A correlation of our earlier in vitro and in vivo studies using Boswellic acid reveals a decline in plasma concentrations of Tumour necrosis factor-alpha (TNF-alpha), Vascular endothelial growth factor (VEGF), Prostaglandin E2 (PGE2) and Leukotriene (LTB4) values, suggesting their role in the management of chronic inflammatory conditions. With encouraging results from the preliminary study, the present study was undertaken to evaluate the safety and efficacy of AKBBA in patients suffering from mild to moderate chronic plaque psoriasis.
Introduction. Psoriasis is a common chronic inflammatory, immune-mediated disease that predominantly affects the skin and joints, characterized by circumscribed, red, thickened plaques with an overlying silver-white scale (1). Though many pharmaceutical drugs and biologics are available in the market, they have very less impact on the psoriatic patients due to their own and many limitations. Therefore, as a complementary and alternative medicine (CAM), Boswellia serrata Roxb has been explored and found to be safe and efficient in the management of mild to moderate psoriasis.
Objective. In the current study, we aimed at investigating a cream of Boswellia serrata Roxb extract standardized for 5% of 95% 3-O-Acetyl-11-Keto Beta Boswellic Acid (AKBBA) (in the form of a cream), for the management of mild to moderate chronic plaque Psoriasis.
Method. An open label, multi centred phase III clinical trial, evaluating 200 psoriatic patients with application of AKBBA cream thrice a day for a period of 12 weeks was carried out. Changes in ‘modified’ Psoriasis Activity Severity Index (PASI) & biomarkers (LTB4, TNF alpha, VEGF, PGE2) from the baseline values along with remissions in clinical lesions observed through photographic images were considered for efficacy evaluation.
Results. Highly significant changes in LTB4 (p<0.001) & TNF alpha (p<0.01) values from the baseline along with significant changes (p<0.05) in VEGF & PGE2 were observed. Reduction in ‘modified’ PASI score from the baseline visit was in consensus with the global evaluations by physician and patients.
Conclusion. We propose topical application of AKBBA cream, may be useful in the management of mild to moderate chronic plaque psoriasis. Study for Boswellin Cosmetic Grade [SBBOSWCG]
Clinical evaluation of AKBBA (from Bosweliia serrata extract Boswellin) in the management of psoriasis, Muhammed M., Nagabhushanam K., Sankaran N., Sood R., Karri S.K. - Clinical Dermatology 2014; 2 (1): 17-24

Boswellin is a natural extract from the gum resin of the Indian frankincense tree Boswellia serrata, an Ayurvedic botanical with clinically proven anti-inflammatory effects. Boswellin contains boswellic acids that inhibit two pro-inflammatory enzymes 5-lipoxygenase and elastase, thereby supporting skin texture and integrity. Inhibiting inflammation is known to be an effective approach to slow skin aging
A double blind placebo controlled clinical study was conducted on 21 healthy female subjects in the age group of 20-35 years. The subjects were provided with “Under Eye cream” containing 1% of Boswellin (and other natural ingredients) and a placebo, to be applied under each eye twice a day for a period of 4 weeks. The appearance of dark circles and puffiness was assessed by a dermatologist at predetermined time intervals
Usage :
Recommended use levels in creams and lotions is 3-5%
Tested formulations containing the ingredient showed no untoward effects on skin or eyes.
Leaflet 1 page on Double blind placebo controlled clinical study conducted on 21 healthy female subjects, provided with “Under Eye cream” containing 1% of Boswellin / Boswellin® Cosmetic Grade

Abstract : Frankincense extracts and boswellic acids, biologically active pentacyclic triterpenes of frankincense, block leukotriene biosynthesis and exert potent anti-inflammatory effects. Screening for additional effects of boswellic acids on further pro inflammatory pathways, we observed that acetyl-11- keto- beta- boswellic acid, an established direct, nonredox and noncompetitive 5-lipoxygenase inhibitor, decreased the activity of human leukocyte elastase (HLE) in vitro with an IC50 value of about 15 µM. Among the pentacyclic triterpenes tested in concentrations up to 20 µM, we also observed substantial inhibition by beta-boswellic acid, amyrin and ursolic acid, but not by 18 beta - glycyrrhetinic acid. The data show that the dual inhibition of 5-lipoxygenase and HLE is unique to boswellic acids: other pentacyclic triterpenes with HLE inhibitory activities (e.g., ursolic acid and amyrin) do not inhibit 5-lipoxygenase, and leukotriene biosynthesis inhibitors from different chemical classes (e.g., NDGA, MK-886 and ZM-230,487) do not impair HLE activity. Because leukotriene formation and HLE release are increased simultaneously by neutrophil stimulation in a variety of inflammation- and hypersensitivity-based human diseases, the reported blockade of two proinflammatory enzymes by boswellic acids might be the rationale for the putative antiphlogistic activity of acetyl- 11- keto- beta- boswellic acid and derivatives.
Inhibition by Boswellic Acids of Human Leukocyte Elastase / University of Tuebingen, Hasan Safayhi, Beatrice Rall, Eckart-Roderich Sailer And Hermann P T. Ammon, The Journal Of Pharmacology And Experimental Therapeutics Vol. 281, No. 1

-> 5-Lipoxygenase (5-LOX) products from endogenous arachidonic acid in ionophore-stimulated
peritoneal polymorphonuclear leukocytes (PMNL) and from exogenous substrate (20 gM) in 105,000 g
supernatants were measured.
-> The effects of natural pentacyclic triterpenes and their derivatives on 5-LOX activity were compared
with the inhibitory action of acetyl-l -keto-beta-boswellic acid (AKBA), which has been previously shown
to inhibit the 5-LOX by a selective, enzyme-directed, non-redox and non-competitive mechanism.
-> The 5-LOX inhibitory potency of AKBA was only slightly diminished by deacetylation of the
acetoxy group or reduction of the carboxyl function to alcohol in intact cells (ICs = 1.5 vs. 3 and 4.5 pM,
respectively) and in the cell-free system (8 vs. 20 and 45 gM).
-> beta-Boswellic acid (f-BA), lacking the 1 1-keto function, inhibited 5-LOX only partially and
incompletely, whereas the corresponding alcohol from fl-BA, as well as amyrin, acetyl-ll-keto-amyrin,
11-keto-f-boswellic acid methyl ester had no 5-LOX inhibitory activity up to 50 pM in either system.
-> beta-BA only partially prevented the AKBA-induced 5-LOX inhibition, whereas the non-inhibitory
compounds, amyrin and acetyl-1 l-keto-amyrin, almost totally antagonized the AKBA effect and shifted
the concentration-inhibition curve for the incomplete inhibitor fl-BA to the right. In contrast, the noninhibitory
beta-keto-fl-BA methyl ester exerted no antagonizing effect.
-> The results demonstrate that the pentacyclic triterpene ring system is crucial for binding to the highly
selective effector site, whereas functional groups (especially the 11 -keto function in addition to a
hydrophilic group on C4 of ring A) are essential for 5-LOX inhibitory activity.
Keywords: Leukotriene synthesis inhibitor; 5-lipoxygenase; boswellic acid; amyrin; pentacyclic triterpene; inflammation; antiinflammatory
Acetyl- 11- keto- beta- boswellic acid (AKBA) structure requirements for binding and 5-lipoxygenase inhibitor activity / University of Tuebingen, British journal of pharmacology (1996) 117, 615-618

Abstract : Isomers (alpha- and beta-) of boswellic acids (BAs), 11-keto-beta-BA and their acetyl derivatives were isolated from the gum resin of Boswellia serrata. BA and derivatives concentration dependently decreased the formation of leukotriene B4 from endogenous arachidonic acid in rat peritoneal neutrophils. Among the BAs, acetyl-11-keto-beta-BA induced the most pronounced inhibition of 5-lipoxygenase (5-LO) product formation with an IC50 of 1.5 microM. In contrast to the redox type 5-LO inhibitor nordihydroguaiaretic acid, BA in concentrations up to 400 microM did not impair the cyclooxygenase and 12-lipoxygenase in isolated human platelets and the peroxidation of arachidonic acid by Fe-ascorbate. The data strongly suggest that BAs are specific, nonreducing-type inhibitors of the 5-LO product formation either interacting directly with the 5-LO or blocking its translocation.
Boswellic acids : Novel, specific, nonredox inhibitors of 5-lipoxygenase / University of Tuebingen, the Journal of pharmacology and therapeutics, vol 261, n°3, H Safayhi, T Mack, J Sabieraj, M I Anazodo, L R Subramanian, H P Ammon

Mixed acetylboswellic acids, pentacyclic triterpenes extracted from the gum resin of Boswellia serrata Roxb., significantly inhibited the ionophore-stimulated release of the leukotrienes (LT) B4 and C4 from intact human polymorphonuclear neutrophil leukocytes (PMNLs), with IC50 values of 8.48 micrograms/ml and 8.43 micrograms/ml, respectively. Purified acetyl-11-keto-beta-boswellic acid was about three times more potent as inhibitor of the formation of both LTB4 (IC50 = 2.53 micrograms/ml) and LTC4 (IC50 = 2.26 micrograms/ml) from human PMNLs in the same assay. The comparative agent MK 886 (3-[1-(4-chlorobenzyl)-3-t-butyl-thio-5-isopropylindol-2-yl]- 2,2-dimethylpropanoic acid, L-663,536, CAS 118, 414-82-7) was about 10 to 100-fold more active than the boswellic acids in inhibiting the formation of 5-lipoxygenase products in human PMNLs, with IC50 values of 0.0068 microgram/ml (LTB4) and 0.49 microgram/ml (LTC4). After daily intraperitoneal dosage the extract of mixed acetylboswellic acids (20 mg/kg) significantly reduced the clinical symptoms in guinea pigs with experimental autoimmune encephalomyelitis (EAE) between days 11 and 21. However, the inflammatory infiltrates in the brain and the spinal cord were not significantly less extensive in the treated animals than in the respective control group. The multiple intraperitoneal application of boswellic acids did not inhibit the ionophore-challenged ex vivo release of leukotrienes B4 and C4 from PMNLs separated from the blood of guinea pigs with EAE. The boswellic acids have thus been characterized as selective, non-redox and potent inhibitors of the biosynthesis of leukotrienes in vitro.
Effects of boswellic acids extracted from a herbal medicine on the biosynthesis of leukotrienes and the course of experimental autoimmune encephalomyelitis, - University of Tuebingen, Arzneim Forsch / drug - Res 48 (1) 668-674 (1998)

Abstract : Suspensions of rat peritoneal polymorphonuclear leukocytes (PMNL) elicited with glycogen were stimulated by calcium and ionophore to produce leukotrienes and 5-HETE from endogenous arachidonic acid (AA). We investigated the effect of ethanolic extracts of the gum resin exudate of Boswellia serrata. A concentration-dependent inhibition of LTB4 and 5-HETE production by different charges of exudate extracts were found. All products of the 5-lipoxygenase (5-LOx) from endogenous arachidonic acid (AA) in PMNL were reduced to the same extent by the extracts tested. The ethanolic extract of the gum resin also decreased 5-LOx mediated metabolisation of exogenously added AA to LTB4 and 5-HETE. Since steroidal-type anti-inflammatory drugs do not exert an immediate effect in the test system used, we conclude that the activity of the 5-LOx itself represents the side of inhibition by the gum resin extract. Therefore, an inhibition of 5-LOx catalysed mediator synthesis might be involved in the previously reported anti-inflammatory activity in vivo.
Keyword : 5-Lipoxygenase, leukotrienes, Boswellia serrata, Salai guggal.
Inhibition of Leukotriene B4 Formation in Rat Peritoneal Neutrophils by an Ethanolic Extract of the Gum Resin Exudate of Boswellia serrata / University of Tuebingen / Boswellin, Planta Med. 57(1991), H.P. T. Ammon, T. Mack, G. B. Singh, and H. Safayhi