, and drafting the manuscript. All authors reviewed and approved the final version of the manuscript. AuthorAos Biographies Dali is a Lecturer at the Department of Nursing. Health Polytechnic of Kendari. She is interested in identifying research on stunting, local food potential for health, and other public health research. She is author of books about Nutrition. She can be contacted at email: dalimashar@gmail. Harlyanti MuthmaAoinnah Mashar is a Lecturer at the Department of Nutrition. Health Polytechnic of Palangka Raya. She is interested in traditional medicinal plants, local food potential for health, and other pharmaceutical research. She is author of books on secondary She can be contacted at email: harlyanti@polkesraya. Teguh Supriyono is a Lecturer at the Department of Nutrition. Health Polytechnic of Palangka Raya. He is interested in food Technology. He can be contacted at email: teguh. supriyono@polkesraya. Sukmawati A. Damiti is Lecturer at the the Department of Midewifery. Health Polytechnic of Palangka Raya polytechnic. She has conducted research and written books in the scope of health sciences and pharmaceutical sciences, especially clinical pharmacy. She can be contacted at email: sukmawati@polkesraya. Ysrafil Ysrafil is a Lecturer in Department of Pharmacotherapy. Faculty of Medicine. Universitas Palangka Raya. His expertises are Pharmacology. Molecular Pharmacology, as well as Molecular biology. His research interest are drug discovery and development as well as healt related research. He can be contacted at email: ysrafil@med. References