Introduction
The consumption and application of frankincense is closely related to the cultural and historical use of resins for ritual and mystic purposes. Apart from the traditional significance of the natural resin for cosmetics and perfumes, the medical therapeutic application is recently focused to the centre of attention.
The therapeutic effectiveness of the frankincense is pharmacologically validated. This shows that modern clinical research of traditional medicine from other cultures is important to western medicine.
Particular in the long-term treatment of chronicle preceding illnesses the school medicine does not sufficiently meat the requirements of patients, since with the use of medicine such as glucocorticosteroides or non-steroidal anti-inflammatory drugs (NSAIDS) substantial side effects can arise.
With boscari® we have a property in our hand, with which we can pursue an up-to-date direction while comprising proven effectiveness, gentle application and smallest side effect. boscari® is a registered and protected natural drug derived from the Boswellia genus, Boswellia carterii, originating from Eritrea (north-east Africa).

Chemical Constituents
Characteristic groups of frankincense are gum resins, with can be gained by scratching the bark of a Boswellia tree. Milk-like components escape from the wound. After water has evaporated the dried up resin still contains a mixture of ethereal oils, resin materials, mucus and proteins.
The main active substances of frankincense are the pentacyclic triterpenoid boswellic acids, which qualitatively and quantitatively differ depending on the Boswellia genus. Analysis reveals exceedingly high concentrations of boswellic acids (especially of AKBA, KBA and AcBA; see below) over other Boswellia plants. Meanwhile 14 genuine occurring derivatives of boswellic acids have been identified: alpha- and beta-boswellic acids, acetyl-11-keto-beta-boswellic acid (AKBA), 11-keto-beta-boswellic acid (KBA) and acetyl-beta-boswellic acid (AcBA) which together make up over 90 % of the mixture. In particular the acetylated boswellic acid is probably most important.

Pharmacology
According to recent scientific research boswellic acids (AKBA, KBA and AcBA) are very interesting biological active agents. Boswellic acids derived from the natural product frankincense represent a specific inhibitor of 5-Lipoxygenase (5-LO). The enzyme 5-LO selectively, in concert with other mediator substances, results in the biosynthesis of leukotrienes (LT), which on their behalf promote inflammation, bronchial spasm and enhancing the chemo taxis of macrophages.
Noxious substances, pathogenic micro organisms, endogenous messengers or connective tissue lesions can result in the activation of the arachidonic acid cascade. Arachidonic acid is released from the membrane phospholipids and undergoes further metabolism by either, the enzyme cyclooxygenase (Cox) to prostaglandins (PG) or via the enzyme 5-LO to leukotrienes (LT). Both PG and LT are tissue hormones involved as mediators in the processes of inflammation.

Currently used inflammation inhibitors are primarily those that block the synthesis of PG and LT. Medical drugs that exclusively block the formation of LT are so far not available on the market. Therapeutically inflammation is essentially treated using substance classes that block the synthesis of PG (acetylsalicylate) or block both PG and LT synthesis (glucocorticosteroids). With both substance classes inflammation can be suppressed, but we all are aware of the substantial side effects that can lead to chronic illnesses especially with a long-term application.

It is speculated boswellic acids may suppress inflammation by inhibiting the activation of complement.
Experimental investigations suggest that frankincense, by an increase of lysosomal stability may inhibit inflammation. This happens by reducing the elimination of hydroxyprolin (and its metabolites) and through the inhibition of the catabolism of glycosaminoglycans.

Furthermore in vitro tests show that AKBA inhibits two proteases, the leukocyte elastase and plasmin. In vitro studies also show that at higher concentrations boswellic acids inhibited the proliferation of tumor cells, possibly via inducing tumor cells to undergo programmed cell death (apoptosis). In a hepato-toxic model certain hepato-protective effects of boswellic acids were observed through the partial inhibition of the cholesterol biosynthesis.

Therapeutic Applications

The boswellic acids of boscari® represent a new class of anti-inflammatory agents that selectively inhibit the synthesis of LT. This represents a unique mechanism and a completely new approach of blocking the inflammatory cascade. Particularly this is eminent for the therapy of chronic inflammations, allergic illnesses and tumors because substances aiming the explicit elimination of LT-synthesis are not available at present.A variety of chronic diseases is predominantly accompanied by excessive formation of LT and hence support and prolong the inflammatory process. LT are not only important for the inflammatory pathway but also responsible for bronchial contraction and invasion of other pro-inflammatory substances. Boscari® has important applications in the therapy of chronic inflammatory diseases, allergic diseases and tumor induced oedema. Furthermore an effect of boscari® at higher concentrations on tumor cells (Glioblastoma, Astrocytoma, brain metastases) is being observed (see most resent results from the Grönemeyer-Institut of Microtherapy, Dr. H. Sahinbas).

Safety and Side Effects
Toxicological data from animal models shows no acute (LD50 with rats and mice > 2g/kg) or chronic (125-500 mg/kg/day with Rhesus apes) toxicity. Regarding biochemical, haematological and histo-pathological clinical parameters no significant aberrations as well as abnormalities in behaviour were observed. Additionally according to mutagenic and genetic testing of cell lines (AMES test, chromosomal aberration test and cell transformation test) frankincense showed no potential for DNA aberrations or tumorogeneticity.
Side effects such as local skin irritations with pruritis, nausea and diarrhoea occur seldom.
Due to incomplete data related to reproduction toxicity, namely the transfer into breast milk, the consumption of boscari® during pregnancy and lactation should be avoided.
Interactions with other drugs were so far not observed.

Therapeutic Concept for Treatment with boscari® Frankincense Caps,
Boswellia carterii
The treatment of patients with boscari® should to be regarded as a complementary therapeutic approach embedded in an adjuvant concept. It is not supposed to replace first line drugs used in primary therapy.
However clinical experience with boscari® reveals that in patients refractory to western medicine, long-term therapy with boscari® can substitute these first line drugs: For example a) gold compounds and sulphasalazine at patients suffering chronic polyarthritis, b) NSAIDS and/or glucocorticosteroides at patients having Crohns disease, ulcerative colitis disease, polyarthritis and peri-tumorale brain oedema.
Unfortunately patients were given advice by mass media concerning the application of frankincense. Such unprofessional information, witch leads patients to accomplish chronic illnesses in self medication is thoughtless. Essential for a therapy with boscari® is the absolute guidance and monitoring of the patients by an experienced therapists. Patient, affected by chronic illnesses, expect no assumptions or speculations over possible effects, but clear estimates regarding risks, safety and benefits of the potential treatment.
Based on experience with frankincense so far, we know that the dosage of boscari® is of primary importance to achieve the desired effectiveness. Incorrect dosages can even lead to degradation of the illness.

Apart from subjective parameters the normality of inflammation parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein, leucocyte counts (thrombocytes and lymphocytes) and fibrinogen should be monitored.
The concerned physician should be aware of the long-term therapy concerning the application of boscari®. This therapy is embedded in a complementary-medical approach and thus should not be considered as a drug derived from school-medicine.
The resin fraction of Boswellia carterii contains 65% - 70% boswellic acids. Depending upon the genus of the master plant the concentration of effective boswellic acids differs extremely and therefore requires a standardisation. Each boscari® capsule (400 mg Olibanum frankincense according to Dr. Fernando) is titrated to 40 mg AKBA, KBA and AcBA. The Boswellia genus from northeast Africa, in particular Eritrea, delivers an outstanding quality of the pharmaceutical drug and is free from heavy metals and preservatives. Throughout production of the capsules the entire pulverised resin of Boswellia carterii is inserted without extraction and concentration. The capsules are manufactured without any addition of supplementary materials.

From the phyoto-therapeutical point of view the healing power of frankincense, is not reduced to the intrinsic activity of individual enriched components, but results in the synergy effect derived from the cooperation of all components of the hole plant, as it only can occur in nature. This synergy effect underlines the effectiveness of healing power originated from plants by the unique balance of all occurring ingredients. It is recommended that for the period of therapy with boscari® other medicines should never be reduced abruptly but slowly, probably until set off.
The initial dose refers to a treatment of 6 - 8 weeks; for tumor diseases 6 - 12 months. Subsequently, depending on the initial dose, the dosage can be reduced according to the normalisation of diagnostic parameters and the tendency of the therapeutic process. boscari® capsules are to be taken orally with copious volumes of water after meals.

Dosage recommendation
Initial dose: 3 x daily 2 - 5 boscari® capsules
Acute treatment: 3 x daily 4 - 5 boscari® capsules

Package size boscari®
100 capsules at 400 mg per cap., 41,80 Euro; (condition: July 2005)

Present clinical studies
Universitätsklinikum Charité, 10117 Berlin
Phase II -III with permission of the Ethical Commission.

1. Effectiveness and compliance of boscari® with patients with bronchial Asthma. Study line: Prof. Dr. Witt, Prof. Dr. Kiesewetter

2. Effectiveness and compliance of boscari® with patients with chronic Polyarthritis. Study line: Prof. Dr. Burmester, Prof. Dr. Kiesewetter

3. Effectiveness and compliance of boscari® with patients with Migraine. Study line: Dr. Jansen, Prof. Dr. Kiesewetter

Further Literature
Weihrauch und seine heilende Wirkung
Heidelore Kluge, Dr. R. Charles Fernando, Dr. Michael Winking, Haug publishing house, Heidelberg, 1998

Weihrauch Gold und Myrrhe
Heidelore Kluge, Dr. R. Charles Fernando, Edzard F. Keibel, Haug publishing house, Heidelberg, 1999