Therapeutic potential of Boswellia serrata in arthritis management: mechanistic insights into COX-2, 5-LOX, and NFĸB modulation.

Arthritis is a chronic inflammatory disorder characterized by joint pain, stiffness, and progressive cartilage degeneration, significantly impacting patient's quality of life. Current pharmacological treatments, including nonsteroidal anti-inflammatory drugs and corticosteroids, provide symptomatic relief but are associated with adverse effects and limited long-term efficacy. Boswellia serrata, a medicinal plant with a long history of use in traditional medicine, has gained attention for its potential in arthritis management due to its anti-inflammatory, chondroprotective, and immunomodulatory properties. The bioactive constituents, particularly boswellic acids, have been shown to inhibit primary inflammatory pathways including NFĸB, COX-2, and 5-LOX, thereby reducing inflammation and cartilage degradation. Preclinical and clinical studies suggest that Boswellia serrata alleviates pain, improves joint mobility, and slows disease progression with a favorable safety profile compared to conventional therapies. Despite these promising findings, challenges such as limited large-scale clinical trials, variability in extraction methods, and low bioavailability hinder its clinical application. Future research should focus on optimizing formulation strategies, exploring synergistic effects with existing therapies, and conducting high-quality randomized controlled trials to validate its efficacy and safety. In addition, mechanistic studies investigating its molecular targets and interactions with the gut microbiome could provide deeper insights into its therapeutic potential. This review critically evaluates the current evidence on Boswellia serrata in arthritis management, highlights existing research gaps, and discusses future directions for its clinical development. Addressing these challenges will facilitate its integration into mainstream medicine, offering a natural, safer, and potentially more effective alternative for arthritis treatment.