censo Indiano, Indian Frankincense

oswellia serrata

seraceae

Camelia Alexandra Manaila

2016205278
Manaila.camelia@gmail.com

Incenso Indiano, Indian

Frankincense
Bosvellia serrata
Burseraceae

Active components:
Resins (60%) (Oleo-gum resin - components including
among others alphaboswellic acid, beta-boswellic acid,
methyl ester of 3-acetylpVboswellic Acid) - exuded when
incisions are made in the bark of the trunk
Volatile oil (5-9%): chief components 1-octyl acetate
(sliare 60%), 1-octanol (share 12.7%), including as well
alphapinene (3.5%), incensol (2.7%)
Mucilages (12-20%)

Approved for:

Chronic inflammatory diseases

Pharmacological effect:
Leukotriens inhibitor (LTB4, LTC4),
Prostanglandins inhibitor,
Thromboxanes inhibitor
Anti-inflammatory
effect
Anti-oxidant
activity

Anti-microbial activity
Diuretic activity

Primary indications:
Arthritis,
Osteoarthritis,

 Potential Indications:
Crohn's disease,
Agingskin,
Asthma,
Brain tumors,
Cluster headache,
Inflammatory bowel disease,
Rheumatoid arthritis
Administration:
Oral extracts in capsules and tincture (Studies shows Boswellia is better
absorbed with a meal)
Topical- 3% to 5% As it acts as a strong anti-inflammatory agent, Boswellin may
be used in stand alone or in combination with COX-2 inhibitors
Therapeutical dose:
Osteoarthritis: 100-250 mg daily of a specific extract (5-Loxin); 100 mg daily of
another specific extract (ApresFLEX, formerly known as Aflapin); 333 mg daily of
another specific extract.
Ulcerative colitis: 300-350 mg three times daily.
Side effects: (overdose)
-stimulation of blood flow in the uterus and pelvis
-nausea,
-acid reflux,
-diarrhea,
-skin rashes.

 Boswellic acids from sap of Boswellia trees block

leukotriene biosynthesis by inhibiting the enzyme 5lipoxygenase. They also decrease activity of human
leukocyte elastase (HLE) in vitro. In addition, 5Boswellic-acid, as a COX-2 inhibitory, might have
antialzheimeran, antiarthritic, certainly
antiinflammatory, and possibly antitumor activities.

 Possibly effectivefor:
Osteoarthritis - Some studies show that taking certain extracts of Indian
frankincense (5-Loxin, ApresFLEX, formerly known as Aflapin) can reduce pain and
improve mobility in people withosteoarthritisin joints. Research shows that it
might decrease joint pain by 32% to 65%.
Ulcerative colitis - Taking Indian frankincense seems to improvesymptoms of
ulcerative colitisin some people. For some people, Indian frankincense seems to
work as well as the prescription drugsulfasalazine. Some research shows that it
can induce disease remission in 70% to 82% of people.

Insufficient evidence for:

Agingskin - In early research, applying Indian frankincense cream to the face reduced
fine surface lines, roughness, andsun damagein women with sun-damaged skin. Skin
coloring and wrinkling were not improved.
Asthma - Developing evidence suggests that taking Indian frankincense extract might
helpasthma.
Brain tumors - There is early evidence that suggests Indian frankincense might benefit
people with brain tumors. In one study, taking 4200 mg of Indian frankincense daily
reduced tumor size.
Cluster headache - Limited evidence suggests that Indian frankincense might reduce
the frequency and intensity ofcluster headaches.
Inflammatory bowel disease (collagenouscolitis) - In a small study, taking 400 mg
of Indian frankincense three times daily for six weeks reduced disease symptoms.
Crohn's disease - There is some evidence that taking Indian frankincense extract might
reducesymptoms of Crohn's disease, but research findings have been inconsistent.
Rheumatoid arthritis - (RA). Research results are mixed so far about the effectiveness
of Indian frankincense in the treatment of RA.

 J Rheumatol.2000 Jun;27(6):1365-72.
Randomized double blind trial of an ayurvedic plant derived formulation for
treatment of rheumatoid arthritis.
Authors: Chopra A,Lavin P,Patwardhan B,Chitre D
Abstract
OBJECTIVE:
To evaluate RA-1, a standardized plant extract formulation, traditionally considered a safe,
effective antiarthritic in the Asian-Indian Ayurvedic medicinal system.
METHODS:
One hundred eighty-two patients with active-on-chronic rheumatoid arthritis (RA)
participated in a 16 week randomized, double blind, placebo controlled, parallel efficacy
clinical drug trial in Pune, India. Tenderness, pain, swelling, and several other efficacy
measures were assessed by (1) ACR core set 20% and 50% improvement; (2) ACR 20%
improvement response. An intent-to-treat analysis was performed; p<0.05 considered
significant.
RESULTS:
Seventeen patients withdrew (active = 9; placebo = 8); none withdrew due to drug toxicity.
An unprecedented placebo response (often p<0.001 in within-group change) was observed.
The active RA-1 group remained numerically superior at all evaluation timepoints. RA-1
demonstrated few significant differences: (1) increased proportion with 50% reduction in
swollen joint count (95% CI approximately 1.52, 29.90) and swollen joint score (95% CI
approximately 0.91, 28.73); (2) reduced rheumatoid factor (95% CI approximately -303.7,
-2.72); 39% in the RA-1 group versus 30% placebo showed ACR 20% improvement (95% CI
approximately -5.48, 24.59). Only minor side effects were seen, with no significant
differences by treatment group.
CONCLUSION:
In a trial with sufficient power, RA-1 revealed efficacy that was not significantly superior to
the strong placebo response, except for improvement in joint swelling. Further, the effect on
RF and good safety profile led to an open label phase.

Phytomedicine. 2003 Jan;10(1):3-7.

Efficacy and tolerability of Boswellia serrata extract in treatment of
osteoarthritis of knee--a randomized double blind placebo controlled trial
Authors: Kimmatkar N,Thawani V,Hingorani L,Khiyani R
Abstract
Osteoarthritis is a common, chronic, progressive, skeletal, degenerative disorder,
which commonly affects the knee joint. Boswellia serrata tree is commonly found
in India. The therapeutic value of its gum (guggulu) has been known. It posses
good anti-inflammatory, anti-arthritic and analgesic activity. A randomized double
blind placebo controlled crossover study was conducted to assess the efficacy,
safety and tolerability of Boswellia serrata Extract (BSE) in 30 patients of
osteoarthritis of knee, 15 each receiving active drug or placebo for eight weeks.
After the first intervention, washout was given and then the groups were crossed
over to receive the opposite intervention for eight weeks. All patients receiving
drug treatment reported decrease in knee pain, increased knee flexion and
increased walking distance. The frequency of swelling in the knee joint was
decreased. Radiologically there was no change. The observed differences between
drug treated and placebo being statistically significant, are clinically relevant. BSE
was well tolerated by the subjects except for minor gastrointestinal ADRs. BSE is
recommended in the patients of osteoarthritis of the knee with possible
therapeutic use in other arthritis.

PMID:12622457DOI:10.1078/094471103321648593
[PubMed - indexed for MEDLINE]

In vitro metabolism, permeation, and brain availability of six major boswellic acids
from Boswellia serrata gum resins.
Authors: Gerbeth K,Hsch J,Fricker G,Werz O,Schubert-Zsilavecz M,Abdel-Tawab M
Abstract
Boswellia serrata gum resin extracts (BSE) revealed potent anti-inflammatory actions in
preclinical and clinical studies. In 2002 BSE was assigned an orphan drug status by the
European Medicines Agency (EMA) for the treatment of peritumoral edema. In the past
pharmacological effects of BSE were mainly attributed to 11-keto--boswellic acid (KBA) and 3acetyl-11-keto--boswellic acid (AKBA). Therefore pharmacokinetic and pharmacodynamic
studies focused mainly on these two boswellic acids (BAs). However, other BAs, like boswellic acid (BA), might also contribute to the anti-inflammatory actions of BSE. Here, we
determined the metabolic stability, permeability and brain availability of six major BAs, that is,
KBA, AKBA, BA, 3-acetyl--boswellic acid (ABA), -boswellic acid (BA), and 3-acetyl-boswellic acid (ABA). For permeability studies, the Caco-2 model was adapted to
physiological conditions by the addition of bovine serum albumin (BSA) to the basolateral side
and the use of modified fasted state simulated intestinal fluid (FaSSIF) on the apical side.
Under these conditions the four BAs lacking the 11-keto moiety revealed moderate
permeability. Furthermore the permeability of AKBA and KBA was improved compared to
earlier studies. In contrast to A- and ABA, BA and BA were intensively metabolized after
incubation with human and rat liver microsomes. Finally, the availability of all six major BAs
could be confirmed in rat brain 8h after oral administration of 240mg/kg BSE to rats showing
mean concentrations of 11.6ng/g for KBA, 37.5ng/g for AKBA, 485.1ng/g for BA, 1066.6ng/g
for BA, 43.0ng/g for ABA and 163.7ng/g for ABA.

Copyright 2012 Elsevier B.V. All rights reserved.

PMID:23103296DOI:10.1016/j.fitote.2012.10.009

Conclusions:
47 potentially relevant studies
seven met all inclusion criteria (five placebo
controlled, two with active controls)
The included trials related to asthma, rheumatoid
arthritis, Crohn's disease, osteoarthritis, and
collagenous colitis
Results of all trials indicated that Boswellia serrata
extracts were clinically effective
Three studies were of good methodological quality
No serious safety issues were noted
The evidence for the effectiveness of Boswellia
serrata extracts is encouraging but not compelling

 References:
https://www.ncbi.nlm.nih.gov/pubmed/12622457
https://www.ncbi.nlm.nih.gov/pubmed/10852255
http://www.ema.europa.eu/docs/en_GB/document_library/Orphan_designation/
2009/10/WC500005903.pdf
http://www.webmd.com/arthritis/understanding-arthritis-treatment#1
https://www.drugs.com/npp/frankincense-indian.html
https://examine.com/supplements/boswellia-serrata/
http://www.healthline.com/health/boswellia#1
https://www.ncbi.nlm.nih.gov/pubmed/23103296
N. Kimmatkar,V. Thawani. Efficacy and tolerability of Boswellia serrata extract
in treatment of osteoarthritis of knee--a randomized double blind placebo
controlled trial. Phytomedicine. 2003; 10: 3-7
Chopra A,Lavin P. Randomized double blind trial of an ayurvedic plant derived
formulation for treatment of rheumatoid arthritis. The Journal of Rheumatology.
2000; 27(6):1365-1372
Kathleen Gerbeth,Jan Hsch. In vitrometabolism, permeation, and brain
availability of six major boswellic acids fromBoswellia serratagum resins.
Fitoterapia. 2013; 84: 99-106