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Belcaro G, Dugall M, Hosoi M, Feragalli B, Cotellese R, Saggino A, Cesarone MR, Ippolito E, Cornelli U, Ledda A, Cox DB. Pycnogenol® improves cognitive function in post-stroke patients: a 6 month-study. J Neurosurg Sci 2024; 68:109-116. [PMID: 38299491 DOI: 10.23736/s0390-5616.22.05855-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND This pilot study in post-stroke patients evaluated the effects of supplementation with Pycnogenol® on alterations in cognitive functions (COFU) over a period of 6 months, starting 4 weeks after the stroke. METHODS The effects of supplementation - possibly acting on residual brain edema, on global cognitive function, attention and on mental performance - were studied. A control group used standard management (SM) and the other group added Pycnogenol®, 150 mg daily to SM. RESULTS 38 post-stroke patients completed the 6-month-study, 20 in the Pycnogenol® group and 18 in the control group. No side effects were observed with the supplement. The tolerability was very good. The patients included into the two groups were comparable for age, sex and clinical distribution. There were 2 dropouts in the control group, due to non-medical problems. Main COFU parameters (assessed by a cognitive questionnaire) were significantly improved (all single items) with the supplement compared to controls (P<0.05). Additional observations indicate that Pycnogenol® patients experienced significantly less mini-accidents (including falls) than controls (P<0.05). The incidences of (minor) psychotic episodes or conflicts and distress and other problems including rare occurrence of minor hallucinations, were lower with the supplementation than in controls (P<0.05). Single observations concerning daily tasks indicated a better effect of Pycnogenol® compared to controls (P<0.05). Plasma free radicals also decreased significantly with the supplement in comparison to controls (P<0.05). Globally, supplemented subjects had a better recovery than controls. CONCLUSIONS In post-stroke subjects, Pycnogenol® supplementation resulted in better recovery outcome and faster COFU 'normalization' after the stroke in comparison with SM; it can be considered a safe, manageable post-stroke, adjuvant management possibly reducing local brain edema. Nevertheless, more patients and a longer period of evaluation are needed to confirm these results.
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Affiliation(s)
- Gianni Belcaro
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy -
| | - Mark Dugall
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | - Morio Hosoi
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | | | | | | | | | | | | | - Andrea Ledda
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
| | - David B Cox
- IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy
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2
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Cai C, Zeng B, Lin L, Zheng M, Burki C, Grether‐Beck S, Krutmann J. An oral French maritime pine bark extract improves hair density in menopausal women: A randomized, placebo-controlled, double blind intervention study. Health Sci Rep 2023; 6:e1045. [PMID: 36620515 PMCID: PMC9817492 DOI: 10.1002/hsr2.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
Background and Aims Female pattern hair loss affects females of all ages with a trend to increase after menopause. This disorder may have significant psychological impact and lead to anxiety and depression. Objective In a single center, double blind, randomized, placebo-controlled study, the effects of oral Pycnogenol® intake (3 × 50 mg/day for a total of 6 months) on hair density, scalp microcirculation, and a variety of skin physiological parameters was studied in Han Chinese menopausal women (N = 76) in Shanghai, China. Methods Measurements were taken at the beginning and after 2 and 6 months, respectively. Hair density was determined by digital photographs and further evaluated by Trichoscan software. Transepidermal water loss was measured by a humidity sensor in a closed chamber on the skin surface. Changes in microcirculation were detected as resting flux on the scalp by reflection photoplethysmography. Results Pycnogenol® intake significantly increased hair density by 30% and 23% after 2 and 6 months of treatment, respectively, as detected by Trichoscan® evaluation of digital photographs. Interestingly, photoplethysmography revealed that this beneficial effect was associated with a decrease in resting flux of the scalp skin, which might indicate an improvement of microcirculation. None of these effects were observed in the placebo taking group. In addition, a significant transient decrease of transepidermal water loss was observed in scalp skin under Pycnogenol,® but not placebo treatment. Conclusion Oral intake of Pycnogenol® might have the potential to reduce hair loss in postmenopausal women.
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Affiliation(s)
- Carr Cai
- Intertek Testing Services LtdShanghaiChina
| | - Bill Zeng
- Intertek Testing Services LtdShanghaiChina
| | - Lydia Lin
- Intertek Testing Services LtdShanghaiChina
| | | | | | | | - Jean Krutmann
- IUF ‐ Leibniz Research Institute for Environmental MedicineDüsseldorfGermany
- Medical FacultyHeinrich Heine UniversityDüsseldorfGermany
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3
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Nattagh-Eshtivani E, Gheflati A, Barghchi H, Rahbarinejad P, Hachem K, Shalaby MN, Abdelbasset WK, Ranjbar G, Olegovich Bokov D, Rahimi P, Gholizadeh Navashenaq J, Pahlavani N. The role of Pycnogenol in the control of inflammation and oxidative stress in chronic diseases: Molecular aspects. Phytother Res 2022; 36:2352-2374. [PMID: 35583807 DOI: 10.1002/ptr.7454] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/23/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023]
Abstract
The prevalence of chronic diseases has increased significantly with the rising trend of sedentary lifestyles, reduced physical activity, and dietary modifications in recent decades. Inflammation and oxidative stress play a key role in the pathophysiology of several chronic diseases, such as type II diabetes, cardiovascular diseases, and hepatic conditions. Therefore, reducing inflammation and oxidative stress may be beneficial in the prevention and treatment of various chronic disorders. Since chronic diseases are not completely curable, various methods have been proposed for their control. Complementary therapies and the use of natural antioxidant and antiinflammatory compounds are among these novel approaches. Pycnogenol (PYC) is a natural compound that could control inflammation and oxidative stress. Furthermore, some previous studies have shown that PYC could effectively reduce inflammation through signaling the downstream of insulin receptors, inhibiting the phosphorylation of the serine residues of insulin receptor substrate-1, reducing pro-inflammatory cytokines and oxidative stress indices through the stimulation of antioxidant pathways, increasing free radical scavenging activities, preventing lipid peroxidation, and protecting the erythrocytes in glucose-6-phosphate dehydrogenase-deficient individuals, although these effects have not been fully proved. The present study aimed to comprehensively review the evidence concerning the positive physiological and pharmacological properties of PYC, with an emphasis on the therapeutic potential of this natural component for enhancing human health.
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Affiliation(s)
- Elyas Nattagh-Eshtivani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Gheflati
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pegah Rahbarinejad
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kadda Hachem
- Laboratory of Biotoxicology, Pharmacognosy and Biological Valorization of Plants (LBPVBP), Faculty of Sciences, University of Saida- Dr Moulay Tahar, Saida, Algeria
| | - Mohammed Nader Shalaby
- Biological Sciences and Sports Health Department, Faculty of Physical Education, Suez Canal University, Ismailia, Egypt
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Golnaz Ranjbar
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dmitry Olegovich Bokov
- Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Pegah Rahimi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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4
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Malekahmadi M, Shadnoush M, Islam SMS, Shirvani A, Pahlavani N, Gholizadeh Navashenaq J, Firouzi S, McVicar J, Nematy M, Zali MR, Moradi Moghaddam O, Norouzy A. The effect of French maritime pine bark extract supplementation on inflammation, nutritional and clinical status in critically ill patients with traumatic brain injury: A randomized controlled trial. Phytother Res 2021; 35:5178-5188. [PMID: 34382717 DOI: 10.1002/ptr.7187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/09/2022]
Abstract
Inflammation plays an important role in the pathophysiology of traumatic brain injury (TBI). Based on the anti-inflammatory properties of French maritime pine bark extract and the neuroprotective effects, we aimed to evaluate the effects of its supplementation on TBI. Sixty-seven TBI patients admitted to the intensive care units (ICUs) were enrolled. After stabilizing the hemodynamic status, the intervention group received 150 mg of French maritime pine bark extract supplementation (Oligopin) with enteral nutrition for 10 days. The control group received a placebo. Inflammatory status and oxidative stress markers were measured three times. Also, clinical and nutritional statuses were assessed. Supplementation, significantly decreased IL-6 (β = -53.43 pg/ml, 95% confidence interval [CI] = -91.74, -15.13, p = .006), IL-1β (β = -111.66 pg/ml, 95% CI = -183.79, -39.5402, p = .002) and C-reactive protein (β = -19.99 mg/L, 95% CI = -27.23, -12.76, p ˃ .001) in the intervention group compared to control group after 10 days. Clinical scores including acute physiology and chronic health evaluation II and sequential organ failure assessment were reduced (β = -3.72, 95% CI = -5.96, -1.49, p = .001and β = -2.07, 95% CI = -3.23, -0.90, p < .001, respectively), and Nutric score was reduced compared to control group (β = -.60, 95% CI = -1.08, -0.12, p = .01). The survival rate was higher by 15% in the intervention group compared to control group. Oligopin supplementation in TBI patients in ICU reduced inflammation and improved the clinical status and malnutrition score and thereby reducing the mortality rate.
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Affiliation(s)
- Mahsa Malekahmadi
- Department of Clinical Nutrition, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.,Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Shadnoush
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Armin Shirvani
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Safieh Firouzi
- Department of Clinical Nutrition, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Jenna McVicar
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Mohsen Nematy
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Zali
- Department of Clinical Nutrition, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center, Critical Care Department, Rasoul-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Norouzy
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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5
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Belcaro G, Cornelli U, Cesarone MR, Scipione C, Scipione V, Hu S, Feragalli B, Corsi M, Cox D, Cotellese R, Hosoi M, Burki C. Preventive effects of Pycnogenol® on cardiovascular risk factors (including endothelial function) and microcirculation in subjects recovering from coronavirus disease 2019 (COVID-19). Minerva Med 2021; 113:300-308. [PMID: 34060731 DOI: 10.23736/s0026-4806.21.07650-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this open supplement study was to evaluate the effects of Pycnogenol® in comparison with controls on symptoms of post-COVID-19 syndrome and in improving endothelial function, microcirculation, inflammatory markers and oxidative stress over 3 months in symptomatic subjects recovering from COVID-19. METHODS Sixty subjects recovering from symptomatic COVID-19 were included. One group of 30 followed a standard recovery management while 30 comparable subjects received a supplement of 150 mg Pycnogenol® daily (in 3 doses of 50 mg) in addition to standard management. RESULTS Two groups of selected subjects were comparable at baseline. The groups progressively improved both with the SM (standard management) and with the SM in combination with the supplement. Patients, supplemented with Pycnogenol® showed significantly better improvement compared to the control group patients. No side effects from the supplementation were observed; tolerability was optimal. The progressive evolution over time was visible in all target measurements. Physiological tests. Endothelial function, low in all subjects at inclusion was assessed by flow mediated dilation (FMD) and finger reactive hyperemia in the microcirculation (laser Doppler measurements) after the release of an occluding suprasystolic cuff). It was significantly improved in the Pycnogenol® group after one month and after 3 months (p<0.05 vs controls). The rate of ankle swelling (RAS) by strain gauge decreased significantly in the supplemented group (p<0.05) in comparison with controls showing an improvement of the capillary filtration rate. At inclusion, the kidney cortical flow velocity indicated a decrease in perfusion (lower systolic and diastolic flow velocity) in all patients. Kidney cortical flow velocity increased significantly with the supplement (p<0.05) in comparison with controls with improvement in systolic velocity and in diastolic component. High sensitivity CRP (hs-CRP) and Il-6 plasma levels decreased progressively over 3 months with a significant more pronounced decrease in the supplement group (p<0.05). The number of patients with normal plasma IL-6 levels at the end of the study was higher (p<0,05) with the supplement. ESR followed the same pattern with a progressive and a more significant decrease in the supplemented subjects (p<0.02). Oxidative stress decreased significantly in the supplemented group (p<0.05) compared with the control group. Blood pressure and heart rate were normalized in all subjects in the supplement group; systolic pressure was significantly lower in the supplemented group (p<0,05) at the end of the study. Finally, the scores of Quality-of-life, mood and fatigue questionnaire and the Karnofsky scale performance index significantly improved in the supplement group (p<0.05) compared to controls after 1 and 3 months. All other blood parameters (including platelets and clotting factors) were within normal values at the end of the study. CONCLUSIONS In conclusion, Pycnogenol® may offer a significant option for managing some of the signs and symptoms associated with post-COVID-19 syndrome. This pilot evaluation offers some potential rationale for the use of Pycnogenol® in this condition that will have significant importance in the coming years.
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Affiliation(s)
| | - Umberto Cornelli
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | - Maria Rosaria Cesarone
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | | | | | - Shu Hu
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | - Beatrice Feragalli
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | - Marcello Corsi
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | - David Cox
- Irvine3 Labs, OOLEX Project for Covid, Chieti, Italy
| | - Roberto Cotellese
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
| | - Morio Hosoi
- Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University, Pescara, Italy
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6
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Weichmann F, Rohdewald P. Projected supportive effects of Pycnogenol Ⓡ in patients suffering from multi-dimensional health impairments after a SARS-CoV2 infection. Int J Antimicrob Agents 2020; 56:106191. [PMID: 33045354 PMCID: PMC7546273 DOI: 10.1016/j.ijantimicag.2020.106191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/21/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Corona virus disease 2019 (COVID-19) is triggered by the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV2) and has rapidly developed into a worldwide pandemic. Unlike other SARS viruses, SARS-CoV2 does not solely impact the respiratory system, but additionally leads to inflammation of endothelial cells, microvascular injuries and coagulopathies, thereby affecting multiple organs. Recent reports of patients who were infected with SARS-CoV2 suggest persistent health problems even months after the initial infection. The French maritime pine bark extract PycnogenolⓇ has demonstrated anti-inflammatory, vascular and endothelium-protective effects in over 90 human clinical studies. It is proposed that PycnogenolⓇ may be beneficial in supporting recovery and mitigating symptoms and long-term consequences resulting from a SARS-CoV2 infection in COVID-19 patients.
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Affiliation(s)
| | - Peter Rohdewald
- Institute of Pharmaceutical Chemistry, Westfälische Wilhelms-Universität Münster, Münster, Germany
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7
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Hu S, Hosoi M, Belcaro G, Dugall M, Feragalli B, Cotellese R, Luzzi R. Management of mild, primary Raynaud Syndrome: supplementation with Pycnogenol®. Minerva Cardioangiol 2020; 67:392-398. [PMID: 31637898 DOI: 10.23736/s0026-4725.19.04991-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Raynaud syndrome (RS) is associated with vasospasm of the hand and fingers as a response to cold or stress. RS may cause discomfort and color changes (pallor, cyanosis, erythema, as single symptoms, but usually in combination, localized to one or more fingers). The aim of this 4-week registry study was the evaluation of subjects with mild, primary RS and their treatment with a standard management (SM) plan in comparison with SM associated with supplementation with Pycnogenol®. METHODS A group of 67 females with mild, primary RS was included. All subjects were working in shops with refrigerators. No skin lesions were present. The age range was between 30 and 40; the vasospastic changes were symmetrical; no other physical findings were present. RESULTS The two groups, receiving standard management (N.=33) or SM+Pycnogenol®, 100 mg/day, (N.=34) were comparable at inclusion. Considering the main symptoms, the decrease in coldness, burning pain, paresthesias and irregular color changes was more significant with Pycnogenol® (P<0.05) at 4 weeks. At thermography, low temperature areas and discrepancies in temperature and color were decreased with Pycnogenol® more than in controls (P<0.05). In the Pycnogenol® group, one subject (2.94%) decided to use drug treatment (PGE1) in 4 weeks in comparison with 5 controls (15.15%). The lowest finger temperature improved from 20.3° C at inclusion to 26.4° C at 4 weeks (+30.04%) with Pycnogenol® in comparison with lower values (from 20.5 to 23.1 [+12.7%] in controls [P<0.05]). The fingertip skin flux increased significantly (+ 1.55 flux units) with Pycnogenol® (P<0.05), in controls just by +0.14 (ns). Supplementation with Pycnogenol® decreased oxidative stress and increased transcutaneous oxygen pressure (TcPO2) more than in controls. Compliance and tolerability were optimal. CONCLUSIONS This pilot registry study suggests that Pycnogenol® may be used with significant advantages in primary, mild RS. Subjects using Pycnogenol® may control their symptoms and may avoid the need for more complex and, potentially dangerous or expensive treatments.
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Affiliation(s)
- Shu Hu
- IRVINE3 Labs, IAPSS, Nicolaides's Lab, Chieti, Italy
| | - Morio Hosoi
- IRVINE3 Labs, IAPSS, Nicolaides's Lab, Chieti, Italy
| | | | - Mark Dugall
- IRVINE3 Labs, IAPSS, Nicolaides's Lab, Chieti, Italy
| | | | | | - Roberta Luzzi
- IRVINE3 Labs, IAPSS, Nicolaides's Lab, Chieti, Italy
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8
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Malekahmadi M, Moradi Moghaddam O, Islam SMS, Tanha K, Nematy M, Pahlavani N, Firouzi S, Zali MR, Norouzy A. Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol. Trials 2020; 21:162. [PMID: 32046747 PMCID: PMC7014642 DOI: 10.1186/s13063-019-4008-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.
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Affiliation(s)
- Mahsa Malekahmadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Bahonar St, Mashhad, Iran
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center, Critical Care Department, Rasoul-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Kiarash Tanha
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nematy
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Bahonar St, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naseh Pahlavani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Bahonar St, Mashhad, Iran
| | - Safieh Firouzi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Bahonar St, Mashhad, Iran
| | - Mohammad Reza Zali
- Behbood Research Center for Gastroenterology and Liver Diseases, Tehran, Iran
| | - Abdolreza Norouzy
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Bahonar St, Mashhad, Iran. .,Behbood Research Center for Gastroenterology and Liver Diseases, Tehran, Iran.
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9
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Pourmasoumi M, Hadi A, Mohammadi H, Rouhani MH. Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials. Phytother Res 2019; 34:67-76. [PMID: 31637782 DOI: 10.1002/ptr.6515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 08/31/2019] [Accepted: 09/04/2019] [Indexed: 01/30/2023]
Abstract
Several studies investigated the impact of pycnogenol on blood pressure. Nevertheless, the results are inconclusive. The aim of the present systematic review and meta-analysis was to clarify the effect of pycnogenol supplementation on blood pressure. PubMed, Scopus, Web of Science, and Google Scholar were systematically searched until March 2018 to find clinical trials, which examined the effect of pycnogenol supplementation on systolic and diastolic blood pressure in adults. A subgroup analysis was applied to find out potential sources of interstudy heterogeneity. A total of 12 clinical trials (922 participants) were included in the meta-analysis. Pooled analysis suggested that pycnogenol supplementation can reduced systolic blood pressure (SBP) of (-3.22 mmHg; 95% CI [-5.52, -0.92]) and diastolic blood pressure (DBP; -1.91 mmHg; 95% CI [-3.64, -0.18]). Effect of pycnogenol on SBP was more pronounce in subgroup in which pycnogenol was administered along with other treatments. A significant effect of pycnogenol on DBP in studies with >12-week duration, whereas this favorable effect was not observed in subgroup with ≤12-week supplementation. The present systematic review and meta-analysis suggest that pycnogenol had a favorable effect on SBP and DBP. Further, high quality randomized clinical trials are needed to confirm this result.
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Affiliation(s)
- Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Malekahmadi M, Moradi Moghaddam O, Firouzi S, Daryabeygi-Khotbehsara R, Shariful Islam SM, Norouzy A, Soltani S. Effects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2019; 150:104472. [PMID: 31585179 DOI: 10.1016/j.phrs.2019.104472] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/29/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
AIM Clinical trials on the effect of pycnogenol supplementation on cardiometabolic health have been controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the potential effect of pycnogenol supplementation on cardiometabolic profile. METHODS PubMed, Scopus, and ISI Web of Science databases were searched until October 2018. RCTs that evaluated the effects of pycnogenol on cardiometabolic parameters were included. DerSimonian and Laird random-effect models were used to compute the weighted mean differences (WMDs) and 95% confidence intervals (CIs). RESULTS Twenty-four RCTs including 1594 participants were included in the meta-analysis. Pycnogenol significantly reduced fasting blood glucose (WMD: -5.86 mg/dl; 95% CI: -9.56, -2.15), glycated hemoglobin (WMD = -0.29%, 95%CI: -0.56, -0.01), systolic blood pressure (WMD: -2.54 mmhg; 95% CI: -4.08, -0.99), diastolic blood pressure (WMD: -1.76 mmhg; 95% CI: -3.12, -0.41), body mass index (WMD: -0.47 kg/m2; 95% CI: -0.90, -0.03), LDL cholesterol (WMD: -7.12 mg/dl; 95% CI: -13.66, -0.58) and increased HDL cholesterol (WMD: 3.27 mg/dl; 95% CI: 0.87, 5.66). CONCLUSION This meta-analysis suggests that pycnogenol may have a role in preventing cardiometabolic disease. However, further well-designed RCTs are recommended to evaluate its long-term effects and explore the optimal duration of use and dosage.
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Affiliation(s)
- Mahsa Malekahmadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran; Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center, Critical Care Department, Rasoul-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Safieh Firouzi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran; Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Daryabeygi-Khotbehsara
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Abdolreza Norouzy
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Sepideh Soltani
- Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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11
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Rohdewald P. Pleiotropic Effects of French Maritime Pine Bark Extract to Promote Healthy Aging. Rejuvenation Res 2018; 22:210-217. [PMID: 30215292 DOI: 10.1089/rej.2018.2095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Extension of the healthy life span is of primary importance for the aging society. Among exercise, healthy nutrition, and mental training, food supplements are widely used as preventive measures to postpone the diverse symptoms of aging. The extract from the bark of the French maritime pine, Pycnogenol, rich on flavonoids, has anti-inflammatory and antioxidative property, proven in in vivo studies. The extract reduces oxidative stress and improves endothelial health. Its antithrombotic properties are based on inhibition of platelet aggregation. In double-blind, placebo-controlled clinical studies, Pycnogenol shows diverse positive effects. With respect to cardiovascular symptoms, the extract has an antihypertensive effect, slows down the progression of atherosclerosis, and prevents venous thrombosis. As reported in studies in China and the United States, type 2 diabetes and diabetic retinopathy is improved with Pycnogenol. The extract restores mobility of seniors in case of patients suffering from osteoarthritis, Pycnogenol reduces pain and stiffness and use of analgesics. Furthermore, cognitive functions of elderly people, especially spatial memory, are significantly ameliorated. Climacteric symptoms are significantly alleviated by the pine bark extract. Urinary symptoms of benign prostatic hyperplasia are reduced by Pycnogenol. In combination with L-arginine, Pycnogenol restores erectile function in men with erectile dysfunction. The sum of these positive effects on relevant symptoms of aging suggests using Pycnogenol for a more extended period of healthy aging.
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Affiliation(s)
- Peter Rohdewald
- Institute of Pharmaceutical Chemistry, University of Münster, Münster, Germany
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12
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Ledda A, Belcaro G, Feragalli B, Hosoi M, Cacchio M, Luzzi R, Dugall M, Cotellese R. Temporary kidney dysfunction: supplementation with Meriva® in initial, transient kidney micro-macro albuminuria. Panminerva Med 2018; 61:444-448. [PMID: 30486617 DOI: 10.23736/s0031-0808.18.03575-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this registry was to evaluate the efficacy of Meriva® in subjects with temporary kidney dysfunction (TKD) and increased oxidative stress levels. TKD was a casual finding on urinary tests after reported side effects following drug consumption, a clinical event or dehydration. METHODS Patients followed either standard management (SM) or SM plus Meriva® (Curcumin Phytosome®) supplementation (3 capsules/day, corresponding to 1.5 g of Meriva® containing 300 mg of curcumin in a bioavailable delivery form). The follow-up period lasted 4 weeks. Subjects were divided according to macroalbuminuria (>300 mg albumin on 24 hours) or microalbuminuria (<300 mg/day albuminuria). RESULTS Albuminuria decreased in all subjects, with a statistically significant improvement in the supplement group compared with controls (P<0.05). Oxidative stress level was high in all microalbuminuria subjects at inclusion; it was significantly more reduced in the supplement group (P<0.05) after 4 weeks. During follow-up blood pressure values were controlled; all subjects were under one single antihypertensive. Blood and urinary tests at 4 weeks were normalized in all subjects. Fatigue was significantly decreased or disappeared in most supplemented subjects at 4 weeks, with better results than in controls. Compliance and tolerability to Meriva® were good. CONCLUSIONS This registry study indicates that albuminuria - marker of TKD - is safely ameliorated with the standardized supplement Meriva®. Studies are needed to evaluate the effect of Meriva® in subjects with more significant clinical conditions (i.e. diabetics) or risk factors.
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Affiliation(s)
- Andrea Ledda
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Gianni Belcaro
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy - .,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Beatrice Feragalli
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Morio Hosoi
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Marisa Cacchio
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Roberta Luzzi
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Mark Dugall
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
| | - Roberto Cotellese
- Department of Medical and Oral Sciences and Biotechnology, Irvine3 Labs, University of Chieti-Pescara, Pescara, Italy.,International Agency For The Evaluation of Pharma-Standard Supplements (IA-PSS), Pescara, Italy
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13
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Hadi A, Pourmasoumi M, Mohammadi H, Javaheri A, Rouhani MH. The impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials. Phytother Res 2018; 33:276-287. [PMID: 30456865 DOI: 10.1002/ptr.6234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/08/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022]
Abstract
The effects of pycnogenol on plasma lipids are controversial. A systematic review and meta-analysis of clinical trials were conducted to obtain a conclusive result in humans. PubMed, Scopus, and Google Scholar were systematically searched until March 2018, to explore the clinical trials that examined the effect of pycnogenol supplementation on lipid parameters among adult human. Methodological quality of the eligible studies was evaluated using the Cochrane Collaboration's tool. To estimate the effect size, changes in blood lipids were implemented. Results were pooled using a random effects model. Potential sources of heterogeneity were explored by subgroup analysis. A systematic review and meta-analysis of 14 clinical trials with 1,065 participants suggested a significant increase in plasma concentration of high density lipoprotein cholesterol (HDL-C; 3.27 mg/dL; 95% CI [0.19, 6.36]; p = 0.038). In contrast, plasma levels of total cholesterol (TC; -4.45 mg/dL, 95% CI [-11.24, 2.34]; p = 0.199), triacylglycerol (TAG; -3.64 mg/dL; 95% CI [-17.89, 10.61]; p = 0.616), and low density lipoprotein cholesterol (LDL-C; -3.61 mg/dl; 95% CI [-8.76, 1.55]; p = 0.171) were not altered. Adjustment for confounding variables was poor in included studies. Also, these studies did not assess dietary lipid intake. The results indicate that pycnogenol supplementation improves levels of HDL-C; however, the changes in TC, TAG, and LDL-C were not clinically relevant. Since there are few phytochemicals that have a significant increasing effect on HDL-C levels, pycnogenol may have important role in prevention of cardiovascular diseases.
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Affiliation(s)
- Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Makan Pourmasoumi
- Halal Research Center of IRI, FDA, Tehran, Iran.,Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aftab Javaheri
- Food Science, Technology and Business, Faculty of Engineering Technology, Technology Campus Ghent, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Mohammad Hossein Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Vargas F, Romecín P, García-Guillén AI, Wangesteen R, Vargas-Tendero P, Paredes MD, Atucha NM, García-Estañ J. Flavonoids in Kidney Health and Disease. Front Physiol 2018; 9:394. [PMID: 29740333 PMCID: PMC5928447 DOI: 10.3389/fphys.2018.00394] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022] Open
Abstract
This review summarizes the latest advances in knowledge on the effects of flavonoids on renal function in health and disease. Flavonoids have antihypertensive, antidiabetic, and antiinflammatory effects, among other therapeutic activities. Many of them also exert renoprotective actions that may be of interest in diseases such as glomerulonephritis, diabetic nephropathy, and chemically-induced kidney insufficiency. They affect several renal factors that promote diuresis and natriuresis, which may contribute to their well-known antihypertensive effect. Flavonoids prevent or attenuate the renal injury associated with arterial hypertension, both by decreasing blood pressure and by acting directly on the renal parenchyma. These outcomes derive from their interference with multiple signaling pathways known to produce renal injury and are independent of their blood pressure-lowering effects. Oral administration of flavonoids prevents or ameliorates adverse effects on the kidney of elevated fructose consumption, high fat diet, and types I and 2 diabetes. These compounds attenuate the hyperglycemia-disrupted renal endothelial barrier function, urinary microalbumin excretion, and glomerular hyperfiltration that results from a reduction of podocyte injury, a determinant factor for albuminuria in diabetic nephropathy. Several flavonoids have shown renal protective effects against many nephrotoxic agents that frequently cause acute kidney injury (AKI) or chronic kidney disease (CKD), such as LPS, gentamycin, alcohol, nicotine, lead or cadmium. Flavonoids also improve cisplatin- or methotrexate-induced renal damage, demonstrating important actions in chemotherapy, anticancer and renoprotective effects. A beneficial prophylactic effect of flavonoids has been also observed against AKI induced by surgical procedures such as ischemia/reperfusion (I/R) or cardiopulmonary bypass. In several murine models of CKD, impaired kidney function was significantly improved by the administration of flavonoids from different sources, alone or in combination with stem cells. In humans, cocoa flavanols were found to have vasculoprotective effects in patients on hemodialysis. Moreover, flavonoids develop antitumor activity against renal carcinoma cells with no toxic effects on normal cells, suggesting a potential therapeutic role in patients with renal carcinoma.
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Affiliation(s)
- Félix Vargas
- Departamento de Fisiología, Facultad de Medicina, Instituto de Investigación Biosanitaria GRANADA, Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain
| | - Paola Romecín
- Departamento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, Spain
| | - Ana I García-Guillén
- Departamento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, Spain
| | - Rosemary Wangesteen
- Departamento de Ciencias de la Salud, Area de Fisiología, Universidad de Jaén, Jaén, Spain
| | - Pablo Vargas-Tendero
- Departamento de Fisiología, Facultad de Medicina, Instituto de Investigación Biosanitaria GRANADA, Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain
| | - M Dolores Paredes
- Departamento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, Spain
| | - Noemí M Atucha
- Departamento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, Spain
| | - Joaquín García-Estañ
- Departamento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, Spain
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15
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Nikpayam O, Rouhani MH, Pourmasoumi M, Roshanravan N, Ghaedi E, Mohammadi H. The Effect of Pycnogenol Supplementation on Plasma C-Reactive Protein Concentration: a Systematic Review and Meta-Analysis. Clin Nutr Res 2018; 7:117-125. [PMID: 29713620 PMCID: PMC5921329 DOI: 10.7762/cnr.2018.7.2.117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/02/2018] [Accepted: 04/05/2018] [Indexed: 12/22/2022] Open
Abstract
Pycnogenol is a standardized extract from the bark of the French maritime pine. The aim of the present systematic review and meta-analysis was to clarify the effect of Pycnogenol supplementation on C-reactive protein (CRP) concentration. To identify eligible studies in order to find clinical trials which examined the effect of Pycnogenol supplementation on the level of CRP in adult participants, PubMed, Scopus, and Google Scholar were systematically searched until December 2017. Mean of CRP was collected to estimate the effect size of the supplementation. Potential sources of heterogeneity were explored by subgroup analysis. Five trials including 324 participants were included in this meta-analysis. Pooled effect size showed significant effect of Pycnogenol supplementation on CRP (−1.22 mg/dL, 95% confidence interval, −2.43, −0.003; I2 = 99%, pheterogeneity < 0.001). When the meta-analysis was subgrouped by dose of Pycnogenol, heterogeneity was attenuated in > 150 mg/d category (I2 = 0.0%, p = 0.42). There was significant difference between-subgroup heterogeneity (p < 0.001). Furthermore, no evidence of publication bias for CRP (p = 0.27, Begg's test and p = 0.62, Egger's test) was seen. Present systematic review and meta-analysis suggested Pycnogenol consumption can decrease the level of CRP and have anti-inflammatory effect. So, Pycnogenol as an anti-inflammatory agent might be a priority in interventions. Further studies with large-scale and better design are needed to confirm this result.
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Affiliation(s)
- Omid Nikpayam
- Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Mohammad Hossein Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht 95655-41448, Iran
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz 51666-14711, Iran
| | - Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14155-6447, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Student Research Committee, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
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16
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Hügel HM, Jackson N, May B, Zhang AL, Xue CC. Polyphenol protection and treatment of hypertension. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:220-231. [PMID: 26926184 DOI: 10.1016/j.phymed.2015.12.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION High blood pressure is the major risk factor for cardiovascular diseases and the rising prevalence of human hypertension precedes the trend toward a global epidemic of unhealthy ageing. A focus on lifestyle and dietary interventions minimizes dependency on pharmacological antihypertensive therapies. REVIEW Observational studies indicate that the intake of dietary flavonoids is associated with a decreased risk of cardiovascular disease (CVD). The evidence suggests that the dietary intakes of polyphenol-rich foods, herbs and beverages including flavonols, anthocyanidins, proanthocyanidins, flavones, flavanones, isoflavones and flavan-3-ols, improves vascular health, thereby significantly reducing the risk of hypertension and CVD. Consumption is associated with an improvement in endothelial function via vascular eNOS and Akt activation. Increased NO bioavailability improves vasodilation and blood circulation, effects protein kinases, ion channels and phosphodiesterases, counteracting vascular inflammation and LDL oxidative stress. Importantly, some polyphenols also inhibit the activity of matrix metalloproteinases, inhibit angiotensin converting enzyme activity and thereby improving SBP and DSB. We review the improvement of polyphenol intake on blood pressure and endothelial function for the treatment of hypertension, including not only observational but also RCTs and pre-clinical studies. CONCLUSION The antihypertensive phytotherapy of polyphenol-rich foods for protection and improving endothelial function with vascular relaxation occurs via the NO-cGMP pathway and ACE inhibition. OPCs stimulate endothelium-dependent vasodilation, suppress vasoconstrictor ET-1 synthesis, activate a laminar shear stress response in endothelial cells and also inhibit the activity of metalloproteinases including ACE lowering blood pressure.
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Affiliation(s)
- Helmut M Hügel
- School of Applied Sciences, RMIT University, GPO Box 2476, Melbourne, VIC 3001, Australia .
| | - Neale Jackson
- School of Applied Sciences, RMIT University, GPO Box 2476, Melbourne, VIC 3001, Australia
| | - Brian May
- School of Health Sciences and China-Australia International Research Centre for Chinese Medicine, Health Innovations Research Institute, RMIT University, Melbourne, VIC 3001 Australia
| | - Anthony L Zhang
- School of Health Sciences and China-Australia International Research Centre for Chinese Medicine, Health Innovations Research Institute, RMIT University, Melbourne, VIC 3001 Australia
| | - Charlie C Xue
- School of Health Sciences and China-Australia International Research Centre for Chinese Medicine, Health Innovations Research Institute, RMIT University, Melbourne, VIC 3001 Australia
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17
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Gulati OP. Pycnogenol® in Metabolic Syndrome and Related Disorders. Phytother Res 2015; 29:949-68. [PMID: 25931421 DOI: 10.1002/ptr.5341] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/11/2015] [Accepted: 03/11/2015] [Indexed: 12/11/2022]
Abstract
The present review provides an update of the biological actions of Pycnogenol® in the treatment of metabolic syndrome and related disorders such as obesity, dyslipidaemia, diabetes and hypertension. Pycnogenol® is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. Subsp. atlantica. Its strong antioxidant, antiinflammatory, endothelium-dependent vasodilator activity, and also its anti-thrombotic effects make it appropriate for targeting the multifaceted pathophysiology of metabolic syndrome. Clinical studies have shown that it can reduce blood glucose levels in people with diabetes, blood pressure in mild to moderate hypertensive patients, and waist circumference, and improve lipid profile, renal and endothelial functions in metabolic syndrome. This review highlights the pathophysiology of metabolic syndrome and related clinical research findings on the safety and efficacy of Pycnogenol®. The results of clinical research studies performed with Pycnogenol® are discussed using an evidence-based, target-oriented approach following the pathophysiology of individual components as well as in metabolic syndrome overall.
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18
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de Jesús Romero-Prado MM, Curiel-Beltrán JA, Miramontes-Espino MV, Cardona-Muñoz EG, Rios-Arellano A, Balam-Salazar LB. Dietary flavonoids added to pharmacological antihypertensive therapy are effective in improving blood pressure. Basic Clin Pharmacol Toxicol 2014; 117:57-64. [PMID: 25441094 DOI: 10.1111/bcpt.12360] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 11/19/2014] [Indexed: 02/05/2023]
Abstract
Epidemiological studies have suggested that the daily intake of flavonoids is associated with a decreased risk of developing cardiovascular disease. Our purpose was to evaluate the effect of the addition of dietary flavonoids (DF) to antihypertensive treatment (AHT), based on telmisartan (Tms) or captopril (Cpr), on blood pressure (BP), body mass index (BMI), waist/hip ratio, leptin, lipid profile and inflammation in hypertensive young patients. An open-label, randomized, controlled trial was performed among 79 patients aged 20-55 years with grade I or grade II systemic arterial hypertension. The subjects were assigned to one of four groups for AHT plus DF during 6 months: Cpr (n = 14), Cpr + DF (n = 19), Tms (n = 25) and Tms + DF (n = 21). DF consisted of dark chocolate, dehydrated red apple and green tea in an infusion to obtain a daily dose of 425.8 ± 13.9 mg epicatechin equivalents. The BP and anthropometric parameters were measured every 2 weeks. Lipid profile, leptin and hsCRP were determined by standard methods. The combination AHT-DF produced an additional and significant reduction in (i) SBP/DBP of -5/-4 mmHg, being -7/-5 for Cpr + DF and -4/-3 for Tms + DF; (ii) triglyceride levels (-30.6%) versus AHT alone (-9.6%); and (iii) leptin: Cpr + DF versus Tms + DF (p < 0.005). Finally, C-reactive protein plasma levels were reduced significantly in all groups independently of the applied treatment. We conclude that the addition of flavonoids to pharmacological antihypertensive therapy shows additional benefits on BP, lipid profile, leptin, obesity and inflammation.
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Affiliation(s)
- Marina María de Jesús Romero-Prado
- Department of Physiology, INTEC, Universitary Center of Health Sciences (CUCS), Guadalajara, Jalisco, Mexico.,University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Jesús Aarón Curiel-Beltrán
- University of Guadalajara, Guadalajara, Jalisco, Mexico.,Department of Medical Sciences, Coast Universitary Center (CUCosta), Guadalajara, Jalisco, Mexico
| | - María Viviana Miramontes-Espino
- Department of Physiology, INTEC, Universitary Center of Health Sciences (CUCS), Guadalajara, Jalisco, Mexico.,University of Guadalajara, Guadalajara, Jalisco, Mexico
| | | | - Angeles Rios-Arellano
- Cardiology Service, Mexican Institute of Health Security, Regional Hospital No. 45, Guadalajara, Jalisco, Mexico
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Houston M. The role of nutrition and nutraceutical supplements in the treatment of hypertension. World J Cardiol 2014; 6:38-66. [PMID: 24575172 PMCID: PMC3935060 DOI: 10.4330/wjc.v6.i2.38] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/22/2013] [Accepted: 12/17/2013] [Indexed: 02/06/2023] Open
Abstract
Vascular biology, endothelial and vascular smooth muscle and cardiac dysfunction play a primary role in the initiation and perpetuation of hypertension, cardiovascular disease and target organ damage. Nutrient-gene interactions and epigenetics are predominant factors in promoting beneficial or detrimental effects in cardiovascular health and hypertension. Macronutrients and micronutrients can prevent, control and treat hypertension through numerous mechanisms related to vascular biology. Oxidative stress, inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease. There is a role for the selected use of single and component nutraceutical supplements, vitamins, antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies which complement optimal nutrition, coupled with other lifestyle modifications.
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Affiliation(s)
- Mark Houston
- Mark Houston, Hypertension Institute, Saint Thomas Medical Plaza, Nashville, TN 37205, United States
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20
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Houston MC. The role of nutrition and nutraceutical supplements in the prevention and treatment of hypertension. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/cpr.13.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Belcaro G, Cornelli U, Luzzi R, Cesarone MR, Dugall M, Feragalli B, Errichi S, Ippolito E, Grossi MG, Hosoi M, Cornelli M, Gizzi G. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res 2013; 27:1572-8. [PMID: 23359520 DOI: 10.1002/ptr.4883] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 10/08/2012] [Accepted: 10/15/2012] [Indexed: 12/12/2022]
Abstract
This open, controlled study evaluated the effects of 6 month supplementation with Pycnogenol® maritime pine bark extract on health risk factors in subjects with metabolic syndrome. Pycnogenol® was used with the aim of improving risk factors associated with metabolic syndrome, central obesity, elevated triglycerides (TG), low HDL cholesterol, high blood pressure and fasting blood glucose. Sixty-four subjects (range 45-55 years) presenting with all five risk factors of metabolic syndrome were included, and Pycnogenol® was administered for 6 months. A group of 66 equivalent subjects were followed up as controls. In the 6-month study Pycnogenol® supplementation 150 mg/day decreased waist circumference, TG levels, blood pressure and increased the HDL cholesterol levels in subjects. Pycnogenol lowered fasting glucose from baseline 123 ± 8.6 mg/dl to 106.4 ± 5.3 after 3 months and to 105.3 ± 2.5 at the end of the study (p < 0.05 vs controls). Men's waist circumference decreased with Pycnogenol from 106.2 ± 2.2 cm to 98.8 ± 2.3 cm and to 98.3 ± 2.1 after 3 and 6 months. Women's waist decreased from 90.9 ± 1.6 cm to 84.6 ± 2.1 cm and to 83.6 ± 2.2 cm after 3 and 6 months. Both genders waist circumference reduction was significant as compared to controls at both time points. In addition, plasma free radicals decrease in the Pycnogenol group was more effective than in the control group (-34.6%; p < 0.05). In conclusion, this study indicates a role for Pycnogenol® for improving health risk factors in subjects with metabolic syndrome.
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Affiliation(s)
- G Belcaro
- Irvine3 Labs, Department Biomedical Sciences, CH-PE University
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