Monday, November 26, 2012

Ancient Herbs: Boswellia


Originating from India and Egypt, Boswellia (or Frankincense) was used as one of the main components in the medical “Balsam of Jerusalem” and was also used in the treatment of skin wounds, mummification, and cremation. Today we recognize it for its anti-inflammatory properties. Seen both in vitro and in vivo, the type of molecule (triterpenes) that is found in Boswellia inhibits 5-lipoxygenase, which will limit the synthesis of leukotrienes. We know leukotrienes are an important inflammatory marker in major diseases because we see increased levels in inflammatory states such as bronchial asthma and colitis. Leukotrienes contribute by enhancing chemotaxis, superoxide radical formation, breakdown of lysosomes by phagocytes, (and in asthma) bronchoconstriction, increased mucus secretion, and increased edema just to name a few. So as you can see, they can have a powerful effect on the body, and regulating leukotriene levels may be beneficial to many people.

Boswellia help by shifting the immune response to TH2, while inhibiting TH1. It also has been shown to stabilize mast cells and regulate vascular responses to inflammation. Boswellia has also been known to have some anti-cancer properties by enhancing antiproliferation, differentiation, and apoptosis in leukemia cell lines. By inhibiting the renin-angiotensin system and stimulating the kinin system, Boswellia is able to improve sodium-water balance (by indirectly decreasing vasoconstriction and increasing vasodilation). Clinical studies have been done assessing the effectiveness of Boswellia extracts on certain inflammation-related diseases. Positive outcomes (decreased pain, swelling, side effects) were correlated with the intake of Boswellia seen in diseases such as cancer, arthritis, and IBD. However, it should be noted that some of these studies were done in addition to other treatments. Patients also experienced some side effects such as abdominal discomfort, epigastric pain, hyperacidity, and diarrhea. Interesting studies will continue to be done, but in my opinion, centuries of use indicate something positive about this herb. 

Sources: http://csuvets.colostate.edu/pain/articlespdf/benefits%20of%20boswellia.pdf

8 comments:

  1. What kind of plant is this in particular? From what I found, it can be either a tree or a shrub. Is there a difference between the two? Also do you specifically have the references to any of the studies that used this plant? Do you know any of the mechanisms of how the plant works to switch from TH1 to TH2 or how it inhibits the renin-angiotensin system? Overall, I find this post very interesting, however I think it would be more helpful to see how it works. It sounds like it does stuff that modern day medicine does already and if it is so wonderful, why aren't we using it?

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  2. I was also wondering about some of the things mentioned in the post. You had said that patients saw improvements such as decreased pain, swelling and side effects, but then later on it said that they experienced other negative side effects. You had also mentioned that the Boswellia was used in combination with other treatments. I just felt like I didn't have enough information to really see if the plant is as good as it's portrayed. Are the negative side effects the patients experienced due to the herb? Or how can the tell for sure that they weren't caused by the combination of treatments? Also, if the herb was used with other treatments, how can we be sure it's really the Boswellia that is causing the improvement? I just feel like there's a lot more to know before we can conclude anything about the effectiveness of the Boswellia.

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  3. I found some studies done with the crude and purified compound from Boswellia serrate. It looks like it downregulates IFNγ and IL-12 needed for the Th1 response and upregulates IL-4 and IL-10 for the Th2 response. It seems at least in cell culture that it can also reduce NO production in macrophages. I think it would probably be used in cancer prevention and maybe not treatment. It would push towards a Th2 response and M2 macrophages that probably wouldn’t help fight the cancer, but it looks like a great potential anti-inflammatory if some toxicity questions can be answered. The second article is a good review addressing the immune effects of the compound. It seems like some of the best compounds are found in nature. Really cool!

    B. Gayathria et al. Pure compound from Boswellia serrata extract exhibits anti-inflammatory property in human PBMCs and mouse macrophages through inhibition of TNFα, IL-1β, NO and MAP kinases. International Immunopharmacology. April 2007.

    H.P.T. Ammon. Modulation of the immune system by Boswellia serrata extracts and boswellic acids. Phytomedicine 17 (2010) 862–867.

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  4. As far as the type of plant, Boswellia is a genus so it contains a group of species that all produce this type of resin. The important compound in the resin is called Frankincense, and that's probably what people actually use to see results. The source I used summarized several studies done with patients who had a wide range of diseases. Pretty much all of the studies showed positive results, but I guess the authors could have potentially just neglected any negative ones. They do list tons of sources they used though and show where all of these studies came from.

    As far as the renin-angiotensin system, Boswellia is supposed to be acting on ACE (angiotensin converting enzyme), NEP (neutral endopeptidase), and aminopeptidase N. ACE converts angiotensin I to angiotensin II. Angiotensin II has been known to increase blood pressure in many ways like vasoconstriction, retention of Na, Cl, and water, increase in aldosterone, and an increase in sympathetic nervous activity. So Boswellia directly inhibits ACE bringing blood pressure down and keeping a better balance in sodium and water levels in the blood.

    I guess not everyone is going to be excited to use it right away just because it's not really a mainstream form of medicine. It has shown side effects, and I think a lot of people don't believe natural herbs can solve their problems when their doctor is just prescribing them more pills. If information on Boswellia travels and more scientists and doctors believe it has a significant effect, maybe one day it will be widely recommended. Perhaps they will start putting the frankincense extract in multivitamins (since they seem to be able to put whatever they want in them anyways since there's evidence they don't really do anything) or other pharmaceuticals.

    In response to Caitlin's comment, I agree that the studies done had a lot of variables that are difficult to control. But thinking about it realistically, if you had cancer would you really want to stop chemotherapy and any other widely used treatment to be a lab rat and test out an herb most people have never heard of? Not to mention, one of the cancer studies involved people with serious brain tumors. I think it would be very difficult to find sick people who are willing to eliminate other variables and try something with less research and clinical significance. There were a lot of positive correlations shown though which is interesting and I think should be providing motivation for further research. I think what Ross said about it being used as a prevention agent rather than a cure would make a more realistic approach to research.

    And also, thank you Ross for the mechanism regulating Th1 to Th2 shift!

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  5. By reading the comments of Janaa about using cancer patient in a drug trial made me wonder if sick patient should be able to participate in clinical trials. I think this is one of the controversial topic and also ethical issue. You can argue in both ways. If you have a cancer and if you are on a final stage, if trying this new herbal treatment or drug might help you why not try it, as you are dying anyway. There is nothing to loose. But we can also argue saying that every patient has a right to refuse any medical treatment, but we never had a right to demand inappropriate treatment or experimental investigation. The decision of participating in the clinical trail might be due to their vulnerability.

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  6. Hi Boswellia Supports healthy inflammation response in the body.

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  7. If an over application of pure frankincense causes an immune system response, do you think that the resulting antibodies might react to frankincense in the brain, thus causing CTE?

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  8. If an over application of pure frankincense causes an immune system response, do you think that the resulting antibodies might react to frankincense in the brain, thus causing CTE?

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