This 2025 multicentre trial gave 62 people with knee osteoarthritis a combination of Boswellia serrata gum resin (300 mg) and celery seed extract (250 mg), or placebo, for 90 days. Pain, stiffness and swelling improved, inflammatory and collagen breakdown markers fell, and two markers of new type II collagen rose.
Sixty-two participants took part in a randomised, double-blind, placebo-controlled trial run at several centres. The treatment combined standardised Boswellia serrata gum resin (300 mg) with Apium graveolens (celery) seed extract (250 mg). The team assessed function and pain with WOMAC, a visual analogue scale, a physician's assessment and a six-minute walk, took knee X-rays, used the KOOS and FACIT-F questionnaires, and measured blood and urine markers of inflammation, cartilage breakdown and cartilage building at the start and after 90 days.
The treatment group reported lasting relief, with less pain, stiffness and swelling. Inflammatory markers (IL-7, IL-1, IL-6, hs-CRP, TNF-alpha and ESR) and cartilage breakdown markers (serum CTX-II, COMP, MMP-3 and urinary CTX-II) fell against baseline and placebo. PIIANP and PIICP, two fragments released when type II collagen is made, rose, which the authors read as collagen synthesis. No adverse effects showed up in clinical, blood or ECG checks.
This tested a two-ingredient combination, so the results cannot be put down to boswellia alone. The abstract does not say how often the doses were taken or how many people were in each group. Ninety days is short, and the collagen synthesis markers are indirect: more building fragments in the blood is not the same as more cartilage in the knee. MMP13 was not measured.
It measured both sides of the collagen balance in people: fragments of broken type II collagen and fragments released when new type II collagen is made. MMP13 sits on the breakdown side of that balance, so the falling CTX-II is the part of this trial closest to the enzyme.
In animal and lab studies, yes. AKBA, the lead boswellic acid, suppressed MMP13 in rats with chemically induced knee damage, and a frankincense extract lowered MMP13...
Type II collagen is the main collagen in joint cartilage. Collagen makes up about two-thirds of adult cartilage's dry mass, and type II is its principal molecule, woven...