From preclinical to clinical evidence: exploring the multiple perspectives and healing power of Boswellia serrata Roxb. ex Colebr

Boswellia serrata Roxb. ex Colebr. is a species belonging to the Burseraceae family, typical of dry environments of the Indian region. The oil-gum-resin, obtained from the trunk and thick branches, is known in phytotherapy for the volatile fraction which contains up to 70% terpenes. The most important and characteristic constituents are represented by pentacyclic triterpenes, named boswellic acids. B. serrata is known for multiple beneficial effects, mainly correlated to anti-inflammatory activity. This review aims to provide a comprehensive overview on the activities and potential applications of B. serrata based on clinical and preclinical evidence. An up-to-date literature review of preclinical and clinical studies related to the applications of B. serrata preparations in different pathological conditions was conducted using the main databases of scientific literature. A body of evidence point out the role of B. serrata extracts and its active constituents in the treatment of several inflammatory diseases. In particular, clinical trials revealed its use as a topical remedy of skin diseases, such as eczema and psoriasis, and internally in the treatment of asthma, intestinal and osteoarticular inflammatory diseases. Preclinical findings highlighted the positive effects of B. serrata extracts in cardiovascular and neurodegenerative diseases, and in cancer. Finally, B. serrata finds application as a feed additive in veterinary use. Although some limitations must be overcome, such as poor bioavailability, evidence supports that B. serrata is a promising medicinal plant. Furthermore, the use of B. serrata appears to have a favorable toxicological profile, but caution may be necessary regarding potential botanical-drug interactions.