Potassium Salt of Boswellic Acid To Managing Hypokalemia Associated With Irritable Bowel Syndrome (IBS) During Pregnancy

Abstract

Triterpenoids Boswellic acids derived from the resin of Boswellia serrata have proven to be natural anti-inflammatory substances. They have the potential to inhibit 5- lipoxygenase (5-LOX) and inflammatory cytokines like TNF-α and IL-1β which are known to worsen mucosal inflammation. Irritable Bowel Syndrome (IBS) is a long-lasting disorder of the digestive system that manifests in form of abdominal discomfort, bloating, changes in bowel movement, and greatly reduced quality of life. The causes are many; however, more recent studies uncovered a contribution of systemic electrolyte imbalance, especially hypokalemia, in aggravating the inflammatory processes linked to IBS. Hypokalemia, which is a condition where serum potassium levels are less than 3.5 mmol/L, not only decreases the peristaltic movement of smooth muscles and neuromuscular transmission in the intestinal tract but leads to inflammation of the lining or mucosal membrane which tends to worsen the symptoms of IBS. Boswellic acids are pentacyclic triterpenoids extracted from the resin of Boswellia serrata that possess potent anti-inflammatory effects via 5-lipoxygenase inhibition and down regulation of pro-inflammatory cytokines. This study investigates the use of a new compound, the potassium salt of boswellic acid, which may use inflammatory aspect of boswellic acid in addition to potassium’s property of mitigating electrolytic imbalance, for treating inflammation in Hypokalaemia associated Inflammatory Bowel Syndrome (IBS). In our in vitro experiments, we observed that potassium starvation greatly reduced the secretion of pro-inflammatory factors like TNF-α, IL-6, and NFκB from the intestinal epithelial cells. Furthermore, the compound appear to positively influence the tight junctions which could bolster the maintenance of intestinal barrier protection. In an initial clinical assessment of patients with hypokalemic IBS, the use of boswellic acid potassium salt over a six-week period was associated with significant worsened symptom scores, increased potassium levels, and decreased CRP examinations.