Boswellia (Boswellia serrata)

Native to India, boswellia is used extensively in Ayurveda, the traditional medical system of India, to treat arthritis. Extracts from the gum resin of boswellia have been tested in clinical trials and found effective for asthma and ulcerative colitis. More research is needed to determine if boswellia can benefit those with osteoarthritis. Boswellic acid has been found to display antitumor activity in bladder, cervical, and other cancer cell lines as well as anti-inflammatory activity.

Although no adverse effects have been reported with use of boswellia, consequences of long-term use are not known. The notion that herbs are safe because they are natural is not necessarily correct, and herb-drug interactions remain a concern.

Because reliable information about dietary supplements and “alternative” cancer treatments was not readily available to oncologists who needed it to counsel their patients, the MSKCC Integrative Medicine Service developed and maintains the free “AboutHerbs” website (http://www.mskcc.org/AboutHerbs). This site contains two portals, one for oncology professionals and another for the public. Anyone may enter either portal at no cost. This continually updated site provides objective information about herbs and other botanicals, vitamins, other dietary supplements, and unproved cancer therapies.

TREATMENT: Boswellia (Boswellia serrata)

ALSO KNOWN AS: Indian Frankincense, Indian olibanum, Shallaki, Salai guggal

BACKGROUND:Boswellia is a genus of trees containing a fragrant resin, which has been used since antiquity for many medicinal purposes. The resin extract has been used traditionally to treat arthritis, ulcerative colitis, coughs, sores, snakebite, asthma, and to correct disorders of the digestive system. Its aromatic properties also have been known for millennia. The Biblical incense frankincense was extracted from the resin of the Boswellia sacra, obtained by tapping the trees. In modern times, Boswellic acid has been found to display antitumor activity in bladder, cervical, and other cancer cell lines as well as anti-inflammatory activity.

RESEARCH: Boswellic acid, the biologically active constituent of boswellia gum resin, is thought to contribute to its pharmacologic activities. In vitro and animal studies showed that boswellic acid has anti-­inflammatory[1] and ­anticancer properties.[2] The anti-inflammatory effects are due to noncompetitive inhibition of 5-lipoxygenase, the key enzyme in biosynthesis of leukotrienes that play a major role in inflammatory disease.[3]

Data from clinical trials indicate that boswellia reduced both dyspnea and the number of attacks in asthmatic patients.[4] It also helped control symptoms in patients with ulcerative colitis,[3] but may not be useful for those with collagenous colitis.[5]

An analysis of 15 systematic reviews indicated insufficient evidence of boswellia’s effectiveness in treating osteoarthritic pain.[6]

Further research is also warranted to determine efficacy in cancer.

ADVERSE EFFECTS: None reported to date.

References:

REFERENCES:
1. Dahmen U, Gu YL, Dirsch O, et al: Boswellic acid, a potent anti-inflammatory drug, inhibits rejection to the same extent as high dose steroids. Transplant Proc 33:539-541, 2001.
2. Frank MB, Yang Q, Osban J, et al: Frankincense oil derived from Boswellia carteri induces tumor cell specific cytotoxicity. BMC Complement Altern Med 9:6, 2009.
3. Gupta I, Parihar A, Malhotra P, et al: Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 2:37-43, 1997.
4. 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 3:511-514, 1998.
5. Chande N, MacDonald JK, McDonald JW: Interventions for treating microscopic colitis: A Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials. Am J Gastroenterol 104:235-241, 2009.
6. 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 21:675-683, 2007.