Boswellia serrata, commonly known as Indian frankincense, has been studied for its anti-inflammatory and anti-fibrotic properties, primarily attributed to its active constituents called boswellic acids. Preclinical studies, especially in animal models, have shown that Boswellia extract may inhibit key pathways involved in fibrosis, such as the TGF-β/Smad signaling pathway, and can reduce the deposition of extracellular matrix components in tissues. For example, research in rodent models of liver and pulmonary fibrosis demonstrated that administration of Boswellia extracts led to decreased markers of fibrosis and improved tissue histology. Mechanistically, boswellic acids appear to suppress the production of pro-fibrotic cytokines and block fibroblast proliferation.

However, evidence in humans is very limited. There are few, if any, well-conducted clinical trials specifically evaluating Boswellia serrata for treating established fibrotic conditions (such as pulmonary fibrosis or liver cirrhosis) in humans. Most human research has focused on its anti-inflammatory effects in conditions like osteoarthritis or inflammatory bowel disease. As such, while there is preclinical scientific rationale and some promising animal data, clinical validation in humans is lacking. Thus, the evidence supporting its use for fibrosis is best rated as limited (2/5), and it should not be considered a proven or standard therapy for fibrotic diseases at this time.