Boswellic acids in liver health: Potential against Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disorder globally, with limited pharmacological treatment options. Recent scientific interest has turned to natural compounds with multi-targeted effects, such as Boswellic acids (BAs), derived from the gum resin of Boswellia species. BAs, particularly acetyl-11-keto-β-boswellic acid (AKBA), exhibit potent anti-inflammatory and antioxidant properties, making them promising candidates for hepatoprotection. This mini-review explores the mechanistic role of BAs in managing NAFLD and highlights key findings from preclinical studies. BAs mitigate NAFLD progression by inhibiting inflammatory pathways like NF-κB and 5-lipoxygenase (5-LOX), enhancing antioxidant defense via Nrf2 activation, and modulating lipid metabolism. In animal models, BA supplementation has led to reductions in hepatic steatosis, fibrosis, and serum liver enzymes. Despite limited clinical data in NAFLD patients, BAs have demonstrated liver function benefits and safety in trials on other chronic inflammatory diseases. However, challenges such as low bioavailability, lack of standardization, and insuficient human trials hinder their clinical adoption. Future directions include advanced delivery systems and well-designed clinical studies. Overall, Boswellic acids hold significant potential as nutraceutical agents in liver health and warrant further exploration in NAFLD therapy.