Boswellia serrata (Salai/Salai guggul) 

is a tree belonging to the Burseraceae family which grows in India, Middle East and North Africa.

There are 17 genera and about 600 species in tropical regions.

The most important species are:

• Boswellia sacra Flueck
• Boswellia serrata

Resins, essential oils, gums used for a long time in Ayurvedic medicine are obtained from this tree.

The main components of these trees are (1):

• monoterpenes: α-thujene
• diterpenic alcohol: serratol
• triterpenes: β-amirine, α-amirine
• pentacyclic triterpenic acid: boswellic acid

This study established that the crude methanolic  extract and pure compound of Boswellia serrata are capable of natural anti-inflammatory activity at sites of chronic inflammation by switching off cytokines and pro-inflammatory mediators, which initiate the process (2).

The biologically active constituents ofBoswellia serrata, namely 3-acetyl-11-keto-β-boswellic acid and β-boswellic acid, act synergistically to exert anti-inflammatory/anti-arthritic activity showing improvement in physical and functional capacity and reducing pain and stiffness in the management of knee osteoarthritis (3).

Aminosalicylates, corticosteroids, and immunosuppressants are currently the treatment choices in inflammatory bowel disease, however, with limited remission and often serious side effects. Boswellia serrata is a traditional Ayurvedic remedy with anti-inflammatory properties of interest for its utility in inflammatory bowel disease. This study elucidates the pharmacological mechanisms mediated by Boswellia serrata, in protecting the intestinal epithelial barrier from inflammatory damage and supports its use as a safe adjuvant in patients with inflammatory bowel disease  (4).

The most relevant studies on this ingredient have been selected with a summary of their contents:

Boswellia serrata studies

References_________________________________________________________

(1) el-Khadem H, el-Shafei ZM, el-Sekeily MA, Rahman MM. Derivatives of boswellic acids. Planta Med. 1972 Sep;22(2):157-9. doi: 10.1055/s-0028-1099599. 

(2) Gayathri B, Manjula N, Vinaykumar KS, Lakshmi BS, Balakrishnan A. Pure compound from Boswellia serrata extract exhibits anti-inflammatory property in human PBMCs and mouse macrophages through inhibition of TNFalpha, IL-1beta, NO and MAP kinases. Int Immunopharmacol. 2007 Apr;7(4):473-82. doi: 10.1016/j.intimp.2006.12.003.

(3) Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019 May;33(5):1457-1468. doi: 10.1002/ptr.6338.

(4) Catanzaro D, Rancan S, Orso G, Dall'Acqua S, Brun P, Giron MC, Carrara M, Castagliuolo I, Ragazzi E, Caparrotta L, Montopoli M. Boswellia serrata Preserves Intestinal Epithelial Barrier from Oxidative and Inflammatory Damage. PLoS One. 

Compendium of the most significant studies with reference to properties, intake, effects.

Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine. 2003 Jan;10(1):3-7. doi: 10.1078/094471103321648593.

 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.

Börner F, Werner M, Ertelt J, Meins J, Abdel-Tawab M, Werz O. Analysis of Boswellic Acid Contents and Related Pharmacological Activities of Frankincense-Based Remedies That Modulate Inflammation. Pharmaceuticals (Basel). 2021 Jul 10;14(7):660. doi: 10.3390/ph14070660.

Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet. 2011 Jun;50(6):349-69. doi: 10.2165/11586800-000000000-00000.

Kirste S, Treier M, Wehrle SJ, Becker G, Abdel-Tawab M, Gerbeth K, Hug MJ, Lubrich B, Grosu AL, Momm F. Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial. Cancer. 2011 Aug 15;117(16):3788-95. doi: 10.1002/cncr.25945.

Hajhashemi V, Safaei S. Effect of a Selection of Skin Penetration Enhancers on Topical Anti-Inflammatory Effect of Boswellic Acids in Carrageenan-Induced Paw Edema in Rats. Adv Biomed Res. 2021 Jul 29;10:18. doi: 10.4103/abr.abr_222_20.

Attallah NGM, Negm WA, Elekhnawy E, Altwaijry N, Elmongy EI, El-Masry TA, Alturki EA, Yousef DA, Y Shoukheba M. Antibacterial Activity of Boswellia sacra Flueck. Oleoresin Extract against Porphyromonas gingivalis Periodontal Pathogen. Antibiotics (Basel). 2021 Jul 15;10(7):859. doi: 10.3390/antibiotics10070859.

 Żęgota Z, Goździk J, Głogowska-Szeląg J. Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis. Adv Orthop. 2021 May 7;2021:5589597. doi: 10.1155/2021/5589597.