The Effect of Boswellia Vaginal Gel on Oxidative Stress and Expression of Apoptotic Biomarkers in Vaginal Discharge of Women With Vaginitis

Boswellia serrata is an important medicinal plant with strong antioxidant activity. The present study was designed to evaluate the effects of Boswellia vaginal gel on apoptosis and oxidative damage in vaginal mucosal cells of women with vaginal candidiasis.

Ninety-five women with vaginal candidiasis were enrolled in the clinical trial and received the gel for seven consecutive nights. The clinical symptoms of the disease including vaginal secretion, pain, itching, unpleasant odor, and dyspareunia were recorded. Vaginal discharges were collected before and after treatment for the assessment of malondialdehyde (MDA) and total antioxidant capacity (TAC) using TBAR and FRAP methods, respectively. Expression of Bax, Bcl2, and Caspases-3 genes was surveyed by RT-PCR.

Gel therapy significantly decreased the frequency of pain, burning, itching, dyspareunia and secretion compared to the baseline (p<0.001). Boswellia vaginal gel treatment significantly improved TAC values (from 1.27 ± 0.41 μM/mL to 4.69 ± 0.53 μM/mL; p<0.001) and decreased MDA values (from 31.47 ± 6.69 nM/L to 13.85 ± 3.72 nM/L; p<0.001). The therapy caused a significant decrease in Bax and Casp3 expression, as well as Bax/Bcl2 ratio by 2.34-fold (p=0.018), 2.86-fold (p=0.002), and 12.72-fold (p<0.001), respectively. In contrast, BVG treatment significantly enhanced the expression of Bcl2 expression by 5.42- fold (p<0.001). 

Vaginal candidiasis is remarkably linked to oxidative stress, reduction of the antioxidants and vaginal mucosal cells apoptosis. Boswellia vaginal gel has potential role to improve vaginitis symptoms by elevating antioxidants capacity, mitigating oxidative stress, as well as down-regulating of apoptotic factors.