Frankincense

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 25.02.2021

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Definition
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Frankincense or Boswellia resin is the resin of the frankincense tree. There are different incense trees (Boswellia) in the dry regions of Africa and India (e.g. in Somalia, Ethiopia and Arabia). Depending on the origin, a distinction is made between: Somali frankincense = Boswellia frereana, East African frankincense = Boswellia carteri or Indian frankincense = Boswellia serrata, the latter being the best studied and used in medicine.

The different Boswellia species reach heights of 1.0 to 8 m. The greenish-ash-colored bark peels off in paper-thin, smooth pieces. Frankincense trees begin producing resin when they are about 8 to 10 years old. They are tapped 2 to 3 times a year. During this frankincense harvest, the trees are incised on the trunk and branches. From the injuries the tree secretes the frankincense resin (Olibanum indicum). Harvesting can only be done until the leaves sprout and blossom, after that the trees have to be spared.

The frankincense resin obtained is sold in the form of whitish, yellowish, yellowish-reddish or brownish, irregular pieces or small grains (see illustration). The resin yield per tree is 3 to 10 kg. The frankincense resin is a granular dried resin (see picture), which is characterized by a balsamic-spicy, slightly lemony and typical frankincense scent. Pharmacological importance is mainly attributed to the boswellic acids and tirucallic acids contained in the resin extracts. One mechanism of action of the boswellic acids, here above all the acetyl-keto-boswellic acid (AKBA) consists in a direct inhibition of the 5-lipoxygenase (Safayhi H et al. 1992). 5-Lipoxygenase represents a key enzyme in the biosynthesis of leukotrienes. Other pharmacological effects of frankincense are based on the proven inhibition of topoisomerases (Wang L-G et al.1991, Hoernlein RF et al.1999) and inhibition of leukocyte elastase (Safayhi H et al. 1997). Leukotrienes play a key role in many allergic and inflammatory diseases. 5 Lipoxygenase represents the key enzyme in the synthesis of leukotrienes.

It is used in the perfume industry, in cosmetic products s. Boswellia serrata extract (INCI) and in medicinal products.

Frankincense essential oil is obtained from the resin by steam distillation.

The ingredients of the resin are mainly monoterpenes, sesquiterpenes, monoterpenols, sesquiterpenols (see terpenes) and ketones. Other ingredients are various boswellic acids and incensol.

Field of application/use
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The inhibition of leukotriene synthesis defines the application of Boswellia serrata extract for allergic and inflammatory diseases with leukotriene activation.

In classical European naturopathy, frankincense is mainly used and clinically studied in rheumatology, gastroenterology, pulmonology as well as neurology.

Rheumatology: In rheumatoid arthritis there are contradictory study results. On the one hand significant improvements (Etzel R et al. 1996) up to no influence at all on inflammation values and subjective feeling (Sander O et al. 1998).

Gastroenterology: Studies on ulcerative colitis (Grupta I. et al 1997 and 2001) as well as Crohn's disease (Gerhard H et al 2001) have shown comparable effects of Boswellia serrata extracts and sulfasalazine.

Pulmonology: There are indications of a significant improvement with Boswellia serrata extracts, although the study included a very low number of cases (40 patients) (Gupta I et al. 1998).

Neurology: There is evidence of an effect on perifocal oedema in gliomas and astrocytomas (Heldt MR et al. 1998).

Incensol, another ingredient of frankincense resin showed antianxiety and antidepressant effects in animal models. An antidepressant effect of incensol has not yet been demonstrated in humans.

Some studies suggest that olibanum may improve memory performance in part by regulating levels of the transcription factors CREB-1 and CREB-2 (cAMP response element-binding) via positive/negative feedback loops (Jebelli A et al. 2019).

Furthermore, boswellic acids have been shown to have antiproliferative effects on various tumor cell lines (e.g. malignant melanoma, glioblastoma, hepatocellular carcinoma) in vitro, based on an induction of apoptosis.

Traditionally, frankincense is used as an anti-inflammatory and antibacterial agent. In East Africa, for example, it is used against diseases such as syphilis, bilharzia and stomach disorders.

Preparations
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Boswellia serrata extract H15® (Pharmasan GmbH Freiburg), H 15 Ayurmedica® capsules, Trisana® Dermal C

Literature
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  1. Ammon H P (2002) Boswellic acids (constituents of frankincense) as effective principles for the treatment of chronic inflammatory diseases. Wiener Medizinische Wochenschrift 152: 373-378.
  2. Bertsche T el al (2002) Therapy with frankincense extracts. Pharmazeutische Zeitung 51.
  3. Etzel R (1996) Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomed 3: 91 - 94.
  4. Gerhard H et al. (2001) Therapy of active Crohn's disease with Boswellia serrata extract H15. Z Gastroenterol 39: 11 - 17.
  5. Gilbert NC et al. (2020) Structural and mechanistic insights into 5-lipoxygenase inhibition by natural products, Nature Chemical Biology volume 16: 783-790.
  6. Gupta I et al.(1997) Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 2: 3743.
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  9. Heldt MR et al. (1997) Boswellic acids exhibit cytotoxic effects on brain tumor cells independent from 5-lipoxygenase inhibition. Naunyn Schmiedeberg's Arch Pharmacol 355: 30
  10. Hoernlein RF et al (1999) Acetyl-11-keto-beta-boswellic acid induces apoptosis in HL-60 and CCRF-CEM cells and inhibits topoisomerase I. J Pharmacol Exp Ther 288: 613 - 619.
  11. Jebelli A et al. (2019) Beta-Boswellic Acid and Ethanolic Extract of Olibanum Regulating the Expression Levels of CREB-1 and CREB-2 Genes. Iran J Pharm Res Spring 18:877-886.
  12. Safayhi H et al (1992) Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 261: 1143 - 1146.
  13. Safayhi H et al (1997) Inhibition by boswellic acids of human leukocyte elastase. J Pharmacol Exp Ther 28: 1460 - 463.
  14. Sander O et al. (1998) Is H15 (resin extract of Boswellia serrata incense) a useful supplement to established drug therapy of chronic polyarthritis? Results of a double-blind pilot study. Z Rheumatol 57: 11 - 16.
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