How It Works
Bottom Line: Boswellia may be effective for some inflammatory conditions, such as arthritis. Its anticancer effects have not been demonstrated in humans. Boswellia, a tree gum resin often used in
Ayurvedic medicine, was analyzed in the laboratory and found to contain boswellic acid, which scientists think accounts for its biological activity. In lab animals, boswellic acid inhibited an enzyme that is important in the process of inflammation, and it therefore reduces swelling caused by chemicals or arthritis. It also slowed down the replication of cancer cells and caused cell death of some cancer cells in the laboratory. Unlike other anti-inflammatory drugs , boswellic acid does not appear to reduce pain or fever, in lab animals. Boswellia's anti-inflammatory effects were supported in a few clinical trials of patients with colitis and osteoarthritis. But larger studies are needed.
Purported Uses
To treat osteoarthritis
A randomized controlled trial demonstrated that Boswellia serrata extract is better than a placebo for osteoarthritis, but other studies do not find a benefit.
To treat asthma
Results from a clinical trial showed that boswellia may reduce symptoms of bronchial asthma, but more studies are needed to draw a conclusion.
To treat colitis
Studies in laboratory animals suggest that boswellia can reduce inflammation, and clinical trials supports this use in humans, but further research is needed.
To reduce inflammation
Studies in laboratory animals and from clinical trials show that this herb can reduce certain inflammatory conditions.
To relieve menstrual cramps
No scientific evidence supports this use.
To treat cancer
No evidence supports the idea that boswellia has a role in cancer treatment.
Research Evidence
Colitis:
In a clinical trial involving patients with chronic colitis, thirty men or women were given: 1) 300 mg of boswellia gum resin three times daily for six weeks or 2) one gram of sulfasalazine (a drug used for inflammatory bowel conditions) three times daily for six weeks. After treatment, 90% of the patients treated with boswellia showed an improvement as compared to 60% of the patients treated with sulfasalazine. This indicates that boswellia gum resin may be an effective treatment for chronic colitis, but larger clinical trials should be conducted to make sure long-term use of boswellia is safe and effective.
Warnings
This product is regulated by the F.D.A. as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Side Effects
None known
Scientific Name
Boswellia Serrata
Common Name
Indian Frankincense
Clinical Summary
Boswellia or Indian frankincense is an ayurvedic herb that is derived from the resin of the plant. It is used traditionally to treat arthritis, ulcerative colitis, coughs, sores, snakebite, and asthma. The major component is boswellic acid (1). Animal studies show that boswellic acid is a potent 5-lipoxygenase inhibitor that has anti-inflammatory and antiarthritic effects (1) (2) (3). Other studies suggest it also has cytotoxic activities (4) (5) (6). Data from clinical trials suggest effectiveness of Boswellia for bronchial asthma (7) and ulcerative colitis (8). However, evidence is mixed for its benefits for osteoarthritis (9) (10) and collagenous colitis (11) (12). Boswellic acid seems to have less adverse effects commonly found in steroids and non-steroidal anti-inflammatory drugs. However, its long-term effects on humans are unknown. Although similar in many functions, boswellia should not be confused with frankincense, guggul, or myrrh.
Purported uses
Arthritis
Asthma
Colitis
Inflammation
Menstrual cramps
Constituents
Boswellic acid, alpha-boswellic acid.
Mechanism of Action
Boswellic acid, the major constituent of boswellia, is thought to contribute to most of the herb's pharmacological activities. In vitro studies and animal models show that boswellic acid inhibits 5-lipoxygenase selectively (1) (3) and has anti-inflammatory (13), anti-arthritic, and anti-proliferative effects (2). Boswellia reduces chemically-induced edema and inflammation in rodents. Unlike other non-steroidal anti-inflammatory drugs, however, boswellic acid fails to show analgesic or antipyretic effects (13). In addition, it does not cause gastric ulcers in animals. This suggests that the action of boswellic acid is through other mechanisms than the inhibition of prostaglandin synthesis. Research on the cytotoxic effects of boswellic acid indicates that it induces p21 expression through a p53-independent pathway and causes apoptosis in glioma (4) (6) and leukemia (5)cell lines. In addition, a Boswellia extract induced apoptosis in a cervical cancer cell line by inducing endoplasmic reticulum (ER) stress (14). One study suggests that acetyl-boswellic acids can inhibit topoisomerases by competing with DNA for binding sites (15).
Pharmacokinetics
Two to three hours after an oral dose of 1.2 g dry extract boswellia gum resin, plasma concentrations were measured at 10 to 32 micromolar of 11-keto-beta-boswellic acid and 18 to 20 micromolar of acetyl-11-keto-beta-boswellic acid.
(8)
Literature Summary and Critique
Gupta I, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67:391-5.Thirty patients with chronic colitis were included in this study. Twenty patients received 300 mg of gum resin of boswellia three times daily for 6 weeks. Ten patients received one gram of sulfasalazine three times daily for 6 weeks. 90% of the patients treated with boswellia showed an improvement as compared to 60% of the patients treated with sulfasalazine. The author concluded that the gum resin of boswellia could be used to treat chronic colitis with minimal side effects, but larger studies are needed to establish its efficacy and long-term safety.
References
1. Dahmen U, Gu YL, Dirsch O, et al.
Boswellic acid, a potent antiinflammatory drug, inhibits rejection to the same extent as high dose steroids.
Transplant Proc. Feb-Mar 2001;33(1-2):539-541.
2. 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. Mar 2000;66(2):110-113.
3. Safayhi H, Mack T, Sabieraj J, et al.
Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase.
J Pharmacol Exp Ther. Jun 1992;261(3):1143-1146.
4. 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. May 1999;80(5-6):756-765.
5. Jing Y, Nakajo S, Xia L, et al.
Boswellic acid acetate induces differentiation and apoptosis in leukemia cell lines.
Leuk Res. Jan 1999;23(1):43-50.
6. Winking M, Sarikaya S, Rahmanian A, et al.
Boswellic acids inhibit glioma growth: a new treatment option? J Neurooncol. 2000;46(2):97-103.
7. 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. Nov 17 1998;3(11):511-514.
8. Gupta I, Parihar A, Malhotra P, et al.
Effects of Boswellia serrata gum resin in patients with ulcerative colitis.
Eur J Med Res. Jan 1997;2(1):37-43.
9. Chrubasik JE, Roufogalis BD, Chrubasik S.
Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain.
Phytother Res. Jul 2007;21(7):675-683.
10. Sengupta K, Alluri KV, Satish AR, et al.
A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin(R) for treatment of osteoarthritis of the knee.
Arthritis Res Ther. Jul 30 2008;10(4):R85.
11. Chande N, McDonald JW, MacDonald JK.
Interventions for treating collagenous colitis.
Cochrane Database Syst Rev. 2006(4):CD003575.
12. 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. Dec 2007;22(12):1445-1451.
13. Singh GB, Atal CK.
Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent.
Agents Actions. Jun 1986;18(3-4):407-412.
14. Kim HR, Kim MS, Kwon DY, et al.
Bosellia serrata-induced apoptosis is related with ER stress and calcium release.
Genes Nutr. Feb 2008;2(4):371-374.
15. Syrovets T, Buchele B, Gedig E, et al.
Acetyl-boswellic acids are novel catalytic inhibitors of human topoisomerases I and IIalpha.
Mol Pharmacol. Jul 2000;58(1):71-81.
