Boswellia, an herbal extract derived from the Boswellia serrata tree, also known as Indian frankincense, has been a cornerstone of traditional medicine in Asia and Africa for centuries. Resin made from boswellia extract has been used for centuries in Asian and African folk medicine. It’s believed to treat chronic inflammatory illnesses as well as a number of other health conditions. This extract is available in various forms, including resin, pills, and creams, and is recognized for its potential to alleviate inflammation and provide therapeutic benefits for individuals grappling with specific health conditions. Among the bioactive compounds found in Boswellia, acetyl-11-keto-β-boswellic acid (AKBA) stands out as a particularly potent component. This article delves into the multifaceted benefits of acetyl keto boswellic acid, exploring its anti-inflammatory properties, potential therapeutic applications, and mechanisms of action.
Boswellia and Its Active Components
Boswellia's therapeutic potential is attributed to a group of compounds known as boswellic acids (BAs), which are triterpenes present in the oleo gum resins of Boswellia species. Around 12 different pentacyclic triterpenes (BAs) have been identified. Among these, AKBA is considered the most powerful, although some research suggests other boswellic acids may also contribute to the herb’s anti-inflammatory properties. These acids inhibit 5-lipoxygenase (5-LO), an enzyme that produces leukotriene. Boswellia products are generally rated on their concentration of boswellic acids.
Anti-Inflammatory Properties
Some research shows that boswellic acid can prevent the formation of leukotrienes in the body. Leukotrienes are molecules that have been identified as a cause of inflammation. They may trigger asthma symptoms. The ability of boswellic acids to inhibit 5-LO, a key enzyme in the production of leukotrienes, underlies its anti-inflammatory effects. AKBA, in particular, is recognized as a potent inhibitor of 5-LO and the leukotriene-mediated inflammatory pathways. By blocking the formation of leukotrienes, AKBA can help reduce inflammation and alleviate symptoms associated with inflammatory conditions.
Potential Therapeutic Applications
Studies show that boswellia may reduce inflammation and may be useful in treating the following conditions:osteoarthritis (OA)rheumatoid arthritis (RA)asthmainflammatory bowel disease (IBD). The anti-inflammatory properties of boswellia, particularly AKBA, have led to its exploration as a potential treatment for various conditions, including:
Osteoarthritis (OA)
Many studies of boswellia’s effect on OA have found that it’s effective in treating OA pain and inflammation. One 2003 study published in the journalPhytomedicine found that all 30 people with OA knee pain who received boswellia reported a decrease in knee pain. They also reported an increase in knee flexion and how far they could walk. Another study, funded by a boswellia production company, found that increasing the dosage of enriched boswellia extract led to an increase in physical ability. OA knee pain decreased after 90 days with the boswellia product, compared to a lesser dosage and placebo. It also helped reduce the levels of a cartilage-degrading enzyme. Boswellia, including AKBA, has demonstrated effectiveness in alleviating pain and inflammation associated with OA. Studies have reported a decrease in knee pain, increased knee flexion, and improved walking distance in individuals with OA who received boswellia. Furthermore, boswellia has been shown to reduce levels of cartilage-degrading enzymes, suggesting a protective effect on joint cartilage.
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Rheumatoid Arthritis (RA)
Studies on the usefulness of boswellia in RA treatment have shown mixed results. An older study published in the Journal of Rheumatology found that boswellia helps to reduce RA joint swelling. Some research suggests that boswellia may interfere with the autoimmune process, which would make it an effective therapy for RA. Further research supports the effective anti-inflammatory and immune-balancing properties. Research suggests that boswellia may interfere with the autoimmune process, potentially making it an effective therapy for RA. It is characterized by inflammation and swelling of the peripheral joints, pain, and articular cartilage damage. Synovial hyperplasia and tissue inflammation are the characteristic features of the disease. During synovial hyperplasia, monocytes recruited into the synovium secrete cytokines and chemokines, inducing synovial fibroblast proliferation, pro-inflammatory cytokine production, matrix-degrading enzymes secretion, and sustained synovial hypertrophy. The cytokines, such as the receptor activator of nuclear factor-kappa-β ligand and granulocyte-macrophage colony-stimulating factor, control the osteoclast differentiation. Other inflammatory cytokines present in the synovium are tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6, contributing to bone erosion. Nitric oxide (NO), reactive oxygen species (ROS), prostaglandins, leukotrienes, platelet-activating factor, and enzymes [lipoxygenases, cyclooxygenases (COX-1 and COX-2), and phospholipases] are other inflammatory markers in RA. RA is clinically managed using nonsteroidal anti-inflammatory drugs, corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs), and biological response modifiers associated with several adverse effects. Conventional DMARDs, including methotrexate, hydroxychloroquine, and sulfasalazine, are widely used in RA therapy. Biologics are engineered proteins that target cytokines, or inflammatory cells or pathways related to tissue damage. The most common biologics are TNF-α antagonist like etanercept (Enbrel®) infliximab (Remicade®) adalimumab (Humira®), certolizumab pegol (Cimzia®), and golimumab (Simponi®). Other biologics include IL-1 inhibitor anakinra (Kineret®) and T-cell co-stimulation blocker abatacept (Orencia®). Natural products and supplements could reduce the pain and morbidity associated with RA (Yang et al., 2016). Boswellic acids (BAs) have been reported to reduce the inflammation and associated markers in both RA and OA in clinical studies. AKBBA is the most potent inhibitor of 5 lipoxygenases (5-LO) and the leukotriene-mediated inflammatory pathways. Although the Boswellia extracts with different BAs have been extensively studied, comprehensive evaluation of standardized extracts is scarce. Consistency of the chemical constituents of the extract is ensured by standardization. It is essential to study the activity of the standardized extract to confirm their safety and efficacy as they differ from the total plant extract which is used in traditional medicine. In the present study, we evaluated the mechanism of activity of Boswellin Super® FJ (BSE), a standardized extract of Boswellia serrata containing not less than 30% 3-acetyl-11-keto-β-boswellic acid along with other β-boswellic acids, in vivo in a collagen-induced arthritis model. The safety of this composition has been established earlier (Majeed et al., 2020b).
Inflammatory Bowel Disease (IBD)
Due to the herb’s anti-inflammatory properties, boswellia may be effective in treating inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis (UC). A 2001 study compared H15, a special boswellia extract, to the anti-inflammatory prescription drug mesalamine (Apriso, Asacol HD). It showed that the boswellia extract may be effective in treating Crohn’s disease. Several studies found the herb could be effective in treating UC as well. We’re just beginning to understand how the anti-inflammatory and immune-balancing effects of boswellia can improve the health of an inflamed bowel. Boswellia, with its anti-inflammatory and immune-balancing effects, has shown promise in treating IBDs like Crohn's disease and ulcerative colitis. Studies have indicated that boswellia extract may be as effective as mesalamine, a common anti-inflammatory drug, in treating Crohn's disease.
Asthma
Boswellia can play a role in reducing leukotrienes, which causes bronchial muscles to contract. A 1998 study of the herb’s effect on bronchial asthma found that people who took boswellia experienced decreased asthma symptoms and indicators. This shows the herb could play an important role in treating bronchial asthma. Research continues and has shown the positive immune-balancing properties of boswellia can help the overreaction to environmental allergens that happens in asthma. By reducing leukotrienes, which cause bronchial muscles to contract, boswellia may alleviate asthma symptoms. Studies have demonstrated that individuals with asthma who took boswellia experienced a decrease in symptoms and indicators, highlighting its potential role in asthma management. Research continues and has shown the positive immune-balancing properties of boswellia can help the overreaction to environmental allergens that happens in asthma.
Cancer
Boswellic acids act in a number of ways that may inhibit cancer growth. Boswellic acids have been shown to prevent certain enzymes from negatively affecting DNA. Some studies have found that it may even be useful in treating certain cancers, such as leukemia and breast cancer. The anti-inflammatory properties of boswellic acids, including AKBA, have also garnered attention in cancer research. Boswellic acids have been shown to prevent certain enzymes from negatively affecting DNA. Studies have explored its potential in treating certain cancers, such as leukemia and breast cancer.
Additional Potential Benefits
Beyond the conditions mentioned above, AKBA has been investigated for its potential benefits in other areas:
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Non-Alcoholic Fatty Liver Disease (NAFLD)
Acetyl-11-keto-beta-boswellic acid (AKBA), a potent anti-inflammatory compound purified from Boswellia species, was investigated in a preclinical study for its potential in preventing and treating non-alcoholic fatty liver disease (NAFLD), the most common chronic inflammatory liver disorder. Additionally, AKBA prevented the reduction of the active and inactive forms of AMPK-α1 in the prevention group, which is a cellular energy regulator that helps suppress NAFLD progression. Results showed that AKBA improved NAFLD-related serum parameters and inflammatory markers and suppressed PPAR-ϒ and inflammasome complex-related genes involved in hepatic steatosis in both groups. A preclinical study suggests that AKBA may have potential in preventing and treating NAFLD by improving serum parameters, reducing inflammatory markers, and suppressing genes involved in hepatic steatosis.
Lung Cancer
Acetyl-11-keto-β-boswellic acid (AKBA) is a triterpenoid, which is the main component of boswellic acid from Boswellia Serrata, a medicinal plant that has shown immense potential in anti-cancer therapy. AKBA exerts the anti-cancer effects via cell cycle arrest, apoptosis induction, and autophagy suppression in NSCLC cells. We found that AKBA suppressed the formation of autolysosome, and decreased the expression levels of Beclin-1, LC3A/B-I, and LC3A/B-II proteins. The effects of AKBA on the cell viability in A549, H460, H1299, and BEAS-2B cells were determined by the CCK-8 assay. The colony formation assay was used to identify the effects of AKBA on cell proliferation. AKBA reduced cell viability in A549, H460, H1299, and BEAS-2B. In A549 cells, AKBA suppressed the clone formation, arrested the cell cycle at the G0/G1 phase, induced cellular apoptosis. Studies suggest that AKBA may exert anti-cancer effects in NSCLC cells through cell cycle arrest, apoptosis induction, and autophagy suppression.
Glioblastoma
AKBA inhibited cell proliferation, caused the release of LDH, decreased DNA synthesis, and inhibited the migration, invasion, and colony formation of U251 and U87-MG human glioblastoma cell lines. AKBA increased apoptosis as well as the activity of caspase 3/7 and the protein expression of cleaved-caspase 3 and cleaved PARP, while decreasing mitochondrial membrane potential. RNA-sequencing analyses showed that AKBA suppressed the expression of pRB, FOXM1, Aurora A, PLK1, CDC25C, p-CDK1, cyclinB1, Aurora B, and TOP2A while increasing the expression of p21 and GADD45A. The data are consistent with a mechanism in which AKBA arrested the cell cycle in glioblastoma cells at the G2/M phase by regulating the p21/FOXM1/cyclin B1 pathway, inhibited mitosis by downregulating the Aurora B/TOP2A pathway, and induced mitochondrial-dependent apoptosis. AKBA might be a promising chemotherapeutic drug in the treatment of GBM. Studies have shown that AKBA inhibits the viability and proliferation of the human glioblastoma cell lines, U251 and U87-MG. In addition, AKBA inhibited the migration, invasion, and colony formation of the glioblastoma cells as well as inducing them to undergo mitochondrial-dependent apoptosis. Using RNA-sequencing and western blotting analyses, we also found that AKBA arrested the cell cycle at the G2/M phase by regulating the p21/FOXM1/cyclin B1 pathway and inhibited mitosis of glioblastoma cells by downregulating the Aurora B/TOP2A pathway.
Mechanisms of Action
AKBA exerts its therapeutic effects through various mechanisms, including:
Inhibition of 5-Lipoxygenase (5-LO)
AKBA is a potent inhibitor of 5-LO, a key enzyme in the production of leukotrienes, which are inflammatory mediators involved in various conditions, including asthma and IBD.
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Modulation of Inflammatory Cytokines
BAs have been reported to reduce the inflammation and associated markers in both RA and OA in clinical studies. AKBA can modulate the production of inflammatory cytokines, such as TNF-α, interleukin (IL)-1β, and IL-6, which play a role in the pathogenesis of RA and other inflammatory diseases.
Regulation of Cell Cycle and Apoptosis
AKBA has been shown to regulate cell cycle progression and induce apoptosis in cancer cells, suggesting its potential as an anti-cancer agent. Studies have shown that AKBA arrested the cell cycle in glioblastoma cells at the G2/M phase by regulating the p21/FOXM1/cyclin B1 pathway and inhibited mitosis by downregulating the Aurora B/TOP2A pathway, and induced mitochondrial-dependent apoptosis.
Suppression of Autophagy
We found that AKBA suppressed the formation of autolysosome, and decreased the expression levels of Beclin-1, LC3A/B-I, and LC3A/B-II proteins. AKBA was found to suppress the formation of autolysosome, and decreased the expression levels of Beclin-1, LC3A/B-I, and LC3A/B-II proteins.
Dosage and Safety Considerations
Boswellia products can differ greatly. Follow the manufacturer’s instructions, and remember to speak to your doctor before using any herbal therapy. General dosing guidelines suggest taking 300-500 milligrams (mg) by mouth two to three times a day. It is crucial to follow the manufacturer's instructions and consult with a healthcare professional before using any herbal therapy, including boswellia products. While boswellia is generally considered safe, it may interact with certain medications, such as anti-inflammatory drugs, and may not be suitable for everyone. Boswellia may interact with and decrease the effects of anti-inflammatory medications. Talk to your doctor before using boswellia products, especially if you’re taking other medications to treat inflammation.