Frankincense

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

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Last updated on: 06.01.2024

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Definition
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Frankincense or boswellia resin is the resin of the frankincense tree. There are different frankincense 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 different Boswellia species reach growth heights of 1.0 to 8 meters. The greenish-ash-colored bark peels off in paper-thin, smooth pieces. Frankincense trees start to produce resin when they are about 8 to 10 years old. They are tapped 2 to 3 times a year. During this frankincense harvest, the trunk and branches of the trees are cut. The tree secretes the frankincense resin (Olibanum indicum) from the injuries. The trees can only be harvested until the leaves sprout and flower, after which they must be protected (Indian frankincense is collected twice a year, in March and June). The wounds are placed in the tree months beforehand. Indian frankincense is of medicinal interest. The resin of this incense solidifies into yellowish to brownish lumps.

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 illustration), which is characterized by a balsamic-spicy, slightly lemony and typical frankincense scent. The boswellic acids and tirucallic acids in the resin extracts are of pharmacological importance. One mechanism of action of boswellic acids, especially acetyl-keto-boswellic acid (AKBA), is the direct inhibition of 5-lipoxygenase (Safayhi H et al. 1992). The 5-lipoxygenase is a key enzyme for the biosynthesis of leukotrienes. Further 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 is 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 pharmaceuticals.

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

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

Indian frankincense is used phytotherapeutically, see under Boswellia serrata Roxb.

Not yet processed by the HMPC.
ESCOP monograph: for painful joint arthritis, inflammatory bowel diseases.

On December 11, 2002, the Committee for Orphan Medicinal Products of the European Medicines Agency EMEA in London published a positive opinion on the use of Boswellia serrata resin extract from Pharmasan GmbH. This includes a Europe-wide approval of Boswellia serrata resin extract from Pharmasan GmbH, Freiburg, for the treatment of perifocal edema caused by brain tumors (EMEA 2002).

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, boswellia-Loges® frankincense capsules

Literature
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  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
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  13. Safayhi H et al (1997) Inhibition by boswellic acids of human leukocyte elastase. J Pharmacol Exp Ther 28: 1460 - 463.
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