Effect of Pycnogenol on the Healing of Venous Ulcers

Polyphenols in wound healing: unlocking prospects with clinical applications

Wound healing is a multifaceted, complex process that factors like aging, metabolic diseases, and infections may influence. The potentiality of polyphenols, natural compounds, has shown anti-inflammatory and antimicrobial properties in promoting wound healing and their potential applications in wound management. The studies reviewed indicate that polyphenols have multiple mechanisms that promote wound healing. This involves enhancing antioxidant defenses, reducing oxidative stress, modulating inflammatory responses, improving healing times, reducing infection rates, and enhancing tissue regeneration in clinical trials and in vivo and in vitro studies. Polyphenols have been proven to be effective in managing hard-to-heal wounds, especially in diabetic and elderly populations. Polyphenols have shown significant benefits in promoting angiogenesis and stimulating collagen synthesis. Polyphenol treatment has been demonstrated to have therapeutic effects in wound healing and chronic wound management. Their ability to regulate key healing processes makes them suitable for new wound care products and treatments. Future research should enhance formulations and delivery methods to optimize polyphenols' bioavailability and therapeutic efficacy in wound management approaches.

Emerging Pharmacological Interventions for Chronic Venous Insufficiency: A Comprehensive Systematic Review and Meta-Analysis of Efficacy, Safety, and Therapeutic Advances

Background/Objectives: Chronic Venous Insufficiency (CVI) is a progressive vascular condition characterized by venous hypertension and chronic inflammation, leading to significant clinical and socioeconomic impacts. This study aimed to evaluate the efficacy and safety of emerging pharmacological interventions for CVI, focusing on clinical outcomes such as pain, edema, cutaneous blood flow, and quality of life. Methods: Eligible interventions comprised new vasoprotective drugs, such as hydroxyethylrutoside, Pycnogenol, aminaphthone, coumarin + troxerutin, and Venoruton, compared to the standard therapy of diosmin and hesperidin. Results: Hydroxyethylrutoside and Pycnogenol showed significant benefits in pain reduction and resting flux improvement, with mean differences of 38 (95% CI: 10.56-65.44) and 25.30 (95% CI: 18.73-31.87), respectively. Improvements in edema and quality of life were less consistent. Substantial heterogeneity was observed (I2 = 100%, p < 0.001). Conclusions: Hydroxyethylrutoside and Pycnogenol emerge as promising alternatives for managing CVI. However, limitations such as high heterogeneity, small sample sizes, and methodological inconsistencies highlight the need for more robust and standardized clinical trials. This study underscores the importance of personalized and cost-effective strategies, particularly in resource-limited settings.

In Vivo Evaluation of Wound Healing Efficacy of Gel-Based Dressings Loaded with Pycnogenol™ and Ceratothoa oestroides Extracts

Ceratothoa oestroides and French maritime pine bark (Pycnogenol™) extracts are considered promising therapeutic agents in wound healing. This study explores the healing efficacy of composite dressings containing these extracts, aiming to enhance their stability and effectiveness, utilizing a low-temperature vacuum method for producing Sodium Alginate-Maltodextrin gel dressings. Surgical wounds were inflicted on SKH-hr2 hairless mice. Dressings were loaded with Pycnogenol™ and/or C. oestroides extracts and assessed for their efficacy. Wound healing was primarily evaluated by clinical and histopathological evaluation and secondarily by Antera 3D camera and biophysical measurements. Dressings were stable and did not compromise the therapeutic properties of C. oestroides extract. All interventions were compared to the C. oestroides ointment as a reference product. Most of the wounds treated with the reference formulation and the C. oestrodes dressing had already closed by the 15th day, with histological scores of 7 and 6.5, respectively. In contrast, wounds treated with Pycnogenol™, either alone or in combination with C. oestroides, did not close by the end of the experiment (16th day), with histological scores reaching 15 in both cases. Furthermore, treatment with 5% Pycnogenol™ dressing appeared to induce skin thickening and increase body temperature. The study underscores the wound healing potential of C. oestroides extracts and highlights the need for further research to optimize Pycnogenol™ dosing in topical applications.

Micronized purified flavonoid fraction for the treatment of chronic venous insufficiency, with a focus on postthrombotic syndrome: A narrative review

INTRODUCTION

Postthrombotic syndrome (PTS) is a form of secondary chronic venous insufficiency (CVI) that occurs after deep vein thrombosis (DVT). Effective treatments for PTS are lacking. Micronized purified flavonoid fraction (MPFF) is a venoactive drug used in the treatment of CVI.

OBJECTIVE

To determine whether MPFF is a good candidate to explore as a therapeutic agent for PTS.

METHODS

We performed a narrative review in which we identified 14 systematic reviews, 33 randomized controlled trials, and 19 observational studies that discussed the use of MPFF in CVI, as well as studies that reported on the mechanistic action of MPFF in relation to the pathophysiology of PTS.

RESULTS

MPFF targets a number of pathophysiologic components of PTS. Based on animal models and human studies investigating objective vascular and lymphatic measures, MPFF promotes venous recanalization after DVT, decreases venous remodeling and reflux, inhibits inflammatory processes, improves venous tone and stasis, improves lymphatic circulation, improves capillary hyperpermeability, and decreases tissue hypoxia. Furthermore, MPFF shows promise in improving clinical manifestations, quality of life, and objective venous parameters of CVI. Studies suggest good patient acceptability and tolerability with the use of MPFF in CVI.

CONCLUSION

MPFF is a good candidate to explore as a potential therapy for PTS. Confirmatory high-quality studies are still needed to reinforce the evidence supporting the use of MPFF in CVI. Double-blind randomized controlled trials with clinical endpoints are needed to assess the clinical efficacy of MPFF in the treatment of PTS.

Effects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials

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.

Systemic therapies for leg ulcers

Successful management of patients with leg ulcers requires identification of the underlying etiology, with subsequent initiation of causal treatment, if feasible. Supplementary measures of first choice include stage-adjusted wound treatment, usually combined with compression therapy. The significance of systemic drugs has been the subject of controversial debate, depending on the underlying cause of the condition. The present review article is therefore meant to highlight current aspects of systemic drug therapies for the treatment of leg ulcers associated with chronic venous insufficiency, peripheral arterial disease, livedoid vasculopathy, vasculitis, necrobiosis lipoidica, calciphylaxis and pyoderma gangrenosum. In summary, the majority of therapeutic options presented herein are used off-label. While systemic drugs are promising options for the more common types of wounds such as venous, mixed or arterial leg ulcers, they do not represent the current standard of treatment. By contrast, systemic agents play a key role in the management of many of the other disorders presented herein. These agents primarily include immunomodulatory and rheological drugs used to expedite wound healing.

Benefits of Hesperidin for Cutaneous Functions

Hesperidin is a bioflavonoid, with high concentration in citrus fruits. In addition to its well-known benefits for cardiovascular function, type II diabetes, and anti-inflammation, recent studies have demonstrated multiple benefits of hesperidin for cutaneous functions, including wound healing, UV protection, anti-inflammation, antimicrobial, antiskin cancer, and skin lightening. In addition, hesperidin enhances epidermal permeability barrier homeostasis in both normal young and aged skin. The mechanisms by which hesperidin benefits cutaneous functions are attributable to its antioxidant properties, inhibition of MAPK-dependent signaling pathways, and stimulation of epidermal proliferation, differentiation, and lipid production. Because of its low cost, wide availability, and superior safety, hesperidin could prove useful for the management of a variety of cutaneous conditions.

THE INTENSITY OF LIPID PEROXIDATION PROCESSES IN WOMEN WITH PRIMARY VARICOSE VEINS OF THE PELVIC DEPENDING ON THE STAGE OF THE DISEASE

Background: Information about involvement of general nonspecific reactions, in particular lipid peroxidation processes, in the progression of varicose veins of the pelvic (VVP) in women is still too scarce. Aims: To study the intensity of processes of lipid peroxidation and the activity of components of the antioxidant system in women with primary varicose veins of the pelvic at different stages of the disease. Materials and methods: 167 women of reproductive age were examined ― 137 with VVP and 30 made up a control group. All patients with VVP were divided into 3 groups depending on stages of the disease. Spectrophotometric and fluorometric methods of investigation were used. The study was conducted during 2012−2017. Results: It was revealed that the level of primary products of lipid peroxidation, diene conjugates, increased statistically significantly according to the stage of the disease by 1.25 times (in the 1st stage), 1.51 times (in the II stage) and 1.59 times (in the III stage) values. Changes in the content of final TBA-active products showed similar changes-an increase in the mean values for all stages of the disease relative to control (in 1.24, 1.17, and 1.77 times, respectively). Activity of glutathione peroxidase increased in stage 2 of VVP (1.19 times), with the maximum increase in stage III (1.42 times); activity of glutathione-S-transferase increased 1.18 times in the II stage of the disease. The concentration of GSH in the clinical groups was characterized by lower values with respect to the control (by 1.22 times in the 1st stage, in 1.64 times in the II stage), with the maximum decrease of this parameter in the III stage of VVP (3.67 times). The level of catalase activity increased in the I stage of VVP ― by 1.18 times and decreased in the III stage ― by 1.14 times with respect to the control. The activity of SOD showed similar changes with catalase ― in the form of increased activity at the 1st stage (1.35 times higher) and decreased values for II (1.35 times lower) and III (1.65 times lower) for the stages of VVP to the values of control. Conclusions: At progression of primary VVP in women (from the initial stage to the 3rd stage of the disease), there is an increase in imbalance in the lipid peroxidation − antioxidant defense system. Moreover, if the compensatory increase in activity of antioxidant enzymes is registered at stage 1 of the disease, then the most of the antioxidant defense factors decreases as relative to control values, and the initial stages of the disease.