Boswellia

Plant Part Used

Gum resin.

Active Constituents

Boswellic acids; essential oils; 11-keto [1]-boswellic acid (25) [span class=alert]

This section is a list of chemical entities identified in this dietary supplement to possess pharmacological activity. This list does not imply that other, yet unidentified, constituents do not influence the pharmacological activity of this dietary supplement nor does it imply that any one constituent possesses greater influence on the overall pharmacological effect of this dietary supplement.[/span]

Introduction

Boswellia, or olibanum, is a close relative of the Biblical incense frankincense and has been used historically in the Ayurvedic medical system of India for arthritis, dysentery, liver diseases, obesity, neurological disorders, ringworm, boils, and other afflictions. (1) Boswellin is a gum-resin extract from the stem bark of the Boswellia serrata tree. It is a dietary supplement claimed to be useful in the management of symptoms of arthritis. (2)

Dosage Info

Dosage Range

200-400mg (standardized extract), 3 times daily.

Topically: Apply as directed.

Most Common Dosage

400mg (standardized extract), 3 times daily.

Topically: Apply as directed.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 65-75% organic acids and/or 20-25% boswellic acids.

Uses

Frequently Reported Uses

  • Ulcerative Colitis
  • Osteoarthritis
  • Sports Injury
  • Crohn's Disease
Other Reported Uses
  • Acute And Chronic Bronchoconstrictive Conditions
  • Immunosuppressive
  • Inhibition Of Complement System
  • Antihyperlipidemic
  • Anti-Leukemic (In-Vitro)
  • Anti-Inflammatory.
  • Rheumatoid Arthritis
  • Edema (case of brain tumours)

 

Toxicities & Precautions

General

Boswellia has been reported safe in humans. (3) However, allergic contact dermatitis from Boswellia serrata extract was detected in a naturopathic cream. (27)

Pregnancy/ Breast Feeding

Use with caution in pregnancy and lactation due to insufficient data. If pregnant or nursing, consult a physician before use.

Age Limitations

Do not use in children under 2 years of age unless recommended by a physician.

Pharmacology

Animal studies performed in India reported ingesting an extract of boswellia decreased polymorphonuclear leukocyte infiltration and migration, decreased primary antibody synthesis, and caused almost total inhibition of the classical complement pathway. (4) An in vitro study of the isolated chemical constituent beta-boswellic acid on the complement system reported a marked inhibitory effect on both the classical and alternate complement systems. (5) An investigation of Boswellia's analgesic and psychopharmacologic effects noted that it "was found to exhibit marked sedative and analgesic effects" in laboratory animals. (6)

Recent reports suggest that boswellic acids from boswellia may induce differentiation and apoptosis of leukemia cells in vitro, thereby suggesting that it may be a powerful agent in the treatment of leukemia. (7)

Boswellia preparations have also been reported to be anti-inflammatory, blocking the synthesis of 5-lipoxygenase products, including 5-hydroxyeicosatetraenoic acid (5-HETE) and leukotriene B4 (LTB4). (8) , (9) These inflammatory agents can cause bronchoconstriction, chemotaxis and increased vascular permeability. Boswellia has also been reported to inhibit human leukocyte elastase (HLE), an inflammatory and mucous stimulating substance involved in chronic and acute respiratory problems such as bronchitis, emphysema and acute respiratory distress syndrome. (10) A double blind, placebo-controlled study of forty patients with bronchial asthma, reported that 70 percent of patients showed improvement of disease, evident by disappearance of physical symptoms and signs such as dyspnea, rhonchi, number of attacks and other determinants of asthma. (11) Recent in-vitro data suggests that there is a major importance of drug standardization when boswellia resin containing preparations are used for the treatment of diseases. (12) Low concentrations of boswellia extracts (1 to 10 micrograms/ml) actually potentiated 5-lipoxygenase product formation, especially the biosynthesis of 5(S)-HETE.

It is known that NSAIDs can cause a breakdown of glycosaminoglycan synthesis, which can speed up the articular damage in arthritic conditions. (13) Boswellia was reported to significantly reduce the degradation of glycosaminoglycans compared to controls, whereas the NSAID ketoprofen was reported to cause a reduction in total tissue glycosaminoglycan content.

Human trials evaluating the anti-inflammatory effects of boswellia in arthritic conditions is limited. One placebo-controlled trial evaluated only 37 patients with rheumatoid arthritis. In addition to previous therapy such as NSAIDs, eighteen received 3600mg daily of a resinous extract of boswellia serrata and 19 received placebo. Whereas most participants demonstrated no alteration of disease, one participant in each group responded positively, 4 in each group worsened. (14) Another trial evaluated the effects of a custom formula on patients with osteoarthritis. The formula contained roots of Withania somnifera, the stem of Boswellia serrata, rhizomes of Curcuma longa and a zinc complex. This randomized, double-blind, placebo controlled trial had 42 patients taking either the formula or placebo for three months. Following a washout period of 15 days, they were transferred to the other treatment group for an additional three months. Though the sample size was small, the formula demonstrated a significant drop in pain severity and a drop in the disability score. (15) The results of a randomized double blind placebo controlled crossover study consisting of 30 patients with osteoarthritis were that all patients receiving Boswellia reported decrease in knee pain, increased knee flexion, increased walking distance and a decrease of swelling in the knee joint. (16)

In human studies, a boswellia extract was compared to sulfasalazine (1gm tid) in individuals with ulcerative colitis. Patients on the boswellia extract showed similar improvements as patients on sulfasalazine, although 82 percent of the boswellia patients went into remission compared to 75 percent of the sulfasalazine patients. (17) These results were further supported in a small study. Twenty patients with chronic colitis were given a gum resin of Boswellia serrata and compared to a control group of 10 patients taking sulfasalazine. Ninety percent of the patients using boswellia showed improvement in specific categories with seventy percent going into remission. This results were compared to the control group where sixty percent showed similar improvement and only forty percent went into remission. (18) Boswellia serrata contains boswellic acids which helps to inhibit gastric ulcer on a gradual dosage (rework this sentence…we already discussed boswellic acids). Boswellic acids are also reported in laboratory studies to inhibit gastric ulcer formation in a dose-dependent manner. However, mechanism of action could not be determined other than the theory of producing gastric mucosal resistance. (26) Boswellia serrata plays a role as an anti-inflammatory through Mitogen-activated kinase (MAP) signals transduction pathways which will induce lymphocyte through extracellular signals and subsequently lead to production of inflammatory cytokines. (24) added into sentence above 2nd paragraph The effectiveness of boswellia serrata in treating patients with Crohn’s disease can be shown whereby treatment with the extract showed no toxic effects and better ability to move as well as increased bone density. (31)

One hundred and two people were randomized in a blinded trial that was completed in Germany comparing an extract of Boswellia serrata to mesalazine (5-aminosalicylic acid or mesalamine) for the symptomatic treatment of Crohn's disease. With 44 patients treated with boswellia and 39 patients receiving mesalazine, both agents improved patient scores on the Crohn's Disease Activity Index (CDAI). The investigators concluded that "therapy with [boswellia serrata extract] is not inferior to mesalazine" and believed that when both the safety and efficacy profile of the Boswellia serrata extract is considered, it offers superiority in terms of a benefit-risk-evaluation. (19)

An animal study in rats was designed to determine the constituents of boswellia the mechanism of effect in treating inflammatory bowel disease. The study demonstrated a decrease in rolling and adherent leukocytes with the use of both a boswellia extract and acetyl-11-keto-beta-boswellic acid. Tissue injury scores were also significantly decreased by acetyl-11-keto-beta-boswellic acid and higher doses of the boswellia extract. The investigators of this study concluded that the significant reductions in both macroscopic and microcirculatory inflammatory features indicate that boswellic acids like acetyl-11-keto-beta-boswellic acid may be responsible for the anti-inflammatory activity of the Boswellia extract in treating inflammatory bowel disease. (20)

Boswellia serrata extract showed considerable improvement in patients suffering from collagenous colitis whereby patients treated with the extract have a higher remission than the placebo group. However, it was shown that histology and quality of life did not show any changes during treatment. (30)

Anti-Cancer

Laboratory studies report that boswellia and components of boswellia may have anti-cancer activity, including leukemia and prostate cancer.(23) Mechanisms include cancer cell apoptosis by activation of caspase 3 and the induction of DNA fragmentation.

Of other interest, a study completed in mice suggests that an alcohol extract from Boswellia serrata may have anti-carcinogenic, anti-tumor, and anti-hyperlipidemic activities.(23)

Other Uses

A recent in vitro study reports that an extract of boswellia had inhibitory effects on hepatitis C virus protease. (21) Other laboratory studies have supported these findings in boswellia species as well as other medicinal plants. (22) Of other interest, a study completed in mice suggests that an alcohol extract from Boswellia serrata may have anti-carcinogenic, anti-tumor, and anti-hyperlipidemic activities. (23)

References

  1. Majeed M, et al. Boswellin: The Anti-Inflammatory Phytonutrient. Piscataway, NJ: Nutriscience Publishing; 1996:2.
  2. View Abstract: Boswellia serrata. Altern Med Rev. Aug1998;3(4):306-07.
  3. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:319.
  4. View Abstract: Wagner H. Search for New Plant Constituents with Potential Antiphlogistic and Antiallergic Activity. Planta Med. Jun1989;55(3):235-41.
  5. View Abstract: Boswellia serrata. Altern Med Rev. Aug1998;3(4):306-07.
  6. Menon MK, et al. Analgesic and Psychopharmacological Effects of the Gum Resin of Boswellia serrata. Planta Medica. 1971;4:332-41.
  7. View Abstract: Jing Y, et al. Boswellic Acid Acetate Induces Differentiation and Apoptosis in Leukemia Cell Lines. Leuk Res. Jan1999;23(1):43-50.
  8. Ammon HP. Salai Guggal - Boswellia serrata: From an Herbal Medicine to a Non-redox Inhibitor of Leukotriene Biosynthesis. Eur J Med Res. May1996;1(8):369-70.
  9. View Abstract: Ammon HP, et al. Inhibition of Leukotriene B4 Formation in Rat Peritoneal Neutrophils by an Ethanolic Extract of the Gum Resin Exudate of Boswellia serrata. Planta Med. Jun1991;57(3):203-07.
  10. View Abstract: Safayhi H, et al. Inhibition by Boswellic Acids of Human Leukocyte Elastase. J Pharmacol Exp Ther. Apr1997;281(1):460-63.
  11. View Abstract: Gupta I, 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. Nov1998;3(11):511-14.
  12. View Abstract: Safayhi H, Boden SE, Schweizer S, et al. Concentration-dependent Potentiating and Inhibitory Effects of Boswellia Extracts on 5-lipoxygenase Product Formation in Stimulated PMNL. Planta Med. Mar2000;66(2):110-3.
  13. View Abstract: Redini F, et al. Modulation of Extracellular Matrix Metabolism in Rabbit Articular Chondrocytes and Human Rheumatoid Synovial Cells by the Non-steroidal Anti-inflammatory Drug Etodolac. II: Glycosaminoglycan Synthesis. Agents Actions. Nov1990;31(3-4):358-67.
  14. View Abstract: Sander O, Herborn G, Rau R. Is H15 (resin extract of Boswellia serrata, "incense") a useful supplement to established drug therapy of chronic polyarthritis? Results of a double-blind pilot study. Z Rheumatol. Feb1998;57(1):11-6.
  15. View Abstract: Kulkarni RR, Patki PS, Jog VP, Gandage SG, Patwardhan B. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol. May1991;33(1-2):91-5.
  16. View Abstract: Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine. Jan2003;10(1):3-7.
  17. View Abstract: Gupta I, Parihar A, Malhotra P, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res. Jan1997;2(1):37-43.
  18. View Abstract: Gupta I, Parihar A, Malhotra P, Gupta S, Ludtke R, Safayhi H, Ammon HP. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. Jul2001;67(5):391-5.
  19. View Abstract: Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn disease with Boswellia serrata extract H 15. Gastroenterol. Jan2001;39(1):11-7.
  20. View Abstract: Krieglstein CF, Anthoni C, Rijcken EJ, Laukotter M, Spiegel HU, et al. Acetyl-11-keto-beta-boswellic acid, a constituent of a herbal medicine from Boswellia serrata resin, attenuates experimental ileitis. Int J Colorectal Dis. Apr2001;16(2):88-95.
  21. View Abstract: Hussein G, Miyashiro H, Nakamura N, et al. Inhibitory Effects of Sudanese Medicinal Plant Extracts on Hepatitis C Virus (HCV) Protease. Phytother Res. Nov2000;14(7):510-6.
  22. View Abstract: Hussein G, Miyashiro H, Nakamura N, Hattori M, Kakiuchi N, Shimotohno K. Inhibitory effects of sudanese medicinal plant extracts on hepatitis C virus (HCV) protease. Phytother Res. Nov2000;14(7):510-6.
  23. View Abstract: Huan MT, Badmaev V, Ding Y, Liu Y, Xie JG, Ho CT. Anti-tumor and anti-carcinogenic activities of triterpenoid, beta-boswellic acid. Biofactors. 2000;13(1-4):225-30.
  24. B. Gayathri, N. Manjula, K.S. Vinaykumar, B.S. Lakshmi, A. Balakrishnan. Pure compound from Boswellia serrata extract exhibits anti-inflammatory property in human PBMCs and mouse macrophages through inhibition of TNFα, IL-1β, NO and MAP kinases. International Immunopharmacology, Volume 7, Issue 4, April 2007, Pages 473-482
  25. Shailesh A. Shah, Ishwarsinh S. Rathod, Bhanubhai N. Suhagia, Dharmesh A. Patel, Vijay K. Parmar, Bharat K. Shah, Vikas M. Vaishnavi. Estimation of boswellic acids from market formulations of Boswellia serrata extract and 11-keto β-boswellic acid in human plasma by high-performance thin-layer chromatography. Journal of Chromatography B, Volume 848, Issue 2, 1 April 2007, Pages 232-238
  26. S. Singh, A. Khajuria, S.C. Taneja, R.K. Khajuria, J. Singh, R.K. Johri, G.N. Qazi. The gastric ulcer protective effect of boswellic acids, a leukotriene inhibitor from Boswellia serrata, in rats. Phytomedicine, Volume 15, Issues 6-7, 20 June 2008, Pages 408-415
  27. Acebo E, Ratón JA, Sautúa S, Eizaguirre X, Trébol I, Pérez JL. Allergic contact dermatitis from Boswellia serrata extract in a naturopathic cream. Contact Dermatitis. 2004 Aug; 51(2):91-2.
  28. Joos S, Rosemann T, Szecsenyi J, Hahn EG, Willich SN, Brinkhaus B. Use of complementary and alternative medicine in Germany - a survey of patients with inflammatory bowel disease. BMC Complement Altern Med. 2006 May 22;6:19. Allergic contact dermatitis from Boswellia serrata extract in a naturopathic cream.
  29. Carsten Dohling. Boswellia serrata (Frankincense) - from Traditional Indian medicine (Ayurveda) to evidence-based medicine. Phytomedicine, Volume 15, Issues 6-7, 20 June 2008, Page 540
  30. A. Madischa, S. Miehlkea, O. Eicheleb, J. Mrwaa, B. Bethkec, E. Kuhlischd, E. Ba¨ stleine, G. Wilhelmse, A. Morgnera, B. Wigginghause, M. Stoltec. Boswellia Serrata Extract For The Treatment Of Collagenous Colitis. A double-blind randomized, placebo-controlled, multi-center trial. Phytomedicine, Volume 15, Issues 6-7, 20 June 2008, Page 544
  31. H. Gerhardt, Z. Bouhmidi-Boumariz, P.G. Buvari, F.C. Seifert. Efficacy and safety of Boswellia serrata extract H15. Phytomedicine, Volume 15, Issues 6-7, 20 June 2008, Page 543