Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors

Abstract

BACKGROUND:Patients irradiated for brain tumors often suffer from cerebral edema and are usually treated with dexamethasone, which has various side effects. To investigate the activity of Boswellia serrata (BS) in radiotherapyrelated edema, we conducted a prospective, randomized, placebo-controlled, double-blind, pilot trial. METHODS: Forty-four patients with primary or secondary malignant cerebral tumors were randomly assigned to radiotherapy plus either BS 4200 mg/day or placebo. The volume of cerebral edema in the T2-weighted magnetic resonance imaging (MRI) sequence was analyzed as a primary endpoint. Secondary endpoints were toxicity, cognitive function, quality of life, and the need for antiedematous (dexamethasone) medication. Blood samples were taken to analyze the serum concentration of boswellic acids (AKBA and KBA). RESULTS: Compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment, a reduction of cerebral edema of >75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P ¼ .023). These findings may be based on an additional antitumor effect. There were no severe adverse events in either group. In the BS group, 6 patients reported minor gastrointestinal discomfort. BS did not have a significant impact on quality of life or cognitive function. The dexamethasone dose during radiotherapy in both groups was not statistically different. Boswellic acids could be detected in patients' serum. CONCLUSIONS: BS significantly reduced cerebral edema measured by MRI in the study population. BS could potentially be steroid-sparing for patients receiving brain irradiation. Our findings will need to be further validated in larger studies. Cancer 2011;117:3788-

Frankincense essential oil prepared from hydrodistillation of Boswellia sacra gum resins induces human pancreatic cancer cell death in cultures and in a xenograft murine model

“…In addition, frankincense is considered as an alternative medicine in Arab countries and has been used as an anti-cancer agent to treat neoplastic diseases. In a prospective, randomized, placebo-controlled, double-blind clinical trial conducted in patients irradiated for brain tumors, an extract prepared from Boswellia serrata gum resins (H15) significantly reduces cerebral edema with anti-tumor properties, without severe adverse effects [9]. Boswellia serrata extracts is included as an adjuvant agent in patients with high grade gliomas under an ongoing phase II clinical trial ( http://www.cancer.gov/clinicaltrials/search/view?cdrid=445603&version=healthprofessional).…”

“…A methanol extract of Boswellia serrata inhibits abnormal skin cell proliferation induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) and tumor promotion initiated by 7,12-dimethylbenz[a]anthracene (DMBA) in a mouse model [8]. In a human clinical study, a Boswellia serrata resin extract has been shown to reduce cerebral edema and potential anti-cancer activity in patients irradiated for brain tumors [9]. These studies suggest that gum resins of Boswellia species contain active ingredients that have anti-cancer activity.…”

Enhanced Neuroprotection of Acetyl-11-Keto-β-Boswellic Acid (AKBA)-Loaded O-Carboxymethyl Chitosan Nanoparticles Through Antioxidant and Anti-Inflammatory Pathways

“…They have been studied or used for a variety of diseases including cancer, analgesia, asthma inflammation, arthritis, and colitis [6]. Clinically, B. serrata resin extracts can significantly reduce cerebral edema in patients [7], showing promise as a new agent for cardiovascular diseases. Furthermore, the European Medicines Agency granted extracts of B. serrata gum resin as the orphan drug to treat brain edema [8].…”

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“…A reduction of cerebral edema of >75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P ¼ .023) compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment. These findings may be based on an additional anti-tumor effect and BS significantly reduced cerebral edema measured by MRI in the study population and it could potentially be steroid-sparing for patients receiving brain irradiation 55 .…”