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Extract from gum resin of Boswellia serrata decreases [IA.sub.2]-antibody in a patient with "Late onset Autoimmune Diabetes of the Adult" (LADA).

Type 1 diabetes and the Late onset Autoimmune Diabetes of the Adult (LADA) are autoimmune diseases where a chronic inflammation of pancreatic islets causes [beta]-cell apoptosis leading to insulin deficiency. Recently it has been reported that an alcoholic extract of the gum resin of Boswellia serrata and two of its active compounds i.e. 11-keto-[beta]-boswellic acid (KBA) and 0-acetyl 11-keto-[beta]-boswellic acid (AKBA) prevent insulitis in two animal models with autoimmune diabetes (Shehata et al., 2011; Ammon and Shehata 2011). Markers being characteristic for Type 1 diabetes and LADA are islet cell antibodies (1CA), glutamatedecarboxylase antibodies (GAD-A) and tyrosinphosphatase antibodies ([IA.sub.2]-A).

Here we report a female patient, 50 years old with a body weight of 72 kg, where diabetes was first diagnosed on 16 November 2012. At this time blood glucose level was 390mg/dl and [HbA.sub.1c] 11.6%. The patient (see Table 1) was treated with Metformin, but there was no significant improvement of blood glucose and [HbA.sub.1c]. On 15th January 2013, testing for IA2-A which is a marker of insulitis--yielded 25 K/U/L suggesting a case of LADA. Therapy was changed to insulin (Humalog[TM], Huminsulin basal[TM]) 10-15 U per day. Thereafter blood glucose and [HbA.sub.1c] dropped significantly. Additional treatment of the patient with an alcoholic extract from the gum resin of B. serrata (Indian Boswellia the Original[TM]), (1) containing 3.6% KBA and 1.4% AKBA, (2) 3 times daily 2 tablets with 400 mg for 8.5 weeks resulted in a drop of [IA.sub.2]-A to normal values and in addition there was a further decrease of blood glucose and [HbA.sub.1c].

As far as the effect of the Boswellia extract on [1A.sub.2]-A is concerned, the data is in line with observations of Sharma et al. (1996) reporting, that boswellic acids inhibited antibody production in mice sensitized with sheep erythrocytes.

This is the first report where an extract of the resin of B. serrata not only prevents insulitis in animal models, but also seems to prevent insulitis in a patient with LADA as indicated by its action on a marker of autoimmune diabetes--in this case [IA.sub.2]-antibodies.

We are aware, that this is only one case with all its restrictions. But it may stimulate other attempts to strengthen the hypothesis that boswellic extracts or boswellic acids including KBA and AKBA may be an option for prevention/treatment of autoimmune diabetes.

References

Ammon, H.P.T., Shehata, A.M., 2011. Prevention of multiple low dose streptozotocin (MLD-STZ) induced diabetes in mice by extract from gum resin of Boswellia serrata and 11-keto-[beta]-boswellic acids. Diabetologia 54 (Suppl. 1), S437.

Shehata, A.M., Quintanilla-Fend, L, Bettio, S., Singh, C.B., Ammon, H.P.T., 2011. Prevention of multiple low-dose streptozotocin (MLD-STZ) diabetes in mice by an extract from gum resin of Boswellia serrata (BE). Phytomedicine 18, 1037-1044.

Sharma, M.L., Kaul, A., Khajura, A., Singh, S., Singh, C.B., 1996. Immunmodulatory activity of boswellic acids (pentacyclic triterpene acids) from Boswellia serrata. Phytother. Res. 10, 107-112.

E. Schrott (a), S. Laufer (b), M. Lammerhofer (b), H.P.T. Ammon (c),*

(a) Steyrerweg 11,93049 Regensburg, Germany

(b) Department of Pharmaceutical and Medical Chemistry, Institute of Pharmaceutical Sciences, University of Tuebingen, Aufder Morgenstelle 8, 72076 Tuebingen, Germany

(c) Department of Pharmacology, Institute of Pharmaceutical Sciences, University of Tuebingen, Aufder Morgenstelle 8, 72076 Tuebingen, Germany

* Corresponding author at: Auf der Morgenstelle 8. 72076 Tubingen, Germany. Tel.: +49 07071 /2974675; fax: +49 07071/292476.

E-mail address: sekretariat.ammon@uni-tuebingen.de (H.P.T. Ammon).

(1) Manufactured by Indian Boswellia Laboratory, Agra, India.

(2) Assayed with an Agilent 1100 LC-MSD-Trap combination.

http://dx.doi.org/10.1016/j.phymed.2014.02.004
Table 1
Extract from Gum Resin of Bosellila serrata normalizes
Tyrosinphosphate [IA.sub.2]-Antibody. ([IA.sub.2]-A) in a Patient
with Late-Onset Autoimmune Diabetes of the Adults (LADA).

Time Schedule        Blood       HbA 1 c%    [IA.sub.2]-A
of Measurements     glucose                      K/U/L
and Therapy          mg/dl

16.10.2012            391          11.9           --
15.11.2012            391          11.6           --
09.01.2013            333          13.7           --
15.01.2013             --           --            25
16.01.2013             --           --            --
19.02.2013            107           --            --
20.02.2013             --           --            --
21.03.2013            129           7.3           --
23.04.2013             84           --            --
24.04.2013             70           --            10
22.05.2013             --           --            10
08.07.2013             99           6.2           --

Time Schedule           Therapies
of Measurements
and Therapy

16.10.2012              Metformin
15.11.2012
09.01.2013
15.01.2013
16.01.2013
19.02.2013
20.02.2013
21.03.2013                Indian
23.04.2013        Boswellia[TM] Insulin
24.04.2013
22.05.2013
08.07.2013
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Author:Schrott, E.; Laufer, S.; Lammerhofer, M.; Ammon, H.P.T.
Publication:Phytomedicine: International Journal of Phytotherapy & Phytopharmacology
Article Type:Clinical report
Date:May 15, 2014
Words:788
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