Commiphora Myrrh A Phytochemical and Pharmacologic PDF

Naunyn-Schmiedeberg's Archives of Pharmacology (2023) 396:405–420
https://doi.org/10.1007/s00210-022-02325-0
REVIEW
Commiphora myrrh: a phytochemical and pharmacological update

Gaber El‑Saber Batiha1 · Lamiaa Wasef1 · John Oluwafemi Teibo2 · Hazem M. Shaheen1 · Ali Muhammad Zakariya3 ·
Opeyemi Abigail Akinfe4 · Titilade Kehinde Ayandeyi Teibo5 · Hayder M. Al‑kuraishy6 · Ali I. Al‑Garbee6 ·
Athanasios Alexiou7,8 · Marios Papadakis9
Received: 5 October 2022 / Accepted: 4 November 2022 / Published online: 18 November 2022
© The Author(s) 2022
Abstract
Medicinal plants have a long track record of use in history, and one of them is Commiphora myrrh which is commonly found
in the southern part of Arabia, the northeastern part of Africa, in Somalia, and Kenya. Relevant literatures were accessed
via Google Scholar, PubMed, Scopus, and Web of Science to give updated information on the phytochemical constituents
and pharmacological action of Commiphora myrrh. It has been used traditionally for treating wounds, mouth ulcers, aches,
fractures, stomach disorders, microbial infections, and inflammatory diseases. It is used as an antiseptic, astringent, anthel-
mintic, carminative, emmenagogue, and as an expectorant. Phytochemical studies have shown that it contains terpenoids
(monoterpenoids, sesquiterpenoids, and volatile/essential oil), diterpenoids, triterpenoids, and steroids. Its essential oil has
applications in cosmetics, aromatherapy, and perfumery. Research has shown that it exerts various biological activities such
as anti-inflammatory, antioxidant, anti-microbial, neuroprotective, anti-diabetic, anti-cancer, analgesic, anti-parasitic, and
recently, it was found to work against respiratory infections like COVID-19. With the advancement in drug development,
hopefully, its rich phytochemical components can be explored for drug development as an insecticide due to its great anti-
parasitic activity. Also, its interactions with drugs can be fully elucidated.
This review highlights an updated information on the history, distribution, traditional uses, phytochemical components,
pharmacology, and various biological activities of Commiphora myrrh.
Keywords Commiphora myrrh · Medicinal properties · Volatile/Essential oil · Anti-septic · Anti-inflammatory · Anti-parasitic
Introduction obtainable in Egyptian, Roman, Greek, and Chinese litera-

tures. These extracts include frankincense, myrrh, benzoin,
Resinous extract of plant origin has been regarded as an Dragon’s blood, and ferulae resin (Brand and Zhao 2017).
important plant resource in traditional medicine. Their Species of Commiphora exist as small trees or shrubs having
effects and applications in traditional medicine are rough and thorny branches. The species Commiphora myrrh
found in the southern part of Arabia to the north-eastern
Highlights
part of Africa (mainly Somalia) and the north-eastern part
1. Medicinal plants have a long track record of use in history, and one of of Kenya is responsible for the production of the true myrrh.
them is Commiphora myrrh which is commonly found in the southern Other types of Commiphora species that produce resins are
part of Arabia, the northeastern part of Africa in Somalia, and Kenya. found in Sudan, south of Arabia, Eritrea, Kenya, Ethiopia,
2. It has been used traditionally for treating wounds, mouth ulcers,
aches, fractures, stomach disorders, microbial infection, and
and Somalia (Hanus et al. 2005b).
inflammatory disease. Myrrh, which has its origin from Arabia, is an extract
3. Phytochemical studies have shown that it contains terpenoids that is produced by secretory tissues found on the bark
(monoterpenoids, sesquiterpenoids, and volatile/essential oil), of Commiphora species. Commiphora is from the family
diterpenoids, triterpenoids, and steroids. Its essential oil has
applications in cosmetics, aromatherapy, and perfumery.
of Burseraceae which has more than 150 species of plant
4. Research has shown it exerts various biological activities such as spread across subtropical and tropical regions, particularly
anti-inflammatory, antioxidant, anti-microbial, neuroprotective, anti- north-east Africa, southern Arabia, and India (Demissew
diabetic, anti-cancer, analgesic, anti-parasitic, and recently against 1993). Species of the genus Commiphora are defined as
respiratory infection like COVID-19.
small trees or shrubs having spinescent branches and bark
Extended author information available on the last page of the article that has pale-gray discharge or a reddish-brown resin. Resins
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406 Naunyn-Schmiedeberg's Archives of Pharmacology (2023) 396:405–420
produced by Commiphora have applications in fragrances, cinnamaldehyde, cadinene cumicalcohol, cuminaldehyde,

bouquet and as ointment in embalmment process, while m-cresol, dipentene, limonine, pinene, sesquiterpenes,
their therapeutic applications have been gaining recogni- furano-sesquiterpenes heerabolene, and terpenes, (Rao et al.
tion in gradation among mankind. They are reported as hav- 2001), alcohols, α-camphorarene, myrcene, Z-guggulsterol,
ing applications in traditional system of medicine for the aldehydes I, II, III guggulsterol (Treas and Evans 1978).
management of all manner of ailments like wounds, ache, Galactose, alongside with acidic polysaccharide arabinose,
joint inflammation, fractures, parasitic infection, obesity, 4–0-methyl-glucuronic acid, and xylose (2:7:8 with 18–20%
and gastrointestinal diseases (Abdul-Ghani et al. 2009a). protein) (Bisset and Wichtl 1994), is the major composi-
Different types of bioactive constituents such as steroids, tion of the gums (soluble in water) or mucilage fraction.
terpenoids, flavonoids, lignans, sugars, etc. were reported Hydrolyzing the gum gives galactose, 4–0-mythylglucuronic
from members of the genus, Commiphora (Hanuš et al. acid, arabinose, and xylose (Leung 1980). The major com-
2005). Biological activities including anti-inflammatory, position of terpenes in myrrh is furano-sesequiterpenoids
antimicrobial, antiproliferative, cardiovascular, and hepato- with elemane, eudes-mane, guaiane, or runcates, structures
protective activities associated with the crude extracts/ (Bisset and Wichtl 1994). It has a peculiar odor resulting
pure compounds have been reported (Shen and Lou 2008). from furano-sesquiterpenes (Bruneton 1995), which is likely
Reviews on the hypo-lipidemic activity of guggul, a resin to be a significant constituent of pharmaceutical myrrh
from Commiphora mukul, was reported (Sahni et al. 2005). (Wichtl 1994). Solvent extraction using 90% alcohol from
Commiphora molmol resin has been particularly applied in gum myrrh yielded 27–60% crude polysaccharide (PS) as
Egypt as an anti-parasitic drug, and the therapeutic applica- reported by Evans and Trease (2002). Crude polysaccha-
tions were recently outlined (Abdul-Ghani et al. 2009a; Shen ride from myrrh was reportedly constituted of 18% protein
et al. 2012). The hypolipidemic property of guggul-sterol (Anderson et al. 1965).
(Sharma et al. 2011), their molecular targets (Shishodia and Myrrh can be regarded as a transduce from Commiphora,
Aggarwal 2004), as well as the secondary metabolites found family Burseraceae, tree bark (Fig. 1). This genus is made
in the genus of Boswellia and Commiphora were described up of over 150 species, having its distribution in the arid,
(Shen and Lou 2008). tropical and subtropical regions (Tucker 1986). The species,
Commiphora myrrha (Nees) Engl., is responsible for the
production of the true myrrh. This species has other syno-
Myrrh nyms; Balsamodendron myrrha Nees or C. molmol Engl
Commiphora myrrha is used since time immemorial for
Myrrh can be defined as an oleo-gum resin produced by treating wound and other medicinal uses (Shen et al. 2012).
different Commiphora species. It is constituted by 3–4% Its bioactive constituents such as furanodienes curzerene
impurities, 7–17% volatile oils, 25–40% alcohol soluble and lindestrene furanoeudesma-1,3-diene are sources of the
resins, and 57–61% water soluble gum (Massoud et al. fragrance emitted by myrrh and of its analgesic property
2001). Myrrh resin constituents soluble in alcohol are com- (Dolara et al. 1996). Myrrh is recognized for its therapeutic
miphorinic acids, commiphoric acids, commiferin, heerabo- properties since the ancient times and has been used exten-
myrrhols, and heeraboresene (Rao et al. 2001). Moreover, sively in the treatment of wounds, management of aches,
these resins have been reported to contain commiphorinic inflammation of the joints, parasitic infections, obesity, and
acid, α-, β-, and γ-commiphoric acids, commiferin, α- and gastrointestinal diseases in the ancient Egypt (Abdul-Ghani
β-herrab-omyyhols, cholestrerol, heerboresene, compesterol, et al. 2009b). It is made up of essential oils, gum (30–60%,
kerto steroids, β-sitosterol, 3-epi-α-amyrin, and α-amyrone water-soluble), myrrhol (3–8%, ether-soluble), and resin,
(Rao et al. 2001). One triterpenoid each was reportedly myrrhine (25–40%, alcohol-soluble). The aromatic and tran-
isolated from Commiphora incisa resin and Commiphora suding resins produced by the stem-bark of Commiphora
kua resin, the importance of each in chemotaxonomy was species (Burseraceae family) are characterized as yellowish
equally emphasized (Provan and Waterman 1986). The to reddish brown powder having a nicely bitter taste with a
volatile oil fraction was reported to be composed of vari- slight irritable balsamic smell (Hanus et al. 2005a).
ous bioactive constituents including elemol, eugenol, esters,
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Naunyn-Schmiedeberg's Archives of Pharmacology (2023) 396:405–420 407
myrrh, Commiphora molmol, or Balsamodendron myr-

rha, in the Greek and Chinese literatures (Germano et al.,
2017). Myrrh, in combination with water, forms an emul-
sion, composed of 2–8% volatile oil, 23–40% resin (myr-
rhin), and 40–60% gum (Shameem, 2018) (Fig. 2). Myrrh
essential oils are used as an adorning agent, incense, and
bioactive agents. These oils are mainly made up of terpe-
noids and terpenes. In addition, myrrh possesses active
ingredients that are of pharmaceutical importance, such
as sesquiterpene lactones, used in the treatment of some
ailments (Singh 2015).
Traditional uses
The most studied and most frequently used species of Com-

miphora are C. molmol, C. myrrha, C. mukul, and Com-
miphora opobalsamum. These species resins have shown
an array of pharmacological activities in treating wound,
mouth ulcer, aches, fracture, stomach disorders, microbial
infection, and inflammatory disease. In Unani medicine,
gums are used as antiseptic, astringent, anthelmintic,
carminative, emmenagogue, expectorant, and stomachic.
They are also applied in combination with other drugs in
Fig. 1 Commiphora myrrha (Akbar 2020) preventive medicine against epidemic diseases and used
ectopically in gouty and painful joints, and for the treat-
ment of wounds. Sesquiterpenoids having an array of phar-
History of Commiphora myrrh macological properties were resin extracts menthofuran
and furanoeudesma 1,3-dieneare known as major compo-
Commiphora genus is from Commiphora myrrh tree. It is a nents in myrrh oil. In rats, myrrh hydro suspension can
flower producing plant classified into Burseraceae family protect the gastric mucosa against various ulcer inducing
(Alyafei, 2020). Burseraceae with origin from the arid, agent, while the ethanolic extract was reported in mice to
tropical, subtropical, and arid regions has species close be anti-inflammatory against acute and chronic inflamma-
to 150 (Gadir and Ahmed, 2014). The term “Myrrh” was tion. (Akbar 2020). In a study on Egyptian patients infected
coined from “murr” that has its origin from the Arabic with tinidazole and methronidazole resistant T. vaginalis,
language, meaning bitter. Traditionally, it is called C. administration of Myrrh between 6 and 8 consecutive days
Fig. 2 Commiphora myrrha,
gum in nature (Alyafei, 2020)
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showed significant improvement in the patients’ health con- applied in the stomach and inflammatory disease manage-
dition. In another study, 85% of the patients infected with ment (Al-Harbi et al. 1997). Myrrh has long been employed
fascioliasis were cured after treatment with 600 mg dose in China as far back as the Tang Dynasty (600 AD) as
for a period of six consecutive days. Several studies have documented in the Chinese medical literature, Hai YaoBen
also documented over 90% recovery from schistosomiasis Cao; resins from C. Myrrha or C. opobalsamum is the com-
in patients from Egypt. In Italy, RCT of myrrh extract in monest resin used in China. Usually, it is co-administered
patients experiencing aches from various etiologies, like with frankincense management of trauma, aches, swelling,
fever- associated ache, joint ache, lower back ache, mus- inflammation of the joints, and fractures (Al-Bishri and Al-
cle aches, headaches, and dysmenorrhea, was observed to Attas 2013). It has a wide application in dermatology for
have significantly alleviated the aches (Akbar 2020). The the treatment of sores, skin ulcer, and empyrosis (Shen et al.
medicinal importance of the myrrh, guggulin, a resin from 2012). The ability of myrrh to break up coagulated blood
an Indian C. mukul, in Ayurvedic medicine dates as far and promote circulation of blood is the bases for its usage in
back as 3000 years ago. This resin has its application in the the treatment of arthritis, fracture, trauma as well as tumors
enhancement of bone fracture healing, mouth ulcer, sore (Singhuber et al. 2009; Yang 2009). China has now become
throat, wound healing, acne, skin disorders, lymphadenopa- the biggest myrrh importing country in the world, and its
thy, and intestinal worms, as documented in Bhava Praka- most application is in medicine (Coppen 1995).
sha’s Materia Medica (Shilpa and Venkatesha Murthy, In the bible, it was related that Christ was given myrrh at
2011). A variety of sesquiterpenes with different pharma- birth. Thus, it was rated higher costing much more than gold.
cological activities have been reported from the resin (Xu The greatest of all medieval clinicians, al-Razi, a Muslim
et al. 2011). Menthofuran and Furanoeudesma 1,3-diene physician, used myrrh to treat diseases of the kidneys and
were shown in report as the main bioactive compounds pre- bladder, and to dissipate swellings in the stomach.
sent in myrrh oil. Ethanol extract was reported to majorly Myrrh belongs to Burseraceae family, being a fragranced
consist of curzerene, 2-tert-butyl-1,4-naphthoquinone, oleo gum resin produced as a transude from Commiphora
benzenemethanol, and 3-methoxy-α-phenyl (Mahboubi myrrha stem bark. Reports have shown that it is an effective
and Kashani 2016). anti-parasitic and microbicidal agent with marked activities
Earliest antimicrobial use of myrrh by Sumerians for on glandular fever, gingivitis, mouth ulcers, sinusitis, brucel-
the treatment of teeth infection and intestinal worms’ dates losis (Abdel-Hay et al. 2002). Furthermore, myrrh volatile oil
as far back as 1100 BC. Another ancient use of myrrh and its crude extracts have shown various pharmacological
was in embalming by the Egyptians in ancient times. activities including microbicidal, anti-inflammatory, cyto-
Also, its oil has for long being used in treating Candida toxic, sedative actions (Massoud et al. 2004c).
albicans, Tinea pedis fungal infections, and subcutane- Generally, the Chinese medical system suggested that myrrh
ous wound (Stevensen 1998). The documentations from has potent synergistic therapeutic activities like analgesic, anti-
British Herbal Pharmacopoeia (de Rapper et al. 2012) inflammatory, blood activation, and antibacterial effects upon
showed myrrh tincture usage as a mouthwash in gingivitis use with frankincense (Sadowska-Bartosz et al. 2014).
and ulcers. Organizations such as the European Commis-
sion ((Blumenthal 1999) approved the use of myrrh in the
management of mild inflammation (topically) of the phar- Pharmacology
yngeal and oral mucosa. In Chinese medical system, myrrh
is also regarded as an important drug for curing syphilis, In rats, an aqueous suspension of myrrh was reported to pro-
leprosy, and rheumatism (Nomicos 2007). A decoction of tect the gastric mucosa from various ulcerogenic agents (Al-
myrrh is traditionally used in the treatment of stomach Harbi et al. 1997). While in mice, ethanolic extract showed
ache in Somalia and Ethiopia (de Rapper et al. 2012). anti-inflammatory activity on acute and chronic inflammation
Terpenoids have been shown to exhibit different pharma- (Atta and Alkofahi 1998). Mirazid, an oleo-resin formula-
cological activities together with anti-molluscic (Borkosky tion obtained from a purified oleo-resin extract, was shown
et al. 2009), hypoglycemic (Agwaya and Nandutu, 2016), to reduce parasite counts of Giardia lamblia by 100% in the
anesthetic (local) (Tsuchiya and Mizogami 2017), cytotoxic intestine and feces of infected rats (Fathy 2011). In dermatol-
(Shoaib et al. 2017), and microbicidal effects (Zengin and ogy, essential oils of myrrh and ethanolic extracts inhibited
Baysal 2014). the growth of these dermatophytes: Microsporum gypseum,
Other diseases such as aches, arthritis, and inflammatory Microsporum canis, Trichophyton rubrum, Trichophyton
diseases have been treated (Ding and Staudinger 2005). In mentagrophytes, and Trichophyton verrucosum (including the
Egypt, C. molmol resin is being marketed as an anti-para- oil was more potent) (Mahboubi and Kashani 2016). Aque-
sitic agent under a brand name Mirazid (Abdul-Ghani et al. ous resin inhibited the growth of Enterococcus faecalis in the
2009a). In Arabian medical system, myrrh is reportedly tooth cavity; this activity was equated with 2% chlorhexidine,
13

a standard drug. Myrrh protects basically by preventing including furanodienone, furanodiene, curzerenone, and
hepatocyte alteration and significantly reducing the portal lindestrene (Vishakha and Ramyasree 2015). Approxi-
areas granulomas. It also ameliorates fibrosis intercellularly mately 20 different types of furano-sesquiterpenoid com-
as observed in mice infected with bilharzia (Massoud et al. pounds have been isolated and characterized from exudates
2004b). A related form of protection has been observed with an of myrrh (Su et al. 2009b). Furthermore, two pure com-
Egyptian strain of Schistosoma mansoni infected mice (Mas- pounds, 2-methoxyfuranodiene and 2-acetoxyfuranodiene
soud et al. 2005). At sub-toxic doses, myrrh oil was reported belonging to furano-sesquiterpenoid family, were isolated
to have stimulated the production of IL-6 and IL-8 not through from C. myrrh gum (Maradufu 1982).
the epithelia cells but by human gingival fibroblasts. How-
ever, it reduced significantly the production of IL-1β (Tipton Terpenoids
et al. 2003). In terms of toxicity, myrrh has been reported to
be highly toxic on EAC cell-bearing mice, while its biological Monoterpenoids, sesquiterpenoids, and volatile oil
action on tumor cells was equated to CP (Ai-Harbi et al. 1994).
Myrrh emulsion has shown good antioxidant potential and Monoterpenoids are seen majorly in volatile oils, character-
guards against hepatic oxidative damage and immunotoxicity ized using the GC technique. Several studies have report-
on exposure to lead acetate by downregulating LPO and stimu- edly used GC analysis for the characterization of Commi-
lating antioxidant and immune defense mechanisms (Ashry phora species volatile oils, such as C. myrrha (Dekebo et al.
et al. 2010). Resins as supplement have been shown to greatly 2002; Morteza-Semnani and Saeedi 2003), Commiphora
attenuate liver injury induced by ammonia and decreased quadricincta (Assad et al. 1997), Commiphora holtziana
ammonia circulation and TNF-α of hyper-ammonemic rats (Dekebo et al. 2002; Provan et al. 1987), Commiphora gui-
(Mahmoud et al. 2017a). About hepatocarcinogenesis in rats dottii (Craveiro et al. 1983), Commiphora kataf, and Commi-
induced by DEN, resin extracts showed a significant decrease phora sphaerocarpa (Dekebo et al. 2002). Mono-terpenoids
in tumor proliferation, circulating markers of inflammation, reported include camphene, myrcene, limonene α-pinene,
liver LPO, NO, and angiogenesis (Mahmoud et al. 2017b). and β-pinene. Observations on the constitution of volatile
However, biochemical parameters showed no improvement oils obtained from species of Commiphora varied signifi-
or delay in hepatocarcinogenesis induced by DEN (El-Shahat cantly. In volatile oil, sesquiterpenoids having a lower degree
et al. 2012). A strong antithrombotic activity has also been of oxidation play an important role. Β-selinene β-Elemene,
reported by myrrh extract (Olajide 1999). α-humulene, α-copaene, and germacrene B have been
reported to be predominately distributed in the volatile oils
from species of Commiphora. Abundance of furanosesquit-
Phytochemical studies erpenoids in the genus Commiphora can be used to define the
genus. Elemanolide (4), guaianolide (5), and cadinanolide (6
Studies have shown over 300 molecules from the genus and 7) isolated from C. myrrha and C. opobalsamum resin
Commiphora. Information on isolated compounds are as are the main bioactive constituents from the genus recently
provided in Hanuš et al. (2005). This review is important as (Shen and Lou 2008; Shen et al. 2008, 2009).
it presents findings of over a decade including phytochemi-
cal regularities of this genus. A broad summary of metab-
olite structures and resources under structural types and Diterpenoids
classification was provided by the Supplementary Data.
On the aspect of phytochemicals from this genus, emphasis C. mukul resin, which commonly has diterpenoids cam-
should be made on: (i) Terpenoids particularly those of the phorene, was the first diterpenoid compound isolated from
sesquiterpenoids and triterpenoids as they are the predomi- essential oil of C. mukul (Sarup et al. 2015). Similarly, these
nant bioactive constitutes of the genus. (ii) With regard to two compounds, cembrane and verticillane, are diterpenoids
phytochemicals, more emphasis had been laid on C. myr- found in same species. A pimarane diterpenoids, aracopi-
rha, C. kua, C. mukul, and C. confuse C. molmol species. maric acid (8), and two abietane diterpenoids, abietic acid
Commiphora species resins were administered based on (9) including dehydroabietic acid (10), were all C. myrrha
recommendations of the traditional medicine systems of isolate (Su et al. 2009a).
China, India, Egypt, etc. Hence, these genus resins are the
most investigated product with a potential of discovering Triterpenoids
bioactive compounds.
Studies on the phytochemicals of resin from C. myrrh Triterpenoids were the most biologically active compounds
showed that it contains heerabolene, elemol, acadinene, identified in resin of species of Commiphora; however, fla-
cuminaldehyde, eugenol, multitude of furano-sesquiterpenes, vonoids and lignans majorly occur in the plant stem (Shen
13

et al. 2012). The main bioactive components in essential oils showed significant improvement in osteoarthritis after
reported from different species of Commiphora were ses- treatment with 500 mg TID for 1 month (Singh et al. 2007).
quiterpenes hydrocarbons, oxygenated sesquiterpenes, and A significant inhibition of NO formation by methanol resin
monoterpenes, that is different in different species (Maron- extract of C. mukul in lipopolysaccharide (LPS) activated
giu et al. 2005). murine macrophages was exhibited using IC50 = 15 mg/
Triterpenoids constitute the largest number of bioactive mL (Meselhy 2003; Matsuda et al. 2004a). Also, MeOH
constituents isolated and purified from species of Commi- extract demonstrated an anti-inflammatory property against
phora. They include cycloartane, dammarane, oleanane, LPS-induced inflammation (Cheng et al. 2011). Isolated
octanordammarane, runca, anostane polypodane, and ursane. compounds, polypodane triterpenoids, cembrane diterpe-
The largest group of triterpenoids are the dammarane with noids, lignans, and steroids have been studied for COX
over twenty-one of them being identified in resins from four inhibitory activity and NO production. Prevention of NO
species including C. confuse (Manguro et al., 2003), Com- production by E and Z-guggulsterones (22 and 21), myr-
miphora dalzieli (Waterman and Ampofo 1985), C. myrrha rhanol A (23), and myrrhanone A (24) has been observed
(Shen et al. 2009), and C. kua (Manguro et al. 2003), and having IC 50 = 1.1, 3.3, 21.1, and 42.3 mM, respectively
C. mukul is the only species from the genus that produces (Meselhy 2003). In lipopolysaccharide activated mouse
the polypodane triterpenoids (Matsuda et al. 2004a, 2004b). peritoneal macrophages, myrrhanol A (23) and mukulol
Cycloartane triterpenoids (11–20) having new replace- (25) were reported to have inhibitory action nitric oxide
ment at carbon (C-2) were reported from C. myrrha and C. synthase (iNOS) induction (Matsuda et al. 2004a). E-gug-
opobalsamum (Shen et al. 2008). gulsterone (22) and Cembrene (26) were reported to be the
most active in COX inhibition. They inhibited COX-1 by
Steroids 79% and 67%, and COX-2 by 83% and 54% individually
at 100 ppm (Francis et al. 2004). The anti-inflammatory
C. mukul are the only species that have produced nine properties of Z-guggulsterones and E-guggulsterones (21
cholestane steroids and eleven pregnane steroids. Also, iso- and 22) were reported, eliciting their anti-inflammatory
lated from C. mukul resin are two isomers of carbon (C 21) activity by subduing NF-kB activation and NF-kB regu-
steroid, Z-, and E-guggulsterones (21 and 22) mukul (Patil lated gene products expression (Shishodia and Aggarwal
et al. 1972). These compounds generated attention due to 2004; Lv et al. 2008). Kimura et al. (2001) reported C.
the potent antitumor, hypolipidemic, and anti-inflammatory mukul resin extract and pure compounds anti-inflammatory
activities they possess (Shishodia et al. 2008). potential (23 and 24) using the model, air pouch granuloma
induced by an adjuvant and observed that 23 was 7 × , 5 × ,
Miscellaneous and 3 × more effective on carmine content, granuloma, and
pouch fluid weight more than the standard drug (hydrocor-
Among the Commiphora species are additional types of tisone) used as control. It, therefore, has the prospect of
bioactive constituents including flavonoids, lignans, carbo- being developed into an anti-inflammatory drug. Further-
hydrates, and long chain aliphatic derivatives. The gum of more, myrrh was reported to have significant inhibitory
Commiphora has been reported to consist of carbohydrate activity on the activator of transcription-1, transcription-3
that basically exists as polysaccharide (Kumar and Shankar (STAT-1 and STAT-3), and signal transducer leading to
1982). The gum yields mono or disaccharide on hydroly- reduced production of cytokines through the pathway of
sis. Resins oozing out of Commiphora species are devoid janus kinase/STAT (Lv et al., 2008). Also, it suppresses
of flavonoids unlike the flower, stem, and bark. Long chain down-regulation of cytokine synthesis, a reaction to a
aliphatic derivatives of 1,2,3,4-tetrahydroxy like guggultet- decreased interferon-gamma and interleukin-beta produc-
rol-20 and D-xylo-guggultetrol-18 have been reported in tion. This auto-regulates JAK/STAT pathway through the
the gum (Patil et al. 1972). They usually occur in nature as control of transcription by transcriptions activator that also
glycoside or runcat acid ester (Shen et al. 2007). inhibits activation of pathway (Su et al. 2011).
Su et al. (2012) reported that myrrh water extract and com-
bined water extract (CWE) at doses of 3.9 g/kg and 5.2 g/kg
Biological activities exhibited formalin-induced paw edema inhibition with an
inhibition rate of 30.44% and 23.50%. Individually, a sig-
Anti‑inflammatory activity nificant (P < 0.01 or P < 0.05) inhibition of PGE2 production
was observed in samples tested. However, CWE was stronger
In Ayurvedic medicine, resin from C. mukul, sometimes in suppressing carrageenan-induced mice paw edema at 2
refered as “guggul,” for centuries was used in arthritis and 3 h after drug was administered. Reports showed the
treatment. Resin extract from C. mukul in a clinical study anti-inflammatory activities of extracts from C. molmol and
13

Commiphora pyracanthoides. Inhibiting the release of IL-6 of the furano-sesquiterpenoids family. Their DPPH radical
and IL-8 stimulated by IL-b in human gingival fibroblasts scavenging potential had IC 50 values of 1.08, 4.29, and
cells stimulated IL-b on the administration of C. molmol 2.56 mg/mL, respectively (Mohamed et al. 2014).
volatile oil has also been reported (Tipton et al. 2003). C. Triterpenes (ursolic and oleanolic acid) and essential
molmol resin pet. ether extract inhibited carrageenan-induced oils in the resins of C. myrrh and Boswellia serrata were
inflammation and cotton pellet granuloma. Extract from reported as having potent antioxidant activity in sunflower
the stem of C. pyracanthoides was reported to be the most oil, although, with negative result in DPPH scavenging
active with an IC50 = 27.86 mg/mL among all the Commi- activity. C. myrrha essential oil (EO) inhibited lipid peroxi-
phora species tested for anti-inflammatory activity applying dation in sunflower oil. It is then safe to conclude that essen-
a 5-lipoxygenase (5-LOX) assay method (Paraskeva et al. tial oil of C. myrrh could be applied in functional foods,
2008). Friedelin, an isolated from Commiphora berryi and pharmaceutical, and cosmetic preparations mainly due to
its pet. ether bark extract, was reported to have shown inhibi- their antioxidant activity in oil substrate (Assimopoulou
tory activity on soybean lipoxygenase with IC50 values of et al. 2005).
35.8 mM and 15.3 mg/mL (Kumari et al. 2011). Commiphora
erythraea resin hexane extract was reported to inhibit edema- Antimicrobial activity
tous response, reducing it by 84% at 1000 mg/cm2 in mice
ear edema caused by croton oil. These compounds, Myrrhone Biological activity of myrrh on viruses and bacteria has
(27), rel-3R-meth-oxy-4S-furanogermacra-1E,10 (15)-dien- been reported in literatures. Empirical evidences have
6-one (28), and rel-2R-methoxy-4R-furanogermacr-1(10) shown that myrrh extracts possess effects on virus by
E-en-6-one (29) present in the extract were proposed to have virtue of which these extracts possess antibacterial and
exhibited the anti-edematous activity of the plant (Fraternale antiviral activities on different virus strains (Khalil et al.
et al. 2011). Ethanol leaf extract of Commiphora caudate 2020). In a particular study, bactericidal, fungicidal, and
administered orally at 250 mg/kg was reported to have inhib- anti-viral activities of myrrh essential oil extracts sug-
ited carrageenan-induced paw edema response by 67% in gested their potential in inhibiting the growth of bacteria
rats (Annu et al. 2010). In vivo anti-inflammatory activity of and virus strains (Brochot et al. 2017). Also, in a study,
isolated compounds, mansumbinoic acid (30) and 2a,3b,23- essential oils from myrrh showed antiviral activities
trihydroxyolean-12-ene (31), were reportedly studied (Fourie against two viruses: herpes simplex virus type 1 (HSV-1)
and Snyckers 1989; Duwiejua et al. 1993). Evidence from and influenza virus type A (H1N1). Myrrh was observed
literatures showed C. mukul resin was the most investigated, to act by free viral particles direct inactivation and dis-
showing promising anti-inflammatory property both in vitro rupting the virion envelope structures which major role is
and in vivo. This further establishes application in Ayurve- in host cell virus invasion (Brochot et al. 2017). Another
dic medicine. Steroids (21 and 22) and triterpenoids (23 and mechanism by which the extracts bring about their activ-
24) present in C. mukul are the active principles bringing ity is by the inhibition of the enzyme, DNA polymerase in
about anti-inflammatory effects. The extracts and compounds viral strains, thereby, hampering virus resistance to spe-
mechanistic activity from the genus Commiphora as it relates cific medications. Therefore, development of new antiviral
to signaling pathways, multiple inflammation-related proteins drugs from the extracts with specific target on DNA holds
were highlighted. Potential anti-inflammatory targets such a lot of prospects (Brochot et al. 2017).
as NO formation, COX, ROS, TNF-a, PGE2, MAPK, and Generally, plants Eos are a mixture of different constitu-
NF-kB were identified and tested. ents (Burt 2004). Specific compounds from phenols were
suggested to show the microbicidal activities of Eos (Ben
Antioxidants Arfa et al. 2006; Lambert et al. 2001). Also, four terpene
molecule activities present in some Eos were investigated on
Compounds of the class diterpenes, sesquiterpenoids, the food pathogens and spoilage bacteria organisms. Since
sterols, and triterpenes present in high quantity in myrrha disruption of cellular membranes was reported to be caused
extracts that may serve as electron donors react with free by Eos and their constituents (Kapros and McDaniel 2009),
radicals converting them to a more stable product thereby studies on their cytotoxicity have been carried out using bac-
terminating the radical chain reactions. This is a corrobo- teria cell model in vitro (Boffa et al. 2016).
rated (Fraternale et al. 2011) research work where they Studies on PE myrrh extract using diffusion test showed
showed myrrha resin hexane extract as having the best antimicrobial potential on C. albicans, Streptococcus pyo-
DPPH radical scavenging activity unlike to its oils. The same genes, and Staphylococcus aureus. The extract of EtOH
authors made suggestion that the action could be attributed showed potent action against the strains tested. However,
to three compounds, 2-methoxy-furanogermacren-6-one greater activity was observed against C. albicans and
myrrhone and 3-methoxy-furano germacradien-6-oneall S. aureus (9 mm zone of inhibition, 20 mg /mL); this further
13

establishes the therapeutic effect of myrrh for curing infec- (PAS) of AchE, and catalytic triad while hydrogen bonding
tious diseases such as gingivitis pharyngitis, phyorrhoea, was used between AchE and alpha-terpineol, elemol, and
and sinusitis (de Rapper et al. 2012). The anti-fungal activ- eugenol (Hussein et al. 2019).
ity exhibited on C. albicans is similar with the findings
reported in previous studies (Dolara et al. 2000). Methanol Stimulates insulin secretion
extract tested on C. albicans, Pseudomonas aeruginosa,
and Escherichia coli demonstrated a very low antimicrobial Medicines of plant origin like Commiphora myrrha (CM)
activity with no zone of inhibition observed at 20 mg/mL, have traditional application in Ayurvedic medicine for dia-
whereas, PE extract demonstrated 3.7 and 5.7 mm zone of betes management in certain regions of Africa and Arabia.
inhibitions for C. albicans and S. albus, which can be com- Several studies have shown that in diabetic animal models,
pared to 5 and 3 mm for S. aureus (Boffa et al. 2016). CM reduced blood glucose, and increased insulin concentra-
tion is achieved with CM. It is, however, not fully clear the
Neuroprotective effects mechanism employed by CM in achieving glycemic control
in the animals (Al-Romaiyan et al. 2021).
From the resins oozing out of Commiphora myrrha was iso- Increase in insulin production that was concentration
lated runcate type sesquiterpenes, i.e., commiterpenes A–C dependent was observed on exposure of MIN6 cells to CM
(1–3) showing neuro-protective activity on M PP+ induced resin solution (0.5–10 mgmL−1) in a static setting. When
neuronal cell death in SH-SY5Y cells (Xu et al. 2011). islet of the mouse was incubated with CM (0.1–10 mgmL−1),
Commiphoins A–C (1–3), the novel runcate type of ses- it brought about a concentration-dependent stimulatory
quiterpenes, including two common runcate type of sesquit- effect on insulin. Reduction in cell viability or cell mem-
erpenes (4 and 5) were gotten the extracts of Commiphora brane integrity was not associated with CM concentrations
myrrha resinous. Screening 1 and 3–5 compounds was at ≤ 2 mgmL−1. Although, a remarkable absorption of trypan
carried out against anti-Alzheimer’s disease (AD) activity blue dye and apoptosis accompanied higher concentrations
employing Caenorhabditis elegans AD pathological model. of CM. At stimulatory and sub-stimulatory glucose levels,
All the compounds tested demonstrated significant anti-Alz- CM (2 mg/mL) resulted in quick and reversible increase in
heimer’s disease activities (Yu et al. 2020). insulin production by islets of both humans and mouse dur-
ing perfusion Total insulin contained in β-cells, mRNA for-
Anti‑acetylcholinesterase activity mulations of preproinsulin, and Pdx1 did not change despite
the stimulating effect of CM on the production of insulin
Acetylcholinesterase inhibitors, natural or synthetic, have (Al-Romaiyan et al. 2021).
been shown to be commonly applied as insecticides or
nootropic drug for boosting memory in patients having Analgesic action
amnesia. Many bioactive constituents have been established
to have the ability to inhibit AchE which helps in boosting In ancient times, myrrh has been used as analgesics, which is
cerebral activity or ameliorate disease symptoms relating possibly due to bioactive constituents present in them acting
to it (Teibo et al. 2020). Herbal preparations with known as pain relievers (El Ashry et al. 2003). Two sesquiterpenoid
activities on the brain for boosting retention and learning are compounds, furanocudesma-1, 3-diene, and curzerene pre-
referred to as “nootropic herbs” or “phyto-nootropics,” and sent have been reported to be acting on the receptors opi-
their isolated active principles are called smart drugs (Hus- oid in the central nervous system, bringing about anesthetic
sein et al. 2019). In Mesopotamia, the species commonly activity (El Ashry et al. 2003). Also, furanocudesma-1,
used to produce essential oils used in aromatherapy is Com- 3-diene in myrrh, particularly the ones isolated from Com-
miphora myrrha (Nees), Engler (Watt and Sellar 2012). C. miphora mukul have been reported to provide significant
myrrha leaves, bark, and resin methyl alcohol extract have relief from abdominal pain and improving health hyper-
been reported to inhibit AchE by 17.00, 26.00, and 29.33% algesia. Hence, these extracts bring about their effects by
compared to eserine. Computational prediction using sil- relieving peripheral nerve pain resulting from chronic com-
ico tools has been used to model the ADMET and puta- pressive damages to the sciatic nerves. These extracts have
tive anticholinesterase potentials of bioactive compounds in been reported to be applied as a substitute medication in the
myrrh. Bioactive constituents from C. myrrha were reported management of nerve pain (Mehta and Tripathi 2015). In
to show a good binding affinity (BA) concerning AchE prin- addition, some isolate such as furanocudesma-1, 3-diene and
cipal sites with a range of − 5.8 (m-cresol) to − 10.5 (abietic lindestrene present in myrrh were reported to relief pain by
acid) kcalmol−1. On these bases, terpenoid compounds (25 acting on nerves and body joints. These compounds bring
out of 28) from myrrh served as dual inhibitors due to the about their effects by suppression of the molecule prosta-
hydrophobic interactions using both peripheral anionic site glandin and hinder the inward movement of sodium current
13

thereby ameliorating the feeling of pain (Nomicos 2007). Furthermore, numerous studies reported the use of myrrh
The presence of the compound furanodiene in high amount components in apoptotic induction and stoppage of tumor cell
acts by lowering pain resulting from fever (Gadir and Ahmed proliferation (Chen et al. 2013). This is similar to reports on
2014). compounds isolated from C. myrrh as used to induce apop-
tosis and arrest of cell cycle progression (Gao et al. 2015).
Anti‑cancer property Furano-sesquiterpene compounds were shown to elicit
some pharmacological activities resulting from the wide
Cell deaths occur in various form, one of which is apoptosis range of bioactive compounds present in them (Frater-
(cell suicide), defined as a programmed process or geneti- nale et al. 2011). The derivatives of furano-sesquiterpenes
cally controlled, or necrosis or a non-programmed/accidental and itself, a soft coral isolate, were reportedly tested on
process (Hotchkiss et al. 2009). One of the most effective leukemia, prostate, lung, breast, and cervix cancer cell
non-surgical cancer treatments is targeting apoptosis, a char- lines which resulted in some of the compounds possess-
acteristic of cancer cells. Targeted attack on apoptosis holds ing promising activity on two of the cancer lines tested,
the possibility of stopping the uncontrolled growth of the leukemia and prostate cancer (Rajaram et al. 2013).
cancer cells. Studies have reported the use of cancer drugs Additionally, a different furano-sesquiterpene report-
to target different pathways of apoptosis (Pfeffer and Singh edly obtained from soft coral was tested for its anticancer
2018), including compounds of plant origin and having vari- activity. Researchers have demonstrated the inhibition of
ous bioactive compounds, is having an effect on the apop- many cancer cell line proliferation in humans, decreased
totic pathways via different mechanisms (Safarzadeh et al. programmed cell death, and cell cycle arrest induction in
2014; Teibo et al. 2021a, b). The use of flow cytometry to human leukemia cells (THP-1) (Arepalli et al. 2009).
detect necrosis or apoptosis by exposing phosphatidylserine Results from different researches have suggested that
(PS) outside of the apoptotic cells, an important method in myrrh possesses inhibitory properties against cell mul-
the induction of apoptosis, has been reported (Wlodkowic tiplication and brings about cell suicide of GC cells pos-
et al. 2011). Another important discovery in the study of sibly achieved by downward control of COX-2 formula-
cancer is the inability to control the normal cell cycle. There tion in GC cells (Sun et al. 2020) (Fig. 3). Below is a
is an increasing interest on the cell cycle as a mechanism schematic representation of relevant proteins showing
for anticancer drug target (Gabrielli et al. 2012). In a study concurrent upward control of Bax formulation, down-
where flow cytometry was used for detecting the activity of ward control of COX-2, and Bcl-2 formulation in cells
certain compounds on HepG2 cell cycles, it was shown that during myrrh administration. In vitro studies have shown
treated HepG2 cells in the S-phase reduced in percentage, myrrh to induce apoptosis in a dose-dependent form in GC
while an increase was observed in the G2/M phase cells.
In a research work, cell cycle phase distribution using flow
cytometry was used to determine the altered compound
in HepG2 cells cell cycle. The results showed decrease in
treated HepG2 at the S phase; however, that of the G2/M
phase increased.
Ethno-pharmacological evaluation has identified myrrh
an anticancer drug. The active constituent possessing anti-
cancer activity is elemene with proven action on various
cancerous cells including glioblastoma, and it was proven
to be safe and effective. Elemene, particularly β-elemene,
was reported to possess anti-proliferative activity. It acts
by activating p38MAPK in glioblastoma (Yao et al. 2008).
Also, the compound 2S-epoxy-4R-furanogermacr-10-3n-6-
one, furose-type sesquiterpene rel-1S isolated from myrrh
was reported to possess low cytotoxic activity on MCF-7 cell
line of breast cancer. This compound, in combination with
bisabolene in myrrh, was effective in reducing the growth
of breast cancer indicating myrrh as containing novel anti-
breast cancer drug (Yeo et al. 2016; Shen et al. 2008). Cyclo-
bolinane, a triterpenoid present in myrrh, was shown to exert
a moderate cytotoxic effect on PC3 and DU145 prostate can- Fig. 3 Myrrh’s inhibition of proliferation of gastric cancer cells and
cer cell lines (Shameem 2018). induction of apoptosis (Sun et al. 2020)
13

cells. GC cell migration rate could be possibly reduced of S. mansoni mice and hamsters, no anti-schistosomal activity
by myrrh. Although, blockage of GC cell migration could was observed. Furthermore, effects on tissue oogram and egg
increase with increase in administration time. arrangement did not show significance (Botros et al. 2004).
Antiparasitic activity Myrrh as a fasciolicide
In Egypt, the use of myrrh as an anti-parasitic agent saw Contrary to the inconsistent activity on schistosomiasis
its revolution in 1990 through evidence-based scientific infection, myrrh has proven to possess a very potent fas-
research. The main focus of research in Egypt was the ciolicidal activity. This is evident from the significant data
human trematode infection shrouded in stories of success generated on this activity from experimental animals, infield
and disagreement. studies, and clinical trials.
Myrrh showed high efficacy when tested on Fasciola in
Myrrh as a schistosomicide animal studies. It was reported in a study, that Mirazid com-
pletely eradicated Fasciola gigantica in rabbits with 20 mg/
Myrrh has been reported to have schistosomicidal activity day dosage administered orally for six days consecutively.
on different phases of S. mansoni. The effect of the drug in The immune response (IgG) was observed to be highest in
infected mice was more pronounced at the 2 1st and 4 5th days infection treated rabbits compared to the infection untreated
of PI. The drug showed a promising prophylactic effect when control (Mahmoud 2008). This lead to the conclusion, that at
administered 5 days before exposure (Massoud et al. 2004c). A parasitology and immunology levels, Mirazid was safe and the
unique myrrh formulation that contains volatile oil and myrrh most effective fasciolicidal drug (Mahmoud 2008).
resin was recorded at the beginning of the 2000s for its efficacy
and safety in mice with S. mansoni infection. Extract of myrrh, Myrrh as a heterophycide
administered at 250 mg/kg and 500 mg/kg, was described to
have stimulated a noticeable reduction in worm burden, increas- Heterophytes are common parasite found on snails and fish
ing hepatic displacement of worms and a radical reduction in serving as intermediary hosts, found along the Nile valley
immature egg percentages situated on the intestine wall (Badria and lakes of Egypt reportedly subjected to myrrh. In animal
et al. 2001). Mirazid was reported in mice model to be safe in and clinical studies, both showed promising results in terms
the treatment of Schistosoma infection by S. mansoni, and it of efficacy on the parasite. In an animal study, emulsion form
was also efficacious (Hamed and Hetta 2005). An improvement of Mirazid showed significant activity on heterophyidiasis
in liver enzyme activities and a significant worm load reduc- with very high reduction in load of worm, tegumental spines
tion by 81.10% and a reduction in ova count by 73.07% on disfigurement, and attrition as seen under a scanning elec-
daily administration of Mirazid, for 3-day fasting at 600 mg/kg tron microscope. It was observed to be very active, leading
(Hamed and Hetta 2005). In another study, myrrh was reported to 100% worm load reduction at 500 mg/kg/day administered
to have shown significant schistosomicidal activity at 500 mg/ for consecutively for 3 days (Abdul-Ghani et al. 2009a).
kg on administration every day for five consecutive days. The
activity remained pronounced in groups that got the drug on Myrrh as a molluscicide
the 21st and 4 5th days post infection (Massoud et al. 2004c).
Furthermore, it was observed in the groups a significant reduc- Aside from its reported termiticidal activity, myrrh extract has
tion in granulomas restored jejunal mucosa continuity and led to been reportedly tested on snail intermediate hosts of trematodes
paucity of eosinophils (Massoud et al. 2004c). However, results for activity. Based on the reports of it being safe and having
from other studies have reported otherwise the chances of myrrh activity on the parasite and its intermediate hosts, this provides
application for the management of schistosomiasis. The most it with the benefit of being effective in the control and treat-
interesting report on inefficacy of myrrh on animals infected ment of diseases. It has been investigated the anti-molluscic
with S. mansoni was from a multi center research carried out potential on Egyptian snail species Bulinus truncates, Lymnaea
by Botros et al. (2004). Mirazid, a commercial formulation, has cailliaudi, and Biomphalaria alexandrina. These snails’ species
been tested alongside myrrh resin derivatives at varying doses and their eggs were subjected to the drug at different conc. over
on various strains. In the Egyptian (CD) strain infected mice a period of 24 and 48 h at 22–26 °C. The outcome of the experi-
reduction in worm infection loads in mice was observed to be ment was B. alexandrina had an LD50 and LD90 (155 ppm
negligible. Solution of Mirazid, at high doses, was observed to and 195 ppm), higher than B. runcates (50 ppm and 95 ppm)
be toxic to mice infected with Puerto Rican (Mill Hill) strain of and L. cailliaudi (50 ppm and 85 ppm) on 24-h exposure. A
S. mansoni but possessed modest to no worm reduction at lower mortality rate of 100% for egg clutches of B. alexandrina and L.
doses. With Puerto Rican (NMRI) and Brazilian (LE) strains cailliaudiat was recorded at 100 ppm and 75 ppm respectively.
13

However, in order to obtain similar results on 48 h of exposure, various diseases due to its diverse biological activities. Also, it
lower concentrations were required. Under laboratory condi- has been reported to possess antiviral activities, hence, can be
tions, reports on myrrh showed significant inhibitory effect on used in the prevention of various diseases. On this bases, it is
snail intermediate hosts, especially their eggs. On snail hosts could be possible to use myrrh or C. myrrh in the treatment of
of schistosomes, myrrh extract showed mulluscicidal activity. the most recent pandemic, COVID-19 (Alyafei 2020).
After 24 h of post exposure, molluscicidal activity on B. alexan- In states like Qatar, the sale of herbal preparations and
drina and Biomphalaria alexandrina, at concentrations 20 and myrrh has skyrocketed on emergence of COVID-19, so has
10 ppm respectively, was reported (Massoud and Habib 2003). charge increased. This trend could be associated to the tradi-
Prolonged exposure was observed by authors to have resulted to tional beliefs in the use of herbal medicines or that existing
increase in infected snail’s number. Ovicidal activity of myrrh knowledge on the medicinal and/preventive properties of myrrh
has been reported to be effective on a day-old egg mass of snail necessitated this, hence, the need for further investigation. It has
than on 5-day-old snail egg mass. Also, the eggs demonstrated been recently proposed that research into the activity of myrrh
more resistance to the drugs than adult snails. mouthwashes on COVID-19 could serve as likely source of a
therapeutic agent against the disease (Alyafei 2020).
Against respiratory infections
Toxicity
Myrrh from Commiphora have been reported as having
activity on sore throat and chest infection. It acts by subduing Essential oils of myrrh at high doses have been reported to
inflammatory responses associated with it (Khalil et al. 2020). produce adverse side effects in mice recently (Lamichhane
Extract of C. myrrh and its essential oil have been reported et al. 2019). It has also been documented that women that
to be used as expectorants, essential for the management of applied substantial quantity of myrrh while pregnant had
respiratory diseases like chest infection and any ailment associ- miscarriages (Al-Jaroudi et al. 2016). In patients with hot
ated to it (Germano et al. 2017). Similarly, in myrrh the activity temperament, it is usually not recommended. There is dearth
of aromatic gum resin has been reported infection in the chest of information on the animal toxicity studies (Akbar 2020).
(Su et al. 2015). The resin employs the anti-inflammation and In terms of human consumption, myrrh, like most herbal and
cytotoxic mechanism on bacteria or fungi infection responsi- botanical products, is perceived as being harmless. Myrrh as
ble for the chest ailment. Also, the C. myrrh extract and resin certified by the US Food and Drug Administration is a natural
were reported to show analgesic and anti-inflammatory activity flavoring agent (Ford et al. 1992). In a research safety of myrrh
which further justifies their use as an essential herbal medicine was determined and carried out by administering the agent
for different chest pain (Su et al. 2011). orally at 11.5 mg/kg for three consecutive days after overnight
fasting (Massoud et al. 1998). After 1, 2, 4, and 8 weeks post-
treatment in individuals that were not infected, liver and kidney
Nasal congestion effects function tests were observed to be normal while no significant
side effect was observed generally (Massoud et al. 1998). In
In infections relating to cold and flu, myrrh or Commiphora a parallel study, 10 mg/kg was administered for 3 to 6 days
myrrh extract reduces nasal congestion. Myrrh resin serves endured with mild and transient detrimental side effects (Mas-
as an immune-stimulant in the season of cold and flu by soud et al. 2001). In another study, myrrh extract of 500 mg/kg
accentuating the immunological system and acting as an was administered for five consecutive days but was observed
expectorant in nasal congestion treatment (Kalra et al. 2011). to show no signs of hepatotoxicity in mice after 12 weeks of
Traditionally, myrrh oil has been added to hot water in a few post treatment (Massoud et al. 2004a). Comparing genotoxic-
drops and inhaled in the form of steam. Headaches associ- ity, hepatotoxicity and carcinogenic outcomes of myrrh extract,
ated with nasal congestion have been treated with myrrh Mirazid formulation and praziquantel (standard drug), in ani-
indicating its analgesic effect (Ferrara 2019). mal model (rat) using various markers such as bilirubin, ALT,
and AST in the serum were assessed, as well as the liver his-
Can myrrh combat COVID‑19? topathology and bone marrow cell cytogenetic studies. Myrrh
administration was at 500 kg/kg daily, for 6 weeks, while the
It is a common belief that myrrh or C. myrrh is a medici- conventional drug, praziquantel, was administered at 1500 mg/
nal plant having applications in the management of various kg weekly for six consecutive weeks (Omar et al. 2005). Prazi-
diseases due to its therapeutic effects. Reported therapeutic quantel had hepatotoxic, genotoxic, and carcinogenic effects.
properties of C. myrrh include analgesic, immunomodulation, However, Mirazid was observed to be safe, showing no signs
cytotoxic, anti-inflammatory, antioxidant, hepatoprotective, of hepatotoxicity, genotoxicity, or carcinogenic effect (Omar
antimicrobial, anti-tumor, and anti-ulcer properties. Hence, et al. 2005). This report corroborates prior findings on the
myrrh could be applied in the treatment and management of safety of myrrh even after prolonged usage. Mirazid solution
13

showed acute toxicity in mice having an LD 50 of 3139 mg/ Acknowledgements We like to appreciate our colleagues that helped
kg. In mice, Mirazid solution showed 100% and 75% mortality to review the draft of this manuscript.
against Puerto Rican S. mansoni strain after 36 h of exposure Author contribution GEB, LW, JOT: formal analysis, investigation,
at a dose of 1000 mg/kg and 300 mg/kg respectively, for 3 days data curation, methodology, writing—original draft and revision.
consecutively (Botros et al. 2004). HMS, AMZ, OAA: formal analysis, investigation, data curation.
TKAT, HMA, AIA, AA, MP: formal analysis, investigation revi-
sion of text.
Potential drug‑herb interaction All the authors read and approved the final version of the
manuscript.
Co-administration of myrrh with cyclosporine was observed
Funding Open Access funding enabled and organized by Projekt
to have decreased the bioavailability significantly in rats (Al- DEAL. This study is supported by the University of Witten-Herdecke,
Jenoobi et al. 2015). 42283, Wuppertal, Germany.
Data availability Data sharing not applicable to this article as no data-

Conclusion sets were generated or analyzed during the current study.
Resinous extract of plant origin has been regarded as an Declarations

important plant resource in traditional medicine. Many
of the biological activities of Commiphora myrrh include Ethics approval Not applicable.
anti-inflammatory, antioxidant, anti-microbial, neuroprotec- Consent to participate Not applicable.
tive, anti-diabetic, anti-cancer, analgesic, anti-parasitic, and
recently against respiratory infection like COVID-19. These Consent for publication Not applicable.
pharmacological properties are owned due to various phyto-
Competing interests The authors declare no competing interests.
chemicals such as terpenoids (monoterpenoids, sesquiterpe-
noids, and volatile/essential oil), diterpenoids, triterpenoids, Open Access This article is licensed under a Creative Commons Attri-
and steroids. Its essential oil has applications in cosmetics, bution 4.0 International License, which permits use, sharing, adapta-
aromatherapy, and perfumery. With the advancement in drug tion, distribution and reproduction in any medium or format, as long
as you give appropriate credit to the original author(s) and the source,
development, hopefully its rich phytochemical components provide a link to the Creative Commons licence, and indicate if changes
can be explored for drug development especially as a formula- were made. The images or other third party material in this article are
tion as insecticide due to its great anti-parasitic activity as well included in the article's Creative Commons licence, unless indicated
as its interactions with drugs can be fully elucidated. otherwise in a credit line to the material. If material is not included in
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Commiphora myrrh
Location Southern part of Arabia, the
northeastern part of Africa in References
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tother Res 30:418–425
Authors and Affiliations
Gaber El‑Saber Batiha1 · Lamiaa Wasef1 · John Oluwafemi Teibo2 · Hazem M. Shaheen1 · Ali Muhammad Zakariya3 ·

Opeyemi Abigail Akinfe4 · Titilade Kehinde Ayandeyi Teibo5 · Hayder M. Al‑kuraishy6 · Ali I. Al‑Garbee6 ·
Athanasios Alexiou7,8 · Marios Papadakis9
1
* Gaber El‑Saber Batiha Department of Pharmacology and Therapeutics,
gaberbatiha@gmail.com Faculty of Veterinary Medicine, Damanhour University,
Damanhour 22511, AlBeheira, Egypt
* John Oluwafemi Teibo
2
johnteibo@usp.br Department of Biochemistry and Immunology, Ribeirão
Preto Medical School, University of São Paulo,
* Marios Papadakis
Ribeirão Preto, São Paulo, Brazil
marios_papadakis@yahoo.gr
3
Department of Biological Sciences, Sule Lamido University,
Lamiaa Wasef
Kafin Hausa, Nigeria
lamiaawasef@vetmed.dmu.edu.eg
4
Department of Biochemistry, University of Ibadan, Ibadan,
Hazem M. Shaheen
Nigeria
drhazemshaheen3010@yahoo.com
5
Department of Maternal‑Infant and Public Health Nursing,
Ali Muhammad Zakariya
College of Nursing, Ribeirão Preto, University of São Paulo,
zakariya.alimuhammad@slu.edu.ng
Ribeirão Preto, São Paulo, Brazil
Opeyemi Abigail Akinfe 6
Department of Clinical Pharmacology and Therapeutic
akinfeopeyemi@gmail.com
Medicine, College of Medicine, Almustansiriyiah University,
Titilade Kehinde Ayandeyi Teibo Bagh‑Dad, Iraq
tayandeyi@usp.br 7
Department of Science and Engineering, Novel Global
Hayder M. Al‑kuraishy Community Educational Foundation, Hebersham,
hayderm36@yahoo.com NSW 2770, Australia
8
Ali I. Al‑Garbee AFNP Med, 1030 Vienna, Austria
dr.alialgareeb78@yahoo.com 9
Department of Surgery II, University Hospital
Athanasios Alexiou Witten-Herdecke, University of Witten-Herdecke,
alextha@yahoo.gr Heusnerstrasse 40, 42283 Wuppertal, Germany
13

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Commiphora Myrrh A Phytochemical and Pharmacologic PDF

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Naunyn-Schmiedeberg's Archives of Pharmacology (2023) 396:405–420

Commiphora myrrh: a phytochemical and pharmacological update

Introduction obtainable in Egyptian, Roman, Greek, and Chinese litera-

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produced by Commiphora have applications in fragrances, cinnamaldehyde, cadinene cumicalcohol, cuminaldehyde,

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myrrh, Commiphora molmol, or Balsamodendron myr-

The most studied and most frequently used species of Com-

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Antiparasitic activity Myrrh as a fasciolicide

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Data availability Data sharing not applicable to this article as no data-

Resinous extract of plant origin has been regarded as an Declarations

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Authors and Affiliations

Gaber El‑Saber Batiha1 · Lamiaa Wasef1 · John Oluwafemi Teibo2 · Hazem M. Shaheen1 · Ali Muhammad Zakariya3 ·

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