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Cosmeceutical Critique: Boswellia

Dr. Leslie Baumann

Volume 37, Issue 11, Page 17 (November 2006)

The Boswellia serrata tree is native to central and western India, where it is known as salai guggal.
It is a member of the Burseraceae family, which comprises roughly 30 tree and bush species found
in India, the Middle East, and East Africa. Boswellia is one of several plants whose components are
known to alleviate swelling (Phytomedicine 2003;10:37; Phytother. Res. 2004;18:34357).
The B. serrata exudate or gum (known in India as guggulu) forms the aromatic resin frankincense,
which has been traditionally used as incense. This exudate has been known for thousands of years
to possess therapeutic properties. It is used in Ayurvedic medicine to treat inflammatory and
arthritic conditions (Phytomedicine 2003;10:37; Wien Med. Wochenschr. 2002;152:3738;
Biofactors 2000;13:22530).
The gum resin extract of B. serrata has recently gained attention in Western medicine for its antiinflammatory, antiarthritic, and analgesic properties. Anticarcinogenic, antitumorigenic, and
antihyperlipidemic activities also have been reported (Phytomedicine 2003;10:37; Carcinogenesis
2002;23:208793; Biofactors 2000;13:22530).
The use of compounds isolated from the gum resin to treat inflammatory conditions comports with
evidence that leukotrienes, which are associated with various chronic inflammatory conditions, are
inhibited by the primary constituents of B. serrata, boswellic acids (Wien Med. Wochenschr.
2002;152:3738; Eur. J. Med. Res. 1998;3:5114). One such condition is irritable bowel disease,
which the gum resin of B. serrata has been found to positively affect (Int. J. Colorectal Dis.
2001;16:8895).
Boswellic acids have been shown to inhibit leukotriene biosynthesis in neutrophilic granulocytes by
hindering 5-lipoxygenase as a result of binding to the enzyme. In addition, boswellic acids have
been noted for inhibiting elastase in leukocytes, and for having wide-ranging effects on human
leukemia and glioma cell lines, particularly inhibiting proliferation, inducing apoptosis, and impairing
topoisomerases (Wien Med. Wochenschr. 2002;152:3738; Anticancer Res. 2002;22:285362).
Moreover, boswellic acids have exhibited antiproliferative properties against various types of
malignant cells.

Antineoplastic Action
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In a study evaluating the ethanolic extract of B. serrata gum resin containing a defined amount of
boswellic acids for its cytotoxic, cytostatic, and apoptotic effects on human malignancies, the
extract dose-dependently induced antiproliferative effects on all five leukemia and two brain tumor
cell lines tested. The total extract was more than twice as potent as the boswellia constituent 3-Oacetyl-11-keto--boswellic acid (AKBA) in three hematologic cell lines (Anticancer Res.
2002;22:285362). AKBA is a naturally occurring pentacyclic triterpene that exerts antiproliferative
effects against various types of tumors.
Anticancer activity also is exhibited by other B. serrata components. -Boswellic acid, keto-boswellic acid (KBA), and AKBAparticularly the last twohave demonstrated antiproliferative
and apoptotic effects on human colon cancer HT-29 cells (Carcinogenesis 2002;23:208793). KBA
and AKBA also exert antiproliferative and anticancer effects on liver cancer Hep G2 cells (Int. J.
Mol. Med. 2002;10:5015).
In a two-stage mouse study, boswellin, a methanol extract of B. serrata containing triterpenoids, boswellic acid, and related derivatives, was topically applied to the backs of mice treated with 7,12dimethylbenz[a]anthracene (DMBA) to initiate and 12-O-tetradecanoylphorbol-13-acetate (TPA) to
promote tumors. The extract was found to inhibit skin inflammation, epidermal proliferation, the
number of epidermal cell layers, and tumor promotion induced by DMBA and TPA. The
investigators also found that DNA synthesis in human leukemia HL-60 cell culture was dosedependently suppressed by -boswellic acid, KBA, or AKBA (Biofactors 2000;13:22530).

Anti-Inflammatory Action
If there is a consensus on the primary health effects of B. serrata, it is that the herb inhibits the
proliferation of tissue in and around inflamed areas and hinders connective tissue deterioration.
Such effects can have far-reaching implications for treatment indications. Promising results have
been reported from clinical trials using boswellic acids to treat bronchial asthma, Crohn's disease,
chronic and ulcerative colitis, peritumoral brain edema, and rheumatoid arthritis (Wien Med.
Wochenschr. 2002;152:3738), as well as anaphylaxis. In a study evaluating antianaphylaxis
activity in rats, a B. serrata formulation containing 60% AKBA as well as KBA was found to dosedependently inhibit passive paw anaphylaxis and confer mast cell stabilizing activity (Indian J. Exp.
Biol. 2003;41:14602).
B. serrata extract was evaluated in a randomized, double-blind, placebo-controlled crossover study
of 30 patients with osteoarthritis of the knee. Fifteen patients received boswellia and 15 received
placebo for 8 weeks, followed by washout and then the opposite intervention for 8 weeks.
Although no changes were noted in x-rays, all patients reported reduced pain, increased flexion,
and increased walking distance in association with B. serrata treatment; the differences between
drug treatment and placebo were statistically significant. Aside from minor gastrointestinal
reactions, the B. serrata extract was well tolerated. The investigators concluded that the extract is a
suitable treatment for osteoarthritis of the knee and has potential for application to other kinds of
arthritis (Phytomedicine 2003;10:37).
A recent study conducted with Sprague-Dawley rats revealed that oral administration of boswellia
extract or AKBA dosedependently conferred significant improvements in an inflammatory bowel
disease model. Specifically, ileitis was induced by indomethacin administration. The resultant
leukocyte-endothelial cell adhesive interactions and severe tissue injury were significantly
diminished by boswellia extract or AKBA treatment (Int. J. Colorectal Dis. 2001;16:8895).
In a 6-week study of the effects of B. serrata on 30 patients (17 men and 13 women) aged 1848
years with chronic colitis, 20 patients were given a B. serrata preparation and 10 patients treated
with sulfasalazine served as controls. In all, 18 of the B. serrata patients (90%) exhibited
improvement in several symptoms, while 6 control patients (60%) improved. The investigators
concluded that B. serrata has potential as a safe and effective treatment of chronic colitis (Planta
Med. 2001;67:3915), which supports previous findings for ulcerative colitis (Eur. J. Med. Res.
1997;2:3743).

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A randomized, double-blind, parallel group study compared the efficacy and safety of mesalazine
with those of the B. serrata extract H15 for treating Crohn's disease, an indication for which H15
has been approved in Germany. H15 was found to be as efficacious as the established drug. It
resulted in significantly larger reductions in the Crohn's Disease Activity Index, suggesting that the
extract has a superior benefit-risk profile (Z. Gastroenterol. 2001;39:117).
In a double-blind, placebo-controlled 6-week study of the effects of the gum resin of B. serrata on
asthma in 23 men and 17 women aged 1875 years, 70% of patients showed improvement as
evidenced by disappearance of dyspnea, rhonchi, and other symptoms, and a reduction in number
of attacks; in comparison, only 27% of controls showed improvement. The investigators concluded
that B. serrata gum resin is a viable treatment for bronchial asthma (Eur. J. Med. Res. 1998;3:511
4).
Others note, though, that although boswellia has been found to be a safe and effective treatment,
alone or in combination, for asthma, no longitudinal data exist to support or contraindicate this
approach (Prim. Care 2002;29:23161).
Finally, B. serrata is a key component of BHUx, a polyherbal formulation that has been shown to be
a potent antioxidant and a suppressant of important inflammatory mediators in the arachidonic acid
cascade (Inflammopharmacology 2004;12:13152).

Conclusions
There is evidence demonstrating B. serrata's anti-inflammatory efficacy and promising research
indicating its potential for treating various indications, including cancer.
Interestingly, boswellia is found in many skin creams, especially the expensive ones (e.g., Este
Lauder Body Performance Toning Bust Serum, 1.7 oz/$45, and Este Lauder Re-Nutriv Ultimate
Lifting Crme, 1.7 oz/$250). However, no studies looking at efficacy in the skin have been
published.
We have no idea if boswellia is stable in a skin product and if it can penetrate the skin to have an
effect. I encourage the companies that have incorporated it into their products to perform a welldesigned trial to look at efficacy before consumers throw more dollars away on the hope that this
ingredient is effective in the skin.
PII: S0037-6337(06)71653-9
doi:10.1016/S0037-6337(06)71653-9
2006 Elsevier Inc. All rights reserved.

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