Therapeutic potential of Euphorbia tirucalli L. (bone-breaking tree): a comprehensive literature review

Abstract

Nasopharyngeal carcinoma (NPC) is a malignancy with high prevalence in Southeast Asia, including Indonesia, in which oxidative stress, chronic inflammation, and dysregulated cellular proliferation play important roles in carcinogenesis. Exposure to carcinogenic substances, such as formaldehyde, can induce excessive production of reactive oxygen species (ROS), resulting in cellular damage, genomic instability, and abnormal proliferation. Euphorbia tirucalli L. (bone-breaking tree) is a medicinal plant that has attracted considerable attention due to its diverse phytochemical composition and broad range of biological activities. Bioactive constituents, including polyphenols, flavonoids, diterpenes, triterpenes, and ellagic acid, have been reported to exhibit antioxidant, anti-inflammatory, and antiproliferative properties. Experimental studies have demonstrated that E. tirucalli extracts can scavenge free radicals, modulate oxidative stress pathways, suppress pro-inflammatory mediators such as NF-κB, TNF-α, and IL-6, and inhibit cancer cell proliferation through apoptosis induction. These findings suggest that E. tirucalli may exert chemopreventive effects through the regulation of oxidative stress, inflammation, and cellular proliferation. Nevertheless, current evidence remains largely limited to in vitro and animal studies. Further investigations focusing on molecular mechanisms, safety profiles, pharmacokinetic characteristics, and clinical efficacy are required to establish its therapeutic potential and support its future application as a chemopreventive agent, particularly in nasopharyngeal carcinogenesis.