Frankincense: A potential phytotherapeutic agent in cancer treatment

Plant-isolated compounds are the roadmap for the modern pharmaceutical industry due to the anticancer activities of their bioactive constituents and metabolites. Boswellia sacra (Burseraceae) oleo gum resin has cytotoxic potential for the cure of various ailments, including infectious, inflammatory and arthritic diseases. Cancer is a complex health condition characterized by gene mutation and increased cell number. Worldwide, cancer is regarded as the most critical reason for morbidity and mortality. Traditional Chinese medicine, Ayurveda and Arab folk medicine all utilized it as an anticoagulant, antimicrobial, immunomodulatory and antidiabetic agent. Boswellic acids (BA), an active component of frankincense isolated from the dried gum resin of B. sacra has been utilized for the cure of several ailments, including inflammatory diseases, cancer, cerebral edema, asthma, chronic pain syndrome, arthritis, memory disorders and chronic bowel diseases since years. This study was designed to summarize the recent scientific knowledge regarding the anti-cancer properties of Frankincense (Olibanum), which is obtained from the B. sacra. However, further studies are required to elucidate its exact underlying molecular mechanisms in cancer treatment. Frankincense's ability to reduce inflammation is mediated by inhibition of several pathways like LOX, COX-2 pathway and downregulation of CXCR4, VEGF, NF-κB and matrix metalloproteinases MMPs. BA also displayed an anti-proliferative effect and induced apoptosis in several cancer cells, such as HCT-116 and MCF-7 cells. AKBA (3-O-acetyl-11-keto-β-boswellic acid) has been shown to activate extrinsic apoptotic pathways by causing the cleavage of procaspases and PARP and to inhibit the Wnt/β-catenin, PI3K/AKT and EGFR pathways, while activating the ATM/P53 signaling pathway. The therapeutic potential and anticancer properties of frankincense are still in the early stages of investigation. This review summarizes the efficacy of BA in various types of cancer and provides a wide scope of study on the anti-cancer properties of BA in terms of the development of novel drugs that would be more helpful both physically and economically.