examining the Potential of *Euphorbia tirucalli* (Patah Tulang) Extract for Nasopharyngeal Epithelial Protection News and Activities
Examining the Potential of
*Euphorbia tirucalli* (Patah Tulang) Extract for Nasopharyngeal Epithelial
Protection: Dr. I Ketut Suanda Earns Doctoral Degree from the Faculty of
Medicine, Udayana University
Held in the 3rd-floor meeting
room of the Postgraduate Program building at Udayana University (Jl. PB
Sudirman, Denpasar, Bali), the Doctoral Study Program in Biomedical Sciences at
the Faculty of Medicine, Udayana University, conducted an open doctoral defense
for candidate Dr. I Ketut Suanda, Sp.THT-BKL, Subsp.Onk. His dissertation is
titled, "The Effect of Ethanolic Extract of *Euphorbia tirucalli* L.
(Patah Tulang) Twigs on SOD Levels, TNF-?, Ki-67 Expression, and
Histopathological Changes in the Nasopharyngeal Epithelium of
Formaldehyde-Induced Wistar Rats." (October 8, 2026)
Nasopharyngeal carcinoma (NPC) is
a malignant tumor of the nasopharyngeal mucosal epithelium with a high
incidence rate in Southeast Asia, including Indonesia. Exposure to
formaldehyde—an environmental risk factor—induces oxidative stress, chronic
inflammation, and cellular proliferation, which can drive the dysplastic
transformation of the nasopharyngeal epithelium. The extract of *Euphorbia
tirucalli* L. (patah tulang) twigs contains flavonoids and polyphenols, which
possess potential antioxidant and anti-inflammatory properties. This study
aimed to investigate the effects of administering an ethanolic extract of
*Euphorbia tirucalli* twigs on superoxide dismutase (SOD) levels, tumor
necrosis factor-alpha (TNF-?), Ki-67 expression, and histopathological changes
in the nasopharyngeal mucosal epithelium of formaldehyde-induced Wistar rats.
This research was an experimental
study utilizing a randomized posttest-only control group design. The subjects
were 28 male Wistar rats (*Rattus norvegicus*), randomly divided into four
groups: a negative control group (K0) receiving neither formaldehyde induction
nor the extract; a positive control group (K1) induced with 20 ppm formaldehyde
for 16 weeks without the extract; a treatment group (P1) induced with
formaldehyde and administered the extract at a dose of 125 mg/kg body
weight/day for 18 weeks; and a treatment group (P2) induced with formaldehyde
and administered the extract at a dose of 250 mg/kg body weight/day for 18
weeks.
The results indicate that the
administration of the ethanolic extract of *Euphorbia tirucalli* (pencil
tree/patah tulang) twigs significantly increased SOD levels and decreased TNF-?
levels in a dose-dependent manner, with the most pronounced effect observed at
a dose of 250 mg/kg body weight/day (p < 0.001). Paradoxically, however,
Ki-67 expression increased significantly in the treatment groups—most notably
at the 250 mg/kg body weight/day dose (p < 0.001)—which is interpreted as a
mechanism of tissue regeneration. Histopathological examination revealed a
significant improvement in the grade of dysplasia among the treatment groups;
specifically, the P2 group showed a complete resolution of severe dysplasia (?²
= 13.13; p = 0.041). Path analysis demonstrated that SOD exerted the greatest
influence on the improvement of dysplasia grades, with the overall model
proving statistically significant (F = 5.072; p = 0.007; R² = 0.388). These
findings suggest that the optimal dose for providing a protective effect against
histopathological changes in the nasopharyngeal epithelium is 250 mg/kg body
weight/day, with the underlying mechanism primarily driven by an enhancement in
antioxidant capacity.
This examination was chaired by
the Dean of the Faculty of Medicine, Udayana University, Prof. Dr. dr. I Gede
Eka Wiratnaya, Sp.OT., Subsp.Onk.Ort.R(K)., with a team of examiners:
1. Prof. Dr. Dr. I Made Jawi,
M.Kes (Promoter)
2. Prof. drh. I Nyoman Mantik
Astawa, Ph.D (Copromoter I)
3. Prof. Dr. Dr. Ni Nyoman Sri
Budayanti, Sp.MK (K) (Copromotor II)
4. Prof. Dr. Dr. I Wayan Putu
Sutirta Yasa, M.Si
5. Prof. Dr. Dr. I Made
Sudarmaja, M. Kes
6. Prof. Dr. Dr. Hamsu Kadriyan,
M.Kes., Sp.THT-KL(K)
7.Dr. Dr. Ni Putu Sriwidyani,
Sp.PA., Subsp.S.M.(K)
8.Dr. Dr. I Nyoman Gede Budiana,
Sp.OG., Subsp.Onk
9.Dr. Dr. I Wayan Eka Sutyawan,
Sp.M(K)
By academic invitation:
1.Dr. Dr. I Made Gede Widnyana,
M.Kes., Sp.An-TI, Subsp.An.R(K)
2.Dr. Dr. Sari Wulan Dwi
Sutanegara, Sp.THT-BKL., Subsp.Rhino(K)
3.Dr. Dr. Made Agus Hendrayana,
M.Ked.
4.Dr. Dr. I Wayan Lolik Lesmana,
M.Biomed., Sp.THT-BKL., Subsp.Onk(K)
5.Dr. Dr. Made Lely Rahayu,
Sp.THT-BKL., Subsp.Oto.
In this exam, Dr. Dr. I Ketut Suanda, Sp.THT-BKL, Subsp.Onk., has successfully graduated as the 511th Doctor from the Doctoral Program in Biomedical Sciences at the Faculty of Medicine, Udayana University, earning the distinction of "very satisfactory."


UDAYANA UNIVERSITY