Potential therapeutic effects of boswellic acids/Boswellia serrata extract in the prevention and therapy of type 2 diabetes and Alzheimer's disease

Naunyn Schmiedebergs Arch Pharmacol. 2021 Nov;394(11):2167-2185. doi: 10.1007/s00210-021-02154-7. Epub 2021 Sep 20.


The link between diabetes and cognitive dysfunction has been reported in many recent articles. There is currently no disease-modifying treatment available for cognitive impairment. Boswellia serrata (B. serrata) is used traditionally to treat chronic inflammatory diseases such as type 2 diabetes (T2D), insulin resistance (IR), and Alzheimer's disease (AD). This review aims to highlight current research on the potential use of boswellic acids (BAs)/B. serrata extract in T2D and AD. We reviewed the published information through June 2021. Studies have been collected through a search on online electronic databases (Academic libraries as PubMed, Scopus, Web of Science, and Egyptian Knowledge Bank). Accumulating evidence in preclinical and small human clinical studies has indicated that BAs/B. serrata extract has potential therapeutic effect in T2D and AD. According to most of the authors, the potential therapeutic effects of BAs/B. serrata extract in T2D and AD can be attributed to immunomodulatory, anti-inflammatory, antioxidant activity, and elimination of the senescent cells. BAs/B. serrata extract may act by inhibiting the IκB kinase/nuclear transcription factor-κB (IKK/NF-κB) signaling pathway and increasing the formation of selective anti-inflammatory LOX-isoform modulators. In conclusion, BAs/B. serrata extract may have positive therapeutic effects in prevention and therapy of T2D and AD. However, more randomized controlled trials with effective, large populations are needed to show a definitive conclusion about therapeutic efficacy of BAs/B. serrata extract in T2D and AD.

Keywords: Adiposity and insulin resistance; Alzheimer’s disease; Anti-inflammatory; Boswellia serrata extract; Boswellic acids; Immunomodulator.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / prevention & control
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / isolation & purification
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Antioxidants / isolation & purification
  • Antioxidants / pharmacology
  • Boswellia / chemistry*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / prevention & control
  • Humans
  • Immunomodulating Agents / isolation & purification
  • Immunomodulating Agents / pharmacology
  • Plant Extracts / pharmacology*
  • Randomized Controlled Trials as Topic
  • Triterpenes / isolation & purification
  • Triterpenes / pharmacology*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antioxidants
  • Immunomodulating Agents
  • Plant Extracts
  • Triterpenes
  • boswellic acid