Exploring boswellic acids as a multitarget therapeutic treatment for Alzheimer’s disease

Boswellia (oleo-gum resin) is used in traditional medicine to treat neurological conditions, including Alzheimer’s disease (AD). It has been shown to include a range of bioactive substances with different pharmacological effects and therapeutic potential. Boswellic acids have been recently studied as a potential therapeutic agent for neurological conditions. The present review aims to provide a widespread analysis of the traditional medicinal uses of several species and parts of Boswellia in relation to multiple pathways implicated in AD. This review covers recent preclinical and clinical studies on Boswellia extracts (BE) and boswellic acids (BAs) for AD, drawing information from scientific electronic databases. The majority of the scientific literature suggests that anti-inflammatory, antioxidant, amyloid beta (Aβ), and tau inhibition with acetylcholinesterase (AChE) inhibition mechanisms may underlie the possible therapeutic effects of BAs/BE in AD. Preclinical and limited human clinical trials indicate that BE/BAs may have a therapeutic impact in AD, pointing to their beneficial potential in treatment and prevention. However, current evidence faces limitations such as poor bioavailability of BAs and inconsistent outcomes from few clinical studies. Moreover, hypotheses regarding the efficacy of BE/BAs in altering disease progression and determining optimal dosing remain unproven in large, well-controlled human studies. To definitively establish the therapeutic effectiveness of BAs/BE in AD, further randomized controlled trials involving larger, well characterized populations are necessary. This would confirm their use as promising multi-target drug candidates addressing the complex pathways involved in AD.