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==Toxicity==
[[File:Tanghinin.png|thumb|[[Tanghinin]], one of the toxins present in ''Cerbera manghas''.]]
The leaves and the fruits contain the extremely toxic [[cardiac glycoside]] [[cerberin]], as well as [[tanghinin]], deactyltanghin, and neriifolin. Only the mechanism of action for cerberin has been extensively studied, although tanghinin and the other molecules are likely proceed through a similar mechanism. Cerberin acts by affecting [[sodium-potassium pump]]s in [[cardiac muscle cells]] via inhibition of Na<sup>+</sup>/K<sup>+</sup>-ATPase.<ref>{{cite journal | vauthors = Babula P, Masarik M, Adam V, Provaznik I, Kizek R | title = From Na+/K+-ATPase and cardiac glycosides to cytotoxicity and cancer treatment | journal = Anti-Cancer Agents in Medicinal Chemistry | volume = 13 | issue = 7 | pages = 1069–1087 | date = September 2013 | pmid = 23537048 | doi = 10.2174/18715206113139990304 | s2cid = 1537056 }}</ref><ref>{{Cite web|url=http://cvpharmacology.com/cardiostimulatory/digitalis|title=CV Pharmacology {{!}} Cardiac Glycosides (Digitalis Compounds)|website=cvpharmacology.com|access-date=2017-06-08}}</ref> In addition to its cardiac effects, symptoms of poisoning include numbness in the upper extremities followed by nausea, vomiting, chest tightness, and dyspnea.<ref name=":1" /> Cerberin is believed to be the most important contributor to the toxicity of the plant, although it is found in lower quantities than the other cardiac glycosides. Like the closely related [[Cerbera odollam]], Cerbera manghas seeds have been purposely ingested in [[suicide]] attempts.<ref name=":1">{{Cite journal |last=Tsai |first=Yi-Cheng |last2=Chen |first2=Chun-Yu |last3=Yang |first3=Ning-I |last4=Yang |first4=Chen-Chang |date=2008 |title=Cardiac glycoside poisoning following suicidal ingestion of Cerbera manghas |url=http://www.tandfonline.com/doi/full/10.1080/15563650701291766 |journal=Clinical Toxicology |language=en |volume=46 |issue=4 |pages=340–341 |doi=10.1080/15563650701291766 |issn=1556-3650}}</ref><ref>{{Cite journal |last=Misek |first=Ryan |last2=Allen |first2=Glenn |last3=LeComte |first3=Valerie |last4=Mazur |first4=Nicholas |date=2018 |title=Fatality Following Intentional Ingestion of Cerbera odollam Seeds |url=https://escholarship.org/uc/item/1gz3g513 |journal=Clinical Practice and Cases in Emergency Medicine |language=en |volume=2 |issue=3 |doi=10.5811/cpcem.2018.5.38345|pmc=6075506 }}</ref>
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