BOSWELLIA

Sometimes known as frankincense, very few clinical trials have been run with boswellia.

However, a 2024 phase I study as adjuvant treatment to breast cancer has produced promising results. Between diagnosis related biopsy and surgery, markers of cell proliferation increased in the control group by over 50% . While the boswellia group treated with 2.4g daily for 11 days before surgery saw cell proliferation rates lowered by 14%, quite a contrast. It remains to be seen if this translates into meaningful improvements in patient outcomes.

Other evidence of anti-inflammatory effects have been seen in rheumatoid arthritis. There are occasional clinical trials showing benefits in overall metabolic health such as glucose and cholesterol. A single patient study showed supportive actions in surgery on brain metastases. (see References)

TYPICAL ABSORPTION LEVELS

20 – 40%

EXAMPLES OF IMPROVED OUTCOMES

NO

PRE-DIAGNOSIS OR PREVENTION

No

Highlighted Studies

Overall, this trial demonstrated that oral administration of B. serrata at a dose of 2400 mg daily for 5–56 days has a good safety profile and reduced breast tumor cell proliferation in humans in a Phase Ia window of opportunity trial and was well tolerated. This correlates with the reduction in proliferation of breast cancer cell lines treated with B.serrata in vitro. The purpose of window of opportunity trials is to provide a relatively inexpensive and fast way to d...

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Elevated levels of hs‐CRP are found to be associated with local inflammation in patients with OA (arthritis). Several studies have shown that hs‐CRP is elevated in the plasma of patients … In this study, a significant decrease in the activity of hs‐CRP in the BSE [boswellia]‐treated group was observed in contrast to that from the placebo receiving group . These findings are clearly suggesting that BSE is a powerful inhibitor of hs‐CRP induced by local inflammation

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After 6 weeks consuming of Boswellia, we were observed significant increase in blood HDL [aka “good cholesterol”] level and remarkable decrease in blood cholesterol, LDL, fructosamine, SGPT, and SGOT levels of patients.. We have not observed other significant changes in blood variables at the end of study in control group.. Comparison between blood parameters of control and Boswellia groups after 6 weeks, showed significant decrease in the levels of VLDL and TG [triglyscerides]</p...

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..we were able to achieve a significant response with Boswellia with near complete resolution of edema, and our patient was able to avoid long-term steroid use. In this context, Boswellia can be used in various settings including decreasing existing cerebral edema, prophylactic risk reduction of symptomatic necrosis, and in management of RN, especially since it has no adverse effects. Drug interactions with steroid use become a particular concern in the modern era given the emergence of immun...

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TABLE OF REFERENCES

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https://link.springer.com/article/10.1007/s10549-023-07215-43 The percent change in proliferation from core biopsy to excisional biopsy in the control group (n = 18) was an increase of 54.6 ± 21.4%. In the B. serrata group, there was a reduction in proliferation between core biopsy and excision (n = 18) of 13.8 ± 11.7%. The difference in Ki-67 staining between core and surgical specimens was statistically significant between the control and B. serrata groups . There was no significant interaction between B. serrata treatment effect and duration of treatmentOverall, this trial demonstrated that oral administration of B. serrata at a dose of 2400 mg daily for 5–56 days has a good safety profile and reduced breast tumor cell proliferation in humans in a Phase Ia window of opportunity trial and was well tolerated. This correlates with the reduction in proliferation of breast cancer cell lines treated with B.serrata in vitro. The purpose of window of opportunity trials is to provide a relatively inexpensive and fast way to determine whether a novel therapeutic has biologic activity in humans. Biologic active of B. serrata in humans was demonstrated in this study.
https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.259452.5Compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment, a reduction of cerebral edema of >75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P = .023). These findings may be based on an additional antitumor effect. There were no severe adverse events in either group. In the BS group, 6 patients reported minor gastrointestinal discomfort. BS did not have a significant impact on quality of life or cognitive function. The dexamethasone dose during radiotherapy in both groups was not statistically different. Boswellic acids could be detected in patients' serum.In this study, patients receiving BS showed a better tumor response to radiotherapy. This was not a planned endpoint, and therefore, it has to be considered carefully. Nevertheless, this observation may be a hint to a cytotoxic or radiosensibilizing effect of BS which will have to be investigated in further studies with long-time BS medication. It also has to be determined whether the impact of BS on cerebral edema may be caused by an antitumor effect. The prospective, randomized, placebo-controlled, double-blind design of this study makes its results highly reliable.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6681146/2More importantly, BSE treatment comprising 30% AKBBA and BBA significantly decreased hs‐CRP values compared with the placebo group clearly supporting the clinical efficacy for OA...findings of the current study show that BSE significantly reduced the serum levels of hs‐CRP providing new insights on the potential anti‐inflammatory mode of action of BSE (Figure 4). Regarding clinical safety, assessment of the laboratory/diagnostic parameters observed in this study confirms that there were no serious adverse events with BSE treatment.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929136/2After 6 weeks consuming of Boswellia, we were observed significant increase in blood HDL level and remarkable decrease in blood cholesterol, LDL...levels of patients. There were no significant difference in serum triglyceride and VLDL levels of patients . In control group, HDL level was significantly increased after 6 weeks... Comparison between blood parameters of control and Boswellia groups after 6 weeks, showed significant decrease in the levels of VLDL and TG (as well as total cholesterol..levels in Boswelia group rather than control groupIn conclusion, the suggested health benefits of Boswellia serrata supplementation in type2 diabetic patients could ameliorate some of biochemical factor levels. Daily consumption of 900 mg of Boswellia serrata possible depicts a safe and effective means to decrease the risk factors associated with type2 diabetic subjects. If diabetes subjects use Boswellia serrata in their food regularly, they may maintain their Fructosamine levels, hepatic enzyme activities and lipid profiles close to normal levels. However, more extensive pharmacological experiments are required.
https://www.appliedradiationoncology.com/articles/role-of-boswellia-serrata-in-management-of-cns-radiation-necrosis-after-radiosurgery-for-brain-metastases2In our patient, we were able to achieve a significant response with Boswellia with near complete resolution of edema, and our patient was able to avoid long-term steroid use. In this context, Boswellia can be used in various settings including decreasing existing cerebral edema, prophylactic risk reduction of symptomatic necrosis, and in management of RN, especially since it has no adverse effects. Drug interactions with steroid use become a particular concern in the modern era given the emergence of immunotherapy for several cancers. Boswellia can potentially decrease steroid dependence in these patients, thus reducing the risk of several side effects. Further prospective studies to evaluate the response rate with the use of Boswellia in patients who develop significant edema after fSRS for brain metastases is warranted. Recent data have reported the beneficial effects of Boswellia on reducing cerebral edema.8 Kirste et al conducted the first randomized clinical trial to study the efficacy of Boswellia in reducing cerebral edema in brain tumor patients treated with radiation, and observed that 60% of patients receiving Boswellia reached a > 75% decrease in edema compared to only 26% in the placebo group.8 The Boswellia preparation has reported no adverse effects. No studies have reported differential response rates based on Boswellia dose and preparation used so far. In another study, a Boswellic acid abstract given to 20 glioblastoma patients after surgery and chemoradiation led to considerable decrease in cerebral edema with maintained quality of life.9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194511/1 β-BA could suppress the glycolysis pathway and reduce ATP production in MCF-10AT cells without an obvious effect on normal MCF-10A. The induced metabolic stress activated the AMPK pathway and inhibited the mTOR pathway, which limited cell proliferation and promoted apoptosis. The consistent precancerous prevention effect of β-BA could be seen in the rat model. Mechanically, β-BA could combine with Glut1 and impair its glucose transporter function, which is critical for providing fuel to glycolysis. Taken together, β-BA [Boswellia] is suggested to be a potential candidate for the treatment of breast precancerous lesions.Although it has been reported that some small molecules derived from natural compounds could be GLUT1 inhibitors, most of them were not tested in actual disease models in vivo. In this article, we successfully constructed a breast precancerous model and proved that β-BA could suppress precancerous cell proliferation in vivo.
https://academic.oup.com/carcin/article/33/12/2441/24642281These results indicate that AKBA-induced antitumor effects in CRC occur, at least partly through the up-regulation of specific miRNA pathways. Our data provide novel evidence that anticancer effects of boswellic acids are due in part to their ability to regulate cellular epigenetic machinery and further highlight the promise for this phytochemical in the preventative and therapeutic applications of CRCWe hypothesized that boswellic acids may achieve their chemopreventive effects by modulating specific microRNA (miRNA) pathways. We found that AKBA significantly up-regulated expression of the let-7 and miR-200 families in various CRC cell lines. Both let-7 and miR-200 are putative tumor-suppressive miRNAs. AKBA modulated the expression of several downstream targets of the let-7 and miR-200 families

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