|Year : 2012 | Volume
| Issue : 1 | Page : 6-8
Glycyrrhiza glabra versus Boswellia carterii in chronic bronchial asthma: A comparative study of efficacy
Faruk H Al-Jawad1, Rafi AM Al-Razzuqi1, Hashim M Hashim2, Nisreen JM Al-Bayati3
1 Department of Pharmacology and Therapeutics, Al-Yarmouk University, Baghdad, Iraq
2 Department of Medicine, Al-Nahrain University, Baghdad, Iraq
3 Department of Pharmacology and Therapeutics, Babylon University, Babylon, Iraq
|Date of Web Publication||10-Dec-2012|
Faruk H Al-Jawad
Department of Pharmacology and Therapeutics, Al-Yarmouk University, Baghdad
Source of Support: Departments of Medicine / College of Medicine / Al-Nahrain University, Conflict of Interest: None
Bronchial asthma is a clinical syndrome with variable causes. It characterizes by episodes of broncho-constriction which leads to shortness of breath. In traditional medicine, some medicinal plants have been used to cure the asthmatic symptoms. We evaluate the bronchorelaxant effect of Boswellia carterii (Olibanum) and Glycyrrhiza glabra (Licorice) then to choose the better. 54 patients with chronic bronchial asthma were participated. After clinical assessment, estimation of pulmonary function tests and serum electrolytes: calcium, magnesium, potassium and selenium were done before and after the study. Boswellia carterii was given to 18 patients and glycyrrhiza glabra to another 18 patients while prednisolone was given to another 18 patients as control for 21 days. The results showed that the tested plants had significant elevation in the values of forced expiratory volume in first second (FEV1%) as (72.45±5.83 vs 61.33±6.04 and 81.10±11.07 vs 62.30±7.22) for olibanum and licorice respectively. Also, elevation in the values of forced volume capacity (FVC) with marked reduction in asthmatic attacks as (2.63±0.82 vs 0.72±0.16, 3.60±0.02 vs 1.08±0.08, and 2.25±0.16 vs 1.05± 0.15) for olibanum licorice and prednisolone respectively, but showed better symptomatic improvement with licorice as compared to olibanum. The results prove the superiority of glycyrrhiza glabra over boswellia carterii for chronic bronchial asthma.
Keywords: Licorice, olibanum, pulmonary function tests, selenium
|How to cite this article:|
Al-Jawad FH, Al-Razzuqi RA, Hashim HM, Al-Bayati NJ. Glycyrrhiza glabra versus Boswellia carterii in chronic bronchial asthma: A comparative study of efficacy. Indian J Allergy Asthma Immunol 2012;26:6-8
|How to cite this URL:|
Al-Jawad FH, Al-Razzuqi RA, Hashim HM, Al-Bayati NJ. Glycyrrhiza glabra versus Boswellia carterii in chronic bronchial asthma: A comparative study of efficacy. Indian J Allergy Asthma Immunol [serial online] 2012 [cited 2018 Jan 22];26:6-8. Available from: http://www.ijaai.in/text.asp?2012/26/1/6/104437
| Introduction|| |
Bronchial asthma is an inflammatory syndrome characterized by paroxysmal or recurrent episodes of bronchial obstruction causing shortness of breath, cough, chest tightness, wheezing and rapid respiratory rate.  Many factors are involved like air pollutants, mold species,  emotional factors,  obesity  and some medications as β-blockers and non-steroidal anti-inflammatory drugs.  Although the pathogenesis of chronic bronchial asthma (CBA) is complex, reactive oxygen species (ROS) have been shown to be directly associated with asthma pathogenesis and an oxidant-antioxidant imbalance.  ROS evoke bronchial hyperactivity through releasing both histamine from the mast cells and mucus from airway epithelial cells. 
G. glabra (Licorice), is a herbaceous perennial, with purple to whitish blue flowers and is native to the Mediterranean and certain areas of Asia. It contains:  glycosides, flavonoides, glycyrrhizin (the main active component), glycyrrhizic acid (has anti-viral effect),  saponins, phytoestrogens, starches (30%) and volatile oil with yellow coloring matter. B. carterii (Olibanum), is one of the oldest aromatic materials used by mankind, obtained from resin of trees of Burseraceae family. It is mainly used in traditional Chinese medicine to alleviate pain and inflammation.  It contains β-boswellic acid (the main active constituent that blocks cancer cell growth),  α-terpenoids, sugars, and volatile oils.
The relative absence of data in this domain is an incentive to evaluate the potential smooth muscle relaxation effect of these two medicinal plants in CBA.
| Materials and Methods|| |
The test medicinal plants were purchased from a well-known bureau for herbs (Al-Medina) in Baghdad and were identified and authenticated by Iraqi National center for Herbs. The plants were cleaned, dried, and powdered with an electrical grinder, and then passed through sieve no.40 to remove the debris. The sieved powder was stored in airtight container at room temperature. Licorice needs covering with boiling water for 15 minutes while olibanum needs soaking in water for 12 hours for use.
Fifty four patients of CBA, 31 males and 23 females, aged from 27-55 years (mean 41.66±0 .3 SD), participated in this randomized, open, and comparative clinical study. The participants were recruited from the outpatient clinic of Department of Medicine of Al-Kadhemiya Teaching Hospital from August 2009 to June 2010 excluding pregnant women, cigarette smokers, alcohol consumers and any disease other than chronic asthma. The trial was explained to all subjects and their consent was obtained.
Approval to conduct this study was granted by the ethical committee in College of Medicine/Al-Nahrain University (Registration No.HEC/41/09/CMANU). The patients were advised to stop medication and prevent any exercise or exposure to any allergen at least 24hrs prior to test. They were randomly allocated to three groups of 18 patients each and received oral daily dose of the following for three weeks
Group I -served as positive control - received 0.15mg/kg/day of prednisolone as a single dose.
Group II - received 3mg/kg of Olibanum thrice daily.
Group III - received 3.5mg/kg of Licorice in 200 ml of water thrice daily.
Blood samples were taken before and at the end of experiment from all the participants. Serum magnesium (Mg +2 ) and serum selenium (Se +2 ) were estimated by using GFA-4B graphite tube with auto sample absorption photometer. Serum calcium (Ca +2 ) and serum potassium (K + ) were measured by using flame emission spectrophotometer.
Pulmonary function tests (forced volume capacity FVC and forced expiratory volume in first second FEV 1 %) were performed using a computerized spirometer (Autospiron chest corporation Tokyo-Japan).
All the results were expressed as mean±standard error mean (SEM). The difference among means has been analyzed by student's t test. A probability value of P<0.05 was considered to be statistically significant.
| Results|| |
The results revealed significant elevation in FEV 1 % of olibanum and licorice as (72.45±5.83 vs. 61.33±6.04, and 81.10±11.07 vs. 62.30±7.22) respectively. Also, significant elevation was showed in FVC/L of olibanum and licorice in addition to prednisolone as (2.63±0.82 vs. 0.72±0.16, 3.60±0.02 vs. 1.08±0.08, and 2.25±0.16 vs. 1.05± 0.15) respectively, but with superiority to licorice [Table 1]. Elevations in serum electrolyte levels were also significantly confirmed the above obtained results [Table 2].
|Table 1: The effect of Glycyrrhiza glabra, Boswellia carterii and Prednisolone on pulmonary function parameters in chronic asthmatic patients|
Click here to view
|Table 2: The effect of Glycyrrhiza glabra, Boswellia carterii and Prednisolone on serum electrolytes levels in chronic asthmatic patients|
Click here to view
| Discussion|| |
Bronchial asthma is an inflammatory condition with episodes of bronchial muscle contraction resulted from releasing of leukotrienes (LTs). Prednisolone which is used in group I, produces bronchial muscle relaxation indirectly through inhibiting the release of LTs and reversing mucosal edema.  In group II with olibanum, The pentacyclic triterpenic acids like α-acids(potent anti-inflammatory substances of boswellia gum resin extract) inhibit polymorphonuclear leukocyte infiltration(the prominent cells of inflammation),  and inhibit the human leukocyte elastase, which is involved in the pathogenesis of chronic bronchitis, emphysema, and acute respiratory distress syndrome.  Also, acetyl-11-keto-β-boswellic acid of boswellia has been identified to prevent the release of LTB4 which are potent inducers of broncho-constriction.  In group III, licorice has similar effect as prednisolone but more potent. This is because glycyrrhizin (the active ingredient) has corticosteroid like activity, while the antispasmodic effect is related to the flavonoids present in the plant.  Changes of serum electrolytes levels in asthmatic patients showed positive correlation between serum Se +2 and Mg +2 levels and each FEV 1 % and FVC. Our results agreed with a study showed that if serum Se +2 and Mg +2 levels decreased the possible risk of asthma would be increase due to reduction in glutathione peroxide and antioxidant activity and vice versa.  Most of the asthmatic patients recorded low levels of serum Ca +2 before treatment and this is due to increased intracellular Ca +2 in leukocytes that directly correlated with severity of asthma. 
| Conclusion|| |
Glycyrrhiza glabr and boswellia carterii can be used in prophylaxis and relieving the symptoms of CBA due to their efficacy but with the superiority of glycyrrhiza glabra.
| Acknowledgment|| |
We would like to express our appreciation to Mr. Thulfuqar R Al-Majeed Al-Razzuqi (Department of Medical Laboratory Sciences, Al-Yarmouk University) for his help in examination the blood samples along work time.
| References|| |
|1.||Drazen JM. Respiratory disease. In: Cecil, editor. Textbook of medicine, 21 st ed; Philadelphia: WB Sanders Comp; 2004. p. 504-8. |
|2.||Homer A, Bertream G. Katzung: Drugs used in asthma; Basic and clinical pharmacology. 10 th ed. New York: Mcgraw Hill; 2010. p. 319. |
|3.||Guerra S, Sherrill DL, Bobadilla A, Martinez F. The relation of body mass index to asthma, chronic bronchitis. Chest 2002;122:1256-63. |
|4.||Szczeklik A, Stevenson DD. Aspirin-induced asthma advances in pathogenesis, diagnosis and management. J Allergy Clin Immunol 2003;111:913-21; quiz 922. |
|5.||Repine JE, Bast A, Lankhorst I. Oxidative stress in chronic obstructive stress in chronic obstructive pulmonary disease, oxidative stress study group. Am J Respir Orit Care Med 1997;156:341-57. |
|6.||Cortigo J, Marti-Cabrera M, Dela Asuncion JG, Pallardo FV, Estero A, et al. Contraction of human airways by oxidative stress protection by N-acetylcysteine. Free Radical Biol Med 1999;27:392-400. |
|7.||Shibata S. A drug over the millennia: Pharmacognosy, chemistry, and pharmacology of licorice. Yakugaku Zasshi 2003;120:849-62. |
|8.||Curreli F, Friedman K, Alvin E, Flore O. Protective mechanism of glycyrrhizin on acute liver injury induced by carbon tetrachloride in mice. Biol Pharm Bull 2007;30:1898-904. |
|9.||Fan AY, Lao L, Zhang RX, Zhou AN, Wang LB, Moudgil KD, et al. Effects of an acetone extract of Boswellia carterii Birdow. (Burseraceae) gum resin on adjuvant-induced arthritis in lewis rats. J Ethnopharmacol 2005;101:104-9. |
|10.||Takada Y, Ichikawa H, Badmaev V, Aggarwal B. Acetyl-11-keto-beta-boswellic acid potentiates apoptosis, inhibits invasion, and abolishes osteoclastogenesis by suppressing NF-kappa B and NF-kappa B-regulated gene expression. J Immunol 2006;176:3127-40. |
|11.||Kulkarni RR, Patki PS, Jog VP, Gandage SG, Patwardhan B. Treatment of osteoarthritis with a prednisolone formulations: A double-blind, placebo-controlled, cross-over study. J Ethnopharm 1991;33:91-5. |
|12.||Gupta I, Gupta V, Parihar A, Ludtke R, Safayhi H. Effects of Boswellia serrata gum resin in patients with bronchial asthma: Results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511-4. |
|13.||Mikhaeil BR, Maatooq GT, Badria FA, Amer MM. Chemistry and immunomodulatory activity of frankincense oil. Z Naturforsch C 2003;58:230-8. |
|14.||Altmann A, Poeckel D, Fischer L, Schubert-Zsilavecz M, Steinhilber D, Werz O. Coupling of β-boswellic acid-induced Ca2 + mobilisation and MAPK activation to lipid metabolism and peroxide formation in human leucocytes. Br J Pharmacol 2004;141:223-32. |
|15.||Al- Jawad FH, Al-Jumaily W. The relaxant effect of some drugs and aqueous extract of medicinal plants on bronchial smooth muscle in rabbits. Tikrit J Pharm Sci 2005;1:58-63. |
|16.||Al-amoudi OS. Hypomagnesemia and reduced selenium are chronic stable asthmatic prevalence. Correlation with severity and hospitalization. Eur Res 2000;16:427-31. |
|17.||Chhabra SK, Khanduja A, Jain D. Increased intracellular Ca +2 and decrease activities of Na, K ATPase and Ca ATPase in asthma. Clin Sci 1999;97:595-601. |
[Table 1], [Table 2]