AKBA and the 5-lipoxygenase target
Boswellia serrata, the source of frankincense resin, contains boswellic acids, of which AKBA (acetyl-11-keto-beta-boswellic acid) is the most studied. AKBA inhibits 5-lipoxygenase (5-LOX), an enzyme that converts arachidonic acid into leukotrienes. Leukotrienes are inflammatory mediators involved in conditions with a strong inflammatory component, so dampening their production is the proposed anti-inflammatory route.
This 5-LOX pathway is distinct from the cyclooxygenase (COX) pathway that common NSAIDs target, which is part of why boswellia is studied as a different kind of modulator.
What the human studies suggest
Some clinical trials, mainly in osteoarthritis, report modest improvements in pain and function with standardized boswellia extracts, but trials are often small and of variable quality, and extract standardization differs between products. The mechanism is well characterized in the lab; the clinical magnitude is less certain.
This is general educational information, not medical advice. Boswellia is not a substitute for diagnosis or prescribed treatment, may interact with medications, and should be discussed with a clinician, particularly by anyone who is pregnant or on anti-inflammatory or anticoagulant drugs.