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Frankincense in Recent Traditional Medicine••One of the best-known formulations with myrrh and frankincense is QiLi San, the name referring to the small dose of the powder to be taken internally each time (7/1000 of a tael, about 0.4 grams).
•QiLi Sanis given for all kinds of injuries. No doubt, this ancient prescription provided the inspiration for the 20th century formula Yunnan BaiYao, an aromatic blend that is currently the most famous injury remedy in Asia.
•Traditional Chinese Medicine recognizes frankincense and myrrh as blood regulating herbs that complement each other. They invigorate the blood, dispel blood stasis and reduce swelling, relieve pain and promote healing.

                        Medical Uses of Frankincense according to recent studies

Frankincense essential oil soothes and calms the mind, slowing down and deepening breathing , and excellent while meditating.
•Antiseptic (Antibacterial and antifungal) and anti-inflammatory , it improves wound healing and relieve swellings.
•Anxiety and Obsessive compulsive disorders.
•Asthma, bronchitis, laryngitis, coughs and colds.
•Menstrual disturbances ; dysmenorrheaand amenorrhea.
•Rheumatoid arthritis and Osteoarthritis.
•Incensol(a component of frankincense essential oil) was found to possess neuroprotective properties in neurodegenerative diseases and boswellic acids were found to reduce brain edema in CVA as well as in cancer.
•Taking frankincense internally helps boost the immune system.

 Frankincense in cancer

•Chemical extracts of Boswellia species resins might possess anti-cancer activities, based on their anti-proliferative and pro-apoptotic activities in rat astrocytomacell lines
•Frankincense essential oil have also been shown to possess cytostaticand cytotoxicactivities in multiple human cancer cell lines, including meningiomacells ,leukemia cells , hepatomacells ,melanoma cells, fibrosarcomacells, colon cancer cells , pancreatic cancer, and prostate cancer cells.
•Derivatives of boswellic acid are suitable for the palliative treatment of progressive or relapsing brain tumors, due to, among other things, their described anti-edematous properties.
•InVitro study ;20 microgram/ml of boswellic acid acetate decreased viable cell number of myeloid leukemia HL-60 cells by 60% within 24 h.
•Recentstudies on brain tumors and leukemic cells indicate that boswellicacids may have antiproliferativeand apoptotic

HK Lin and his team, from the University of Oklahoma Health Sciences Center and Oklahoma City VA Medical Center, set out to evaluate frankincense oil for its anti-tumour activity in bladder cancer cells. The authors investigated the effects of the oil in two different types of cells in culture: human bladder cancer cells and normal bladder cells. The team found that frankincense oil is able to discriminate between normal and cancerous bladder cells in culture, and specifically kill cancer cells.

Within a range of concentration, frankincense oil suppressed cell viability in bladder transitional carcinoma J82 cells but not in UROtsa cells. Comprehensive gene expression analysis confirmed that frankincense oil activates genes that are responsible for cell cycle arrest, cell growth suppression, and apoptosis in J82 cells. However, frankincense oil-induced cell death in J82 cells did not result in DNA fragmentation, a hallmark of apoptosis.
Article: Frankincense oil derived from Boswellia carteri induces tumor cell specific cytotoxicity
Mark Barton Frank, Qing Yang, Jeanette Osban, Joseph T Azzarello, Marcia R Saban, Ricardo Saban, Richard A Ashley, Jan C Welter, Kar-Ming Fung and Hsueh-Kung Lin                       http://www.biomedcentral.com/bmccomplementa

rankincense oil-induced J82 cell death; A- treated with frankincense essential oil 1:1000 solution and B- untreated

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 Antimicrobial activities of frankincense•The use of Frankincense during Khareef
season in Dhofaris so common to prevent
indoor molds and germs growth when sun
Ultraviolet is markedly interrupted by the
long season of mist.
•Methanol and aqueous extracts of frankincense stem bark were found to exhibit broad spectrum inhibiting activity against bacteria, both Gram-positive and Gram-negative, and fungi.
•Methanol and aqueous extracts of Frankincense resin were found to significantly inhibit (>/90% inhibition at 100 microg/mL) hepatitis C virus (HCV) protease.
•Extracts of Frankincense gum resins and the boswellic acids, particularly the ketoboswellic acids (11-keto-beta-boswellic acid and 3-O-acetyl-11-beta-keto boswellic acid) were shown to be potent activators of human polymorph nuclear leukocytes.

Frankincense in Respiratory System*Frankincense is traditionally used (particularly in Oman) to treat coughs (Antitussive& Bronchodilator).
*Modern research confirms that it inhibits the production of leukotrieneswhich mediate airways constrictions and inflammation.
*It is currently being researched and used therapeutically in hospitals in Europe.

Frankincense in AsthmaIn a double-blind, placebo-controlled study of 80 patients, 40 (23 males, 17 females) in the age range of 18 -75 years having mean duration of illness, bronchial asthma, of 9.58 +/-6.07 years were given a boswellia gum resin preparation of 300 mg, 3 times daily for 6 weeks. 70%of patients given boswellia extract showed significant improvement as evidenced by disappearance of physical symptoms (dyspnea, rhonchi, increase in FEV1, FVC and PERF, decreases in ESR and eosinophilcount) and lower number of attacks. In contrast, only 27%of patients in the control group showed improvement.

Frankincense in Arthritis•Boswellic acids were studied in 42 osteoarthritis patients in a randomized, double blind, placebo controlled crossover study. Pain and disability scores were decreased significantly, but radiological assessment showed no change.
•Boswellic acids work well in arthritis, bursitis and tendonitis.
•Boswellic acids in osteoarthritis and rheumatoid arthritis. The anti inflammatory effect of boswellic acid is similar to the conventional NSAID and act by inhibition of leukotrienessynthesis via inhibition of 5-lipoxygenas. 

Boswellic acids versus NSAID•In contrast to non-steriodalanti-inflammatory drugs (NSAID), which are well known to disrupt glycosaminoglycansynthesis, thus accelerating articulardamage in arthritic conditions, boswellic acids have been shown to significantly reduce glycosaminoglycandegradation.
•Long-term use of boswellia does not lead to irritation or ulceration of the stomach.
•Boswellic acids have no effect on 12-lipoxygenase, cyclooxygenase, or the peroxidationof arachidonicacid by iron and ascorbate, suggesting the boswellic acid component to be a specific, non-redox, noncompetitive inhibitor of 5-lipozygenase, the key enzyme of leukotrienebiosynthesis.

Frankincense Immunological Applications•In an immunological study, boswellic acids also have been shown to possess anticomplementaryactivity via C3-convertase inhibition. C3-convertase is involved in the production of anaphylatoxin.
•Inhibition of graft rejection to the same extent as high dose steroids.


Frankincense In Inflammatory Bowel DiseaseUlcerative colitis (an inflammatory bowel disease) respond well via inhibition of 5-lipoxygenase as well.
1997; Patients given Frankincense gum resin preparation (350 mg 3 times daily) for 6 weeks compared with sulfasalazine (1 g 3 times daily), parameters of ulcerative colitis (e.g. stool properties, histopathology, rectal biopsies, blood work) were improved. Remission was 82%with the resin and 75% with sulfasalazine.
A more recent (2001) study led by the same principal investigators evaluated 30 patients (17 males, 13 females ranging in age from 18 to 48 years) with chronic colitis.
Twenty patients were given a preparation of the gum resin (900 mg daily divided in 3 doses for 6 weeks), and 10 patients were given sulfasalazine(3 gm daily divided in 3 doses for 6 weeks).
Among the 20 patients treated with boswellia, 18 showed improvement and 14 went into remission. Among the 10 treated with sulfasalazine, 6 showed improvement and 4 went into remission.
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Although corticosteroids are widely used in the treatment of IBD, ithas major side effects that limit its chronic use in these patients.The boswellic acids have not shown such deleterious side effectsin any of the clinical studies published to date.
Recent (2001) studies of experimental ileitis and Chrondisease have used an AKBA extract called H15.

             Chemical Properties•The gum resin of Frankincense contains biologically active boswellic acid (3-alpha-hydroxy-urs-12-en-23-oic acid) and its derivatives (collectively called terpenoids)
•Acid resin (63%) and Volatile oil (10%) dissolve to 65% in Alcohol. While Gum (27%) and Ash (0-1%) dissolve into 3 portions of water forming thick mucilage.
•So Alcohol extracts about 75% of frankincense (W/V; 1:195% ethyl alcohol or 1:270% ethyl alcohol)
•Standardized*alcoholic (ethanol) extract of Frankincense gum resin contains 60% to 65% boswellic acids.
•Specific gravity of the oil is 0.87 –0.88 @ 25 C°.
                                                        * Primary extraction contains about 45%

•The exudates of the frankincense tree contains volatile oils (frankincense essential oil) and terpenoids (Boswellic acids) and both are alcohol soluble, and gum (the water soluble portion).
•The terpenoids are comprised of four pentacyclic triterpene acids: beta-boswellic acid (the most abundant), 3-o-acteyl beta, 11-keto-beta-boswellic acid, and 3 o-acetyl-11-keto-beta-boswellic acid.
•Of the four primary boswellic acids, 3-O-acetyl-11-keto-beta-boswellic acid (AKBA) has been determined to be the most potent inhibitor of 5-LO.

Major components of Frankincense Essential Oil in (high-low) manner•Alpha-Pinene
•Limonene
•Alpha-Thujene
•Octyl-Acetate
•Beta-Caryophyllene
•Sabinene
•P-Cymene
•Myrcene
•Incensol
•Delta-Cadinene
•Beta-Pinene
•Beta Elemene
•Alpha-Cadinol
•Alpha-Copaene
•Camphene

Structure of β-boswellic acid, one of the main active components of frankincense

 Beta-boswellic acid, keto-beta-boswellic acid and acetyl-keto-beta-boswellic acid (AKBA) have been indicated in apoptosis of cancer cells, particularly brain tumors and cells affected by leukemia or colon cancer .

Acetyl-boswellic acids also exhibit anti-inflammatory behaviour by inhibiting leukotriene synthesis. Specifically, it inhibits the activity of the enzyme 5-lipoxygenase through a non-redox reaction. Clinical trials have investigated the effectiveness of boswellic acids in treating ulcerative colitis, but a study on chemically induced colitis in mouse models showed little effectiveness. This latter study also linked large doses of boswellic acids to hepatotoxicity and increased lipid accumulation. Paradoxically, low doses of Boswellia serrata extract may have hepatoprotective effects.

Boswellic acids are also thought to decrease the symptoms of asthma ; a small 1998 placebo-controlled trial of Boswellia extract for the treatment of asthma showed good results. Boswellia extracts are sold in tablet, capsule and tincture form, but no dosage guidelines have been developed. The risk of hepatotoxicity due to Boswellia administration has not been assessed.