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Life Extension Magazine

LE Magazine March 2007
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Ancient Herb Suppresses Inflammation


By Vicki Brower

Boswellia Improves Symptoms of Arthritis

Osteoarthritis and rheumatoid arthritis can cause disabling pain and immobility in aging adults. Boswellia may offer relief for arthritis suffers because of its well-known analgesic, anti-arthritic, and anti-inflammatory properties.

Osteoarthritis, the “wear and tear” arthritis, is caused by deterioration of the cartilage that cushions joints. Research suggests that boswellia helps prevent the deterioration of cartilage and joint tissue. Scientists now theorize that boswellia may work by inhibiting the breakdown of connective tissues that is caused by tumor necrosis factor-alpha (TNF-a)-induced expression of matrix metalloproteinase enzymes.13

A pre-clinical animal study demonstrated boswellia’s benefits in managing osteoarthritis. Dogs suffering from osteoarthritis received boswellia extract once daily for six weeks. After only two weeks of therapy, 71% of the animals showed significant improvements in clinical symptoms of arthritis, including reduced pain, stiffness, and lameness.14

In a human study, boswellia was similarly shown to be effective in adults with osteoarthritis. Thirty subjects with osteoarthritis of the knee took part in a 16-week, randomized, double-blind, placebo-controlled trial. All of those who took a boswellia supplement reported less pain and swelling, increased knee flexion, and the ability to walk a greater distance.15

Rheumatoid arthritis is classified as an autoimmune disorder, in which the body attacks its own tissues as though they were foreign invaders. Boswellia may also offer relief of autoimmune-related rheumatoid arthritis. Boswellia can help reduce immune cells that encourage inflammation while increasing the number of immune cells that inhibit inflammation.16 Studies indicate that boswellia’s ability to modulate the immune system and inhibit inflammatory activity may help improve the symptoms of rheumatoid arthritis and other autoimmune conditions.17

Boswellia: What You Need to Know
  • Scientists now know that chronic inflammation underlies many of the diseases that afflict aging adults. Because most anti-inflammatory drugs work by inhibiting the COX enzymes, researchers have sought other means to quell disease-provoking inflammation.
  • One of the most promising anti-inflammatory agents today comes from boswellia, a traditional herbal remedy long used to manage conditions such as joint pain and gastrointestinal irritation. Modern research confirms boswellia’s novel inflammation-fighting effects. Boswellia works differently from most conventional anti-inflammatory agents by inhibiting lipoxygenase (LOX) enzymes that are powerful contributors to inflammation and disease.
  • Boswellia is particularly effective in inhibiting 5-lipoxygenase (5-LOX), which promotes disease in part by contributing to the formation of damaging leuko-trienes. Leukotrienes promote asthma, cancer, and other disease processes.
  • Through its action in blocking 5-LOX, boswellia demonstrates effects that may help combat cancer, atherosclerosis, and asthma. Clinical studies reveal that boswellia also relieves the symptoms and discomfort of arthritis and inflammatory bowel disease.
  • An advanced boswellia formulation called 5-LOXIN™ displays particular efficacy in inhibiting 5-LOX’s dangerous inflammatory effects.

Critical Support Against Inflammatory Bowel Diseases

Ulcerative colitis and Crohn’s disease are known as inflammatory bowel diseases. Ulcerative colitis primarily affects the colon, while Crohn’s disease may affect the entire gastrointestinal tract. These autoimmune conditions are marked by symptoms such as severe gastrointestinal pain and cramping, diarrhea, fatigue, weight loss, and malnutrition. Boswellia may offer much-needed support for people facing these challenging conditions.

A recent survey of German patients with inflammatory bowel disease showed that over one third used complementary and alternative medicines—such as herbal therapies, homeopathy, probiotics, or acupuncture—to help manage their condition. Those who used boswellia extract, however, reported better results than those using other approaches.18

Rheumatoid arthritis. The knuckles have become inflamed and swollen.

Researchers recently tested boswellia extract in animals with experimentally induced inflammatory bowel disease. The animals demonstrated tissue injury and adherence of white blood cells to the gastrointestinal lining. When the animals received boswellia extract, however, they exhibited less inflammation and destruction of gastrointestinal tissue. These benefits contributed to a reduction in the symptoms of inflammatory bowel disease.19

Other researchers tested boswellia extract in an animal model of ulcerative colitis to assess its mechanism of action and compare its efficacy with a steroid commonly used to treat the disease in humans.20 They found that the boswellia extract protected the colon by significantly reducing disease activity, as measured by decreased recruitment and adherence of white blood cells as well as platelets in the inflamed colon. They also discovered that boswellia decreased the presence of a biochemical known as P-selectin that plays a role in active colitis. Boswellia’s impressive protective effects were similar to those seen in patients receiving steroids to reduce their symptoms of colitis.

Boswellia shows important treatment activity against ulcerative colitis. In a clinical trial of 30 ulcerative colitis patients, 20 patients took a conventional boswellia extract three times daily for six weeks, while 10 patients in the control group took sulfasalazine (a NSAID used to treat inflammatory bowel disease) three times daily for six weeks. A remarkable 90% of those treated with boswellia showed improvement in one or more disease indicators, compared to only 60% in the sulfasalazine group who showed similar improvement. Even more impressive was that 70% of the boswellia-treated patients went into disease remission, compared to 40% of those taking sulfasalazine.21

An Advanced Boswellia Formulation: 5-LOXIN™

While the anti-inflammatory effects of boswellia are well documented, different preparations of the herb vary greatly in their potency and biochemical makeup.

Scientists avidly studied boswellia to determine how it fights the inflammation-provoking 5-lipoxygenase (5-LOX) enzyme. They discovered a compound known as AKBA (3-O-acetyl-11-keto-B-boswellic acid), which binds directly to 5-LOX and inhibits its activity.23 Other boswellia-derived compounds only partially and incompletely inhibit 5-LOX.23,24

Researchers have long sought an AKBA-rich boswellia extract for the treatment of chronic inflammatory disorders. Even in standardized boswellia extracts, however, biologically active AKBA makes up only a small fraction of the total composition.

Several years ago, researchers discovered how to produce a standardized boswellia formulation that contains a concentration of AKBA greater than 30%. This product was patented and trademarked under the name 5-LOXIN™. Testing found that 5-LOXIN™ inhibits 5-LOX even more effectively than the highest-quality boswellia formulation.

In an animal study comparing the efficacy of 5-LOXIN™ to that of the popular anti-inflammatory drug ibuprofen, 5-LOXIN™ produced a 27% reduction in inflammation, compared to 35% for ibuprofen.5 Another study comparing

5-LOXIN™ to the anti-inflammatory steroid drug prednisone found that 5-LOXIN™ produced a 55% reduction in inflammation, similar to the effects of prednisone.13,25 5-LOXIN™ is not only a powerful anti-inflammatory agent, but is also considered safe and well tolerated.

Blocking Leukotrienes Improves Asthma Symptoms

Cases of asthma are dramatically increasing. An inflammatory disorder of the airways, asthma causes shortness of breath, wheezing, chest tightness, and coughing. By blocking 5-LOX-induced leukotriene production, boswellia may offer relief from the breathing difficulties that characterize asthma.

In a double-blind, placebo-controlled study of 80 asthma patients, 40 patients took an extract of boswellia three times daily for six weeks, and 40 patients took a placebo.22 Of patients taking boswellia, 70% showed an improvement in their symptoms, including the ability to inhale and exhale normally. Additionally, the boswellia-treated subjects demonstrated a decrease in eosinophils, which are white blood cells associated with allergy and asthma. By contrast, only 27% of the placebo-treated group demonstrated improved symptoms.

Conclusion

Every year, scientists are learning more about how inflammation promotes various disease processes. Recent studies have shed light on the interplay between pro-inflammatory lipoxygenase (LOX) enzymes and conditions such as cancer, heart disease, and asthma.

Long used as a traditional herbal medicine, boswellia blocks 5-lipoxygenase (5-LOX), one of the most damaging of the LOX enzymes. Laboratory and clinical studies alike demonstrate that boswellia holds promise in averting the numerous diseases associated with excessive levels of inflammation in the body. Boswellia may benefit adults seeking to manage or prevent conditions caused by the debilitating effects of chronic inflammation.

References

1. Poff CD, Balazy M. Drugs that target lipoxygenases and leukotrienes as emerging therapies for asthma and cancer. Curr Drug Targets Inflamm Allergy. 2004 Mar;3(1):19-33.

2. Lalithakumari K, Krishnaraju AV, Sengupta K, Subbaraju GV. Safety and toxicological evaluation of a novel, standardized 3-o-acetyl-11-keto-beta-boswellic acid (AKBA)-enriched boswellia serrata extract (5-Loxin). Toxicology Mechanisms and Methods. 2006:16;199-226.

3. Safayhi H, Mack T, Sabieraj J, et al. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther. 1992 Jun;261(3):1143-6.

4. Safayhi H, Rall B, Sailer ER, Ammon HP. Inhibition by boswellic acids of human leukocyte elastase. J Pharmacol Exp Ther. 1997 Apr;281(1):460-3.

5. Roy S, Khanna S, Shah H, et al. Human genome screen to identify the genetic basis of the anti-inflammatory effects of Boswellia in microvascular endothelial cells. DNA Cell Biol. 2005 Apr;24(4):244-55.

6. Syrovets T, Buchele B, Gedig E, Slupsky JR, Simmet T. Acetyl-boswellic acids are novel catalytic inhibitors of human topoisomerases I and IIalpha. Mol Pharmacol. 2000 Jul;58(1):71-81.

7. Hostanska K, Daum G, Saller R. Cytostatic and apoptosis-inducing activity of boswellic acids toward malignant cell lines in vitro. Anticancer Res. 2002 Sep;22(5):2853-62.

8. Park YS, Lee JH, Bondar J, et al. Cytotoxic action of acetyl-11-keto-beta-boswellic acid (AKBA) on meningioma cells. Planta Med. 2002 May;68(5):397-401.

9. Gupta S, Srivastava M, Ahmad N, et al. Lipoxygenase-5 is overexpressed in prostate adenocarcinoma. Cancer. 2001 Feb 15;91(4):737-43.

10. Matsuyama M, Yoshimura R, Mitsuhashi M, et al. Expression of lipoxygenase in human prostate cancer and growth reduction by its inhibitors. Int J Oncol. 2004 Apr;24(4):821-7.

11. Zhao W, Entschladen F, Liu H, et al. Boswellic acid acetate induces differentiation and apoptosis in highly metastatic melanoma and fibrosarcoma cells. Cancer Detect Prev. 2003;27(1):67-75.

12. De Caterina R, Zampolli A. From asthma to atherosclerosis--5-lipoxygenase, leukotrienes, and inflammation. N Engl J Med. 2004 Jan 1;350(1):4-7.

13. Roy S, Khanna S, Krishnaraju AV, et al. Regulation of vascular responses to inflammation: inducible matrix metalloproteinase-3 expression in human microvascular endothelial cells is sensitive to antiinflammatory Boswellia. Antioxid Redox Signal. 2006 Mar;8(3-4):653-60.

14. Reichling J, Schmokel H, Fitzi J, Bucher S, Saller R. Dietary support with Boswellia resin in canine inflammatory joint and spinal disease. Schweiz Arch Tierheilkd. 2004 Feb;146(2):71-9.

15. 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.

16. Chevrier MR, Ryan AE, Lee DY, et al. Boswellia carterii extract inhibits TH1 cytokines and promotes TH2 cytokines in vitro. Clin Diagn Lab Immunol. 2005 May;12(5):575-80.

17. Ammon HP. Boswellic acids in chronic inflammatory diseases. Planta Med. 2006 Oct;72(12):1100-16.

18. Joos S, Rosemann T, Szecsenyi J, et al. Use of complementary and alternative medicine in Germany - a survey of patients with inflammatory bowel disease. BMC Complement Altern Med. 2006;619.

19. Krieglstein CF, Anthoni C, Rijcken EJ, et al. Acetyl-11-keto-beta-boswellic acid, a constituent of a herbal medicine from Boswellia serrata resin, attenuates experimental ileitis. Int J Colorectal Dis. 2001 Apr;16(2):88-95.

20. Anthoni C, Laukoetter MG, Rijcken E, et al. Mechanisms underlying the anti-inflammatory actions of boswellic acid derivatives in experimental colitis. Am J Physiol Gastrointest Liver Physiol. 2006 Jun;290(6):G1131-7.

21. Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. 2001 Jul;67(5):391-5.

22. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res. 1998 Nov 17;3(11):511-4.

23. Safayhi H, Sailer ER, Ammon HP. Mechanism of 5-lipoxygenase inhibition by acetyl-11-keto-beta-boswellic acid. Mol Pharmacol. 1995 Jun;47(6):1212-6.

24. Sailer ER, Subramanian LR, Rall B, Hoernlein RF, Ammon HP, Safayhi H. Acetyl- 1 keto-beta-boswellic acid (AKBA): structure requirements for binding and 5-lipoxygenase inhibitory activity. Br J Pharmacol. 1996 Feb;117(4):615-8.

25. Available at: http://www.plthomas.com/PLTbrands/5-Loxin%20Fact%20Sheet%209-05.pdf. Accessed September 12, 2006.