INGREDIENTS & RESEARCH

Boswellin

BACKGROUND

Ingredient Type: Botanical, Extract

Also Known As: Boswellia serrata, Boswellia glabra, Indian frankincense, Olibanum, Frankincense, Boswellia

The main medicinal component from the botanical herb, Boswellia serrata, is obtained by making a careful incision into the tree to collect the sap or gum that is then processed. This process includes a one-month waiting period where the water leaves this gum, resulting in a final, hardened version of oleo-gum resin. The sought-after constituents of the plant are its resin (30-60%) and its essential oils (5-10%). Additionally, the remainder of the Boswellia plant contains between 30-55% of polysaccharides. To further break down the resin, the following components can be found: monoterpenes, diterpenes, triterpenes, tetracyclic triterpenic acids as well as four major pentacyclic triterpenic acids which are mentioned to be key components in the inhibition of the pro-inflammatory process: B-boswellic acid, acetyl-B-boswellic acid, 11-keto-B-boswellic acid and acetyl-11-keto-B-boswellic acid (5).

Native to India, Pakistan, and Northern Africa, Boswellia serrata has been used for centuries in incense and perfumes as well as part of the traditional tool-kit for the Asian, African, and Middle Eastern cultures. The name “frankincense” comes from an old French term, fran encens, which means “pure incense.” Each of the 20 known species of Boswellia produces a resin containing slightly different constituents; thus, the end product and resulting application of each species vary (5).

 

TRADITIONAL USES

In traditional Ayurvedic medicine, this herb, also known as Salai guggal, or in India under Sallaki is one of the few herbs to have been patented (2). Aside from being burnt at religious ceremonies to contribute to spiritual exaltation, this herb is commonly used for medicinal applications related to systemic inflammation as well to alter or ease the mind. Within the Jewish Talmud, Boswellia was said to be used as a wine to ‘benumb the senses’ of prisoners sentenced to death (3). Boswellia also has a long history of use to support the inflammatory response, aid in liver function, and the support of a healthy pain response.

 

WHAT DOES SCIENCE TELL US?

Boswellia Possibly Supports a Healthy Respiratory Tract:

A double-blind, placebo-controlled study was conducted on 40 patients with bronchial asthma to assess the effectiveness of the resin as an alternative treatment. Subjects in this study were treated with 300 mg, three times daily of the gum resin for 6-weeks. According to the results, 70% of the patients showed improvement in their condition, as evidenced by the disappearance of related symptoms such as dyspnea, rhonchi, as well as the number of attacks experienced. Additionally, other parameters indicated an improvement in patient signs such as an increase in FEV and PEFR, along with a decrease in eosinophilic count and ESR. It was concluded from the data and subjective assessment of the subjects that the gum resin of Boswellia serrata does indeed have a role in the treatment of bronchial asthma (26).

Another research study assessed the various pathways in which constituents, such as boswellic acid, can modulate the immune system favorably. Among such various constituents, 11-keto-beta-boswellic acid and acetyl-11-keto-beta-boswellic acid are observed to be the main active components with more substantial focused conducted research. The focus of this research was to seek out other potential constituents that may also show potential activity in the immune system. In the humoral defense system, a mixture of boswellic acid at higher doses was observed to reduce primary antibody titers. In regards to cellular defense, boswellic acids were observed to increase lymphocyte proliferation. Boswellic acids have been noted to even be active in the increase of phagocytosis of macrophages, its interaction with production/release of cytokines, as well as a decrease in leukotriene activity which is a hot topic for the scientific communities since a variety of chronic inflammatory diseases are associated with increased leukotriene activity. More research is necessary to understand further the mechanisms behind the anti-inflammatory activity of boswellic acids and boswellic-based plant extracts. According to the researchers, however, “it is not surprising that positive effects of boswellic-based plant extracts in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative colitis, and Chron’s disease have been reported” (16).

Boswellia Might Support Healthy Joints:

Aflapin is a novel, synergistic compound derived from Boswellia serrata gum resin that is touted to be one of the more superior agents on the market today for inflammation. A 90-day, double-blind, randomized, placebo-controlled study was conducted to evaluate the efficacy and tolerability of 5-Loxin® and Aflapin ® in the treatment of osteoarthritis (OA) of the knee. Fifty-seven subjects participated in this study. To determine efficacy and tolerability, patients were evaluated for pain as well as physical functions using standard assessment tools along with specific biochemical parameters in serum, urine, and hematological parameters in citrated whole blood. These markers were assessed at day 0 as a baseline and days 7, 30, 60, and 90. The group supplemented with 100 mg of Aflapin noted significant improvement in pain within the first 7-days of treatment. From the observed results, it was noted that Aflapin ® is capable of inhibiting cartilage degradation and has the potential to regulate the inflammatory response associated with osteoarthritis. According to this study, Alapin was more efficacious than 5-Loxin ® (27).

A similar, double-blind, randomized, placebo-controlled study was conducted for 30 days to validate the efficacy of Aflapin ® in the management of such symptoms associated with osteoarthritis (OA) of the knee. Subjects received either 100mg of Aflapin ® or a placebo daily for 30 days. Similar to the study mentioned above, subjects were evaluated for pain and physical functions through the use of standard assessment tools (visual analog scale, Lequesne’s Functional Index and Western Ontario and McMaster Universities Osteoarthritis Index) at day 0 for a baseline as well as on days 5, 15, and 30. Additionally, a series of biochemical tests in serum, urine, and hematological parameters were measured. Based on the observed results, the Aflapin provided significant improvements in both the pain scores as well as the functional ability measurements. It was concluded, based on the observed results, that Aflapin is both a safe and effective alternative for the management of those with OA (29).

As one of the more common herbs used in traditional Ayurvedic medicine, Boswellia serrata or “Shallaki” has been used to treat the symptoms associated with osteoarthritis. A study assessed the ability of Shallaki to mediate such symptoms associated with osteoarthritis. Fifty-six patients fulfilling the diagnostic criteria of Sandhigata Vata were divided into two groups. One group received 500 mg of Shallaki, 6 g per day with lukewarm water; the second group as noted before the local application of Shallaki ointment on affected joints. The results from this study revealed that following this course of treatment for two months, patients noted promising symptomatic relief at various levels (28).

Boswellia Possibly Supports Healthy Cell Growth:

A study was conducted to bring light to the potential effects of boswellic acids on malignant glioma cells. Boswellic acids, phytotherapeutic anti-inflammatory agents, were used as an alternative to corticosteroids in the treatment of cerebral edema as there is the concern that steroids may interfere with the efficacy of chemotherapeutic treatment. Testing on the cancer cells revealed that boswellic acids induce apoptosis while not being associated with free radical formation nor blocked by free radical scavengers. It was also found that in contrast to steroids, boswellic acids do not interfere with cancer drug toxicity of glioma cells in acute cytotoxicity. Further research and trials are necessary, however, to determine if boswellic acids are a suitable alternative in use as an adjunct to the medical management of human malignant glioma (20).

One of the derivatives of boswellic acid, acetyl-11-keto-beta-boswellic acid (AKBA) is considered an active component of the gum resin of Boswellia serrata. AKBA is a known alternative medication used for the treatment of various inflammatory conditions. This study aimed to evaluate the efficacy of AKBA as a chemopreventive agent against intestinal adenomatous polyposis. Test subjects were administered AKBA orally by gavage for eight consecutive weeks. Following the treatment, polyp tissues were assessed by light microscopy. A significant reduction was observed in the number of dysplastic cells as well as in the degree of dysplasia in each polyp treated with AKBA. Additionally, interdigitated normal-appearing intestinal villi were observed in the polyps of the treated group. It was noted that during the trial, the AKBA was well tolerated by the subjects. It was observed that AKBA was found to exert a chemopreventive action through the inhibition of the Wnt/B-catenin and NF-kB/cyclooxygenase-2 signaling pathways. It was concluded based on the findings that AKBA could be a potentially promising alternative for chemoprevention against intestinal tumorigenesis (21).

A study was developed to test the ability of acetyl-11-keto-beta-boswellic acid (AKBA) in targeting the androgen receptor (AR) signaling, specifically in prostate cancer cells. Upon testing of AKBA, there was noted arrest in the G1-phase of the cell cycle, along with a reduction of cyclin D1 in the prostate cancer cells. The AKBA-mediate cellular proliferation inhibition was associated with a decrease of AR expression at mRNA and protein levels. It was concluded, from the anti-AR properties of AKBA, that it has potential as being used for the development of novel therapeutic chemicals (22).

Another similar study examined the potential anticancer effects of B. serrata, as well as the mechanisms behind such activity. A B. serrata (BS) extract was noted to have induced apoptosis in HeLa human cervical carcinoma cells. A correlation was recognized between “ER stress signaling and apoptosis, suggesting the possibility of a BS-ER stress initiator as an anticancer therapeutic agent in human cervical carcinoma” (23). In another study, a triterpene diol (TPD) mixture comprising of an isometric mixture form B. serrata was noted to induce apoptosis in cancer cells, human leukemia HL-60 cancer cells specifically. From this study, it was concluded that the TPD produces oxidative stress in the HL-60 cancer cells, triggering apoptosis by reactive oxygen species (ROS) and nitric oxide (NO) regulated activation in both intrinsic and extrinsic signaling cascades (24). Similarly, an alternate species of Boswellia (Sacra) has notably exhibited induction of apoptosis and cell count reduction in certain breast cancer cell lines (T47D, MCF7, and MDA-MB-231) (25).

Boswellia Possibly Supports Mental Health:

A study was conducted to assess the potential anxiolytic-like, anti-depressive behavioral effects of Boswellia resin derived incense. According to various studies, this particular herb has commonly been burned as part of religious and cultural ceremonies to contribute to the spiritual exaltation of such events. The key receptor-targeted is TRPV-3, which has been found in neurons throughout the brain. It was gathered through the department’s research that the incensole acetate (IA), a Boswellia resin constituent, is a TRPV-3 agonist in wild-type mice. The results from this study indicate that the TRPV-3 channels in the brain may potentially play a role in emotional regulation, which may potentially be altered by such constituents as incensole acetate, the incense component of Boswellia resin (11).

Another study was conducted to support further the ability of incensole acetate (IA) to exhibit antidepressant-like effects in the Forced Swim Test (FST) in mice following a considerably lower dosage (10 mg/kg) vs. the standard dose as used in previous studies (50 mg/kg). From the results, it was noted that mice administered the lower dosage of 10 mg/kg exhibited submissive behavior, exerting significant antidepressive-like effects, according to the measured parameters in this study that the behavioral effect was concomitant to reduced serum corticosterone levels. This effect was noted to be dose-dependent. It was further concluded that the IA modulates the hypothalamic-pituitary-adrenal (HPA) axis, influencing hippocampal gene expression, leading to potentially supportive behavioral effects that may be useful for the treatment in depressive-live disorders (12).

Lastly, a study assessed the time-dependent effects of an ethanolic extract of Boswellia papyrifera on spatial memory retention in male rats. According to this study, a total of Boswellia papyrifera (300 mg/kg) was administered nightly every eight hours to three groups of rats by gavage for 1, 2, and 4 weeks. In a separate set of experiments, three doses of a fraction of the extract, boswellic acids, (100, 200 and 300 mg/kg) were administered to the three groups of rats for two weeks. Following the administration of the extract, rats were trained and subsequently tested. From the results, it was noted that the B. papyrifera extracts and boswellic acids exhibited a significant reduction in escape latency and distance traveled. Additionally, the data obtained revealed that systemic administration of the boswellic acid fraction enhanced spatial memory retention in a dose-dependent manner (13).

Boswellia Might Support the Immune System:

Incensole acetate (IA) is a major constituent of the resin obtained from Boswellia seratta. This component has been shown to inhibit NF-kB activation and accompanying inflammation. This study was conducted to assess the ability of IC to protect against ischemic neuronal damage and reperfusion injury in mice post-ischemia. The results noted that the administration of IA post-ischemia, there was a reduction in infarct volumes and improved neurological activity in a dose-dependent fashion. The results of this study suggest that the anti-inflammatory and neuroprotective effects of IA can potentially serve as a novel treatment for ischemic and reperfusion injury (10).

A study was conducted to study the genetic basis of the anti-inflammatory effects of Boswellia extract (BE) in a system of TNF-a-induced gene expression in human microvascular endothelial cells. These cells are critical components in the pathophysiology of inflammation. According to the results of the 552 genes induced by TNF-a, 113 genes were sensitive to BE. This sensitivity thereby prevented the TNF-a expression of matrix metalloproteinases. Upon further testing, it was noted that in vivo, the BE protected against experimental arthritis. The researchers concluded that, indeed, BE has potent anti-inflammatory properties both in vitro as well as in vivo (14,15).

It is surmised that ulcerative colitis (UC) is in part due to “dysregulation of the mucosal immune response towards the resident bacterial flora together with genetic and environmental factors.” The purpose of this research was to bring to light medication alternatives to controlling and reducing the symptoms associated with the associated inflammation of ulcerative colitis. Although not much research has been conducted using traditional Chinese medicines such as Aloe vera gel, wheatgrass juice, Boswellia serrata, and Bovine colostrum enemas in the treatment of UC, there are potential benefits to using herbal medicines in that they may still be safer, more readily accessible and more cost-effective than traditional medications. According to sources, “patients worldwide seem to have adopted herbal medicine in a major way, and the efficacy of herbal medicine has been tested in hundreds of clinical trials in the management of UC.” Although such herbal medicines provide promising results globally, there is still a need for further research along with controlled trials to better understand the mechanisms behind the potential efficacious constituents that such herbs possess (17).

A study aimed to evaluate the antioxidant effect of an extract derived from Boswellia serrata against a model of acetic acid-induced ulcerative colitis. The B. serrata extract was administered by gavage for two days prior and post-induction of colitis with the acetic acid being diluted to 4% in a volume of 4 mL. Upon examination of the group of subjects treated with B. serrata, a significant increase of anal sphincter pressure was noted along with significant decreases in edema, lipid peroxidation as well as superoxide dismutase activity. Additionally, glutathione peroxidase levels significantly increased in the treated group vs. the control group. It was concluded that “the B. serrata extract has active antioxidant substances that exert protective effects in acute experimental colitis cases” (18).

A similar study was conducted to investigate the effects of B. serrata extract (BSE) on symptoms, quality of life, and histology in patients with collagenous colitis. In this study, patients with chronic diarrhea and histologically proven collagenous colitis were randomized to receive either an oral BSE 400 mg 3 times per day for six weeks or a placebo. Of the 31-tested patients who were randomly selected to receive the treatment or the placebo, it was noted that patients in clinical remission were higher in the BSE group vs. the placebo group. The BSE treatment, however, did not exhibit any effect on histology or quality of life. Of the seven patients who received open-label BSE therapy, 5 achieved complete remission of their collagenous colitis. It was concluded from the research that BSE might be a clinically effective alternative in patients with collagenous colitis (19).

 

SAFETY

Boswellia is considered potentially safe when consumed as directed in medicinal quantities or quantities commonly found in food. Unfortunately, as with many other herbs and botanicals, there is limited conducted research on human subjects. With limited research, there is no conclusive safety and or toxicity information available for Boswellia at this time. It is therefore recommended to consume with caution. If you are with or think you may be with any medical conditions, please consult your healthcare professional before supplementing with Boswellia.

For those women who are or may be pregnant, it is recommended to seek the advice of your healthcare professional as Boswellia may increase the menstrual flow, which can potentially induce a miscarriage (1).

Interactions:

Being that Boswellia is with very limited human-based research, it is emphasized that if you are with or think you may be with any medical conditions, please consult your healthcare professional before consuming Boswellia. According to sources, Boswellia has no known mild, moderate, or severe interactions with other drugs (1).

Side-Effects:

Potential side effects associated with the consumption or application of Boswellia are diarrhea, nausea, stomach pain, or rash when applied to the skin (6). In studies assessing the safety threshold of Boswellia on other species, it was noted in various trials that dosages upwards 2,000-3,000 times the effective human dose appears to be nontoxic (7,8,9). 

 

REFERENCES 

  1. Boswellia. Rx List. https://www.rxlist.com/boswellia/supplements.htm. Accessed 26 September 2019.
  2. Miscioscia E, Shmalberg J, Scott K. Measurement of 3-acetyl-11-keto-beta-boswellic acid and 11-keto-beta-boswellic acid in Boswellia serrata Supplements Administered to Dogs. BMC Vet Res. 2019;15: 270.
  3. Moussaieff A, Rimmerman N, Bergman T, et al. Incensole Acetate, an Incense Component, Elicits Psycho-activity by Activating TRPV3 Channels in the brain. FASEB J. 2008;22(8): 3024-3034.
  4. Boswelia. Examine. https://examine.com/supplements/boswellia-serrata/. Accessed 26 September 2019.
  5. Siddiqui MZ. Boswellia serrata, a Potential Anti-inflammatory Agent: An Overview. Indian J Pharm Sci. 2011;73(5): 255-261. doi: 10.4103/0250-474X.93507.
  6. Acebo E, Raton JA, Sautua S, et al. Allergic Contact Dermatitis from Boswellia serrata Extract in a Naturopathic Cream. Contact Dermatitis. 2004;51(2): 91-92.
  7. Krishnaraju AV, Sundararaju D, et al. Safety and Toxicological Evaluation of Aflapin: A Novel Boswellia-Derived Anti-Inflammatory Product. Toxicol Mech Methods. 2010;20(9): 556-563.
  8. Lalithakumari K, Krishnaraju AV, et al. Safety and Toxicological Evaluation of a Novel, Standardized 3-O-Acetyl-11-Keto-Beta-Boswellic Acid (AKBA)-Enriched Boswellia serrata Extract (5-Loxin®). Toxicol Mech Methods. 2006;16(4): 199-226.
  9. Sharma R, Singh S, Singh GD, et al. In vivo Genotoxicity Evaluation of a Plant Based Antiarthritic and Anticancer Therapeutic Agent Boswellic Acids in Rodents. Phytomedicine. 2009;16(12): 1112-1118. DOI: 10.1016/j.phymed.2009.06.009.
  10. Moussaieff A, Yu J, Zhu H, et al. Protective Effects of Incensole Acetate on Cerebral Ischemic Injury. Brain Res. 2013;1443: 89-97.
  11. Moussaieff A, Rimmerman N, Bergman T, et al. Incensole Acetate, An Incense Component, Elicits Psychoactivity by Activating TRPV3 Channels in the brain. FASEB. 2008;22(8): 3024-3034.
  12. Moussaieff A, Gross M, Nesher E, et al. Incensole Acetate Reduces Depressive-Like Behavior and Modulates Hippocampal BDNF and CRF Expression of Submissive Animals. J Psychopharmacol. 2012;26(12): 1584-1593.
  13. Mahmoudi A, Hosseini-Sharifabad A, et al. Evaluation of Systemic Administration of Boswellia papyrifera Extracts on Spatial Memory Retention in Male Rats. J Nat Med. 2011;65(3-4): 519-525.
  14. Roy S, Khanna S, et al. Regulation of Vascular Responses to Inflammation: Inducible Matrix Metalloproteinase-3 Expression in Human Microvascular Endothelial Cells is Sensitive to Anti-Inflammatory Boswellia. Antioxid Redox Signal. 2006;8(3-4): 653-660.
  15. Roy S, Khanna S, et al. Human Genome Screen to Identify the Genetic Basis of the Anti-Inflammatory Effects of Boswellia in Microvascular Endothelial Cells. DNA Cell Biol. 2005;24(4): 244-255.
  16. Ammon HP. Modulation of the Immune System by Boswellia serrata Extracts and Boswellic Acids. Phytomedicine. 2010;17(11): 862-867.
  17. Fei K, Kumar YP, Zhan JL. Herbal Medicine in the Treatment of Ulcerative Colitis. Saudi J Gastroenterol. 2012;18(1): 3-10.
  18. Hartmann RM, Morgan Martins MI, et al. Effect of Boswellia serrata on Antioxidant Status in an Experimental Model of Colitis Rats Induced by Acetic Acid. Dig Dis Sci. 2012;57(8): 2038-2044.
  19. Madisch A, Miehlke S, Eichele O, et al. Boswellia serrata Extract for the Treatment of Collagenous Colitis. A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial. Int J Colorectal Dis. 2007;22(12): 1445-1451.
  20. Glaser T, Winter S, Groscurth P, et al. Boswellic Acids and Malignant Glioma: Induction of Apoptosis but No Modulation of Drug Sensitivity. Br J Cancer. 1999;80(5-6): 756-765.
  21. Liu HP, Gao ZH, Cui SX, et al. Chemoprevention of Intestinal Adenomatous Polyposis by Acetyl-11-Keto-Beta-Boswellic Acid in APC (Min/+) Mice. Int J Cancer. 2013;32(11): 2667-2681.
  22. Yuan HQ, Kong F, Wang XL, et al. Inhibitory Effect of Acetyl-11-Keto-Beta-Boswellic Acid on Androgen Receptor by Interference of Sp1 Binding Activity in Prostate Cancer Cells. Biochem Pharmacol. 2008;75(11): 2112-2121.
  23. Kim HR, Kim MS, Kwon DY, Chae SW, Chae HJ. Boswellia serrata-Induced Apoptosis is Related with ER Stress and Calcium Release. Genes Nutr. 2008;2(4): 371-374.
  24. Bhushan S, Kumar A, Malik F, Andotra SS, et al. A Triterpenediol from Boswellia serrata Induces Apoptosis Through both the Intrinsic and Extrinsic Apoptotic Pathways in Human Leukemia HL-60 Cells. Apoptosis. 2007;12(10): 1911-1926.
  25. Suhail MM, Wu W, Cao A, Mondalek FG, et al. Boswellia sacra Essential Oil Induces Tumor Cell-Specific Apoptosis and Suppresses Tumor Aggressiveness in Cultured Human Breast Cancer Cells. BMC Complement Altern Med. 2011;11:129.
  26. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata Gum Resin in Patients with Bronchial Asthma: Results of a Double-Blind, Placebo-Controlled, 6-Week Clinical Study. Eur J Med Res. 1998;3(11): 511-514.
  27. Sengupta K, Krishnaraju AV, Vishal AA, et al. Comparative Efficacy and Tolerability of 5-Loxin and Aflapin Against Osteoarthritis of the Knee A Double-Blind, Randomized, Placebo Controlled Clinical Study. Int J Med Sci. 2010;7(6): 366-377. doi:10.7150/ijms.7.366
  28. Gupta PK, Samarakoon SM, Chandola HM, Ravishankar B. Clinical Evaluation of Boswellia serrata (Shallaki) Resin in the Management of Sandhivata (Osteoarthritis). Ayu. 2011; 32(4): 478-482.
  29. Vishal AA, Mishra A, Raychaudhuri SP. A Double-Blind, Randomized, Placebo-Controlled Clinical Study Evaluates the Early Efficacy of Aflapin in Subjects with Osteoarthritis of the Knee. Int J Med Sci. 2011;8(7): 615-622. doi:10.7150/ijms.8.615

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