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French Maritime Pine Bark Extract: A Complex Compound with Numerous Metabolic Effects

French Maritime Pine Bark Extract

Standardized pine bark extract (SPBE), also known as French maritime pine bark extract per its source of the Maritime pine (Pinus pinaster Aiton), offers anti-aging benefits that encompass structure, beauty, and function.

French Maritime Pine Bark Extract
French Maritime Pine Bark

A diverse array of clinical research backs the use of this supplement, with data showing it supports the health of tissues and organs ranging from bones and skin to the arterials and the brain. More than 400 PubMed indexed studies exist on the topic of SPBE, and include positive findings in the realm of osteoarthritis, cognitive function, attention-deficit hyperactivity disorder, autoimmune disease, allergies, and even sexual health and function.

Several clinical studies support the use of SPBE for metabolic dysfunction,[1] including dysglycemia, dyslipidemia, hypertension, and their complications. SPBE has active constituents that include procyanidins, bioflavonoids, and organic acids which collectively provide strong antioxidant action, and can impact many metabolic and age-related issues simultaneously.[2] With research, interest has only grown as the mechanisms and physiological effects of SPBE are further understood.

Diabetes. Many studies have shown a positive impact of SPBE on diabetes and its complications. SPBE supports the reduction of blood glucose levels and its uptake and utilization within the cells.[3],[4] SPBE has been shown to inhibit the formation of advanced glycation end products (AGEs),[5] which play a role in the development of diabetes-related complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease.[6]

In patient with type 2 diabetes, supplementation with SPBE at a dosage of 100 mg daily was shown to significantly lower plasma glucose levels compared to placebo, also improving endothelial function.[7] A second, open, controlled study in type 2 diabetics investigated the impact of dosage, as 100 mg of SPBE is on the lower end of that typically used for chronic conditions. In this study, dosages of 50, 100, 200, and 300 mg/day were progressively used for a period of 3 weeks each (having no wash-out period between them).[8] Fasting glucose was reduced dose-dependently until reaching a dosage of 200 mg/day, beyond which no further improvements were seen. However, even at 50 mg/day a significant reduction in post-prandial glucose level was seen (decreasing from 224.7 ± 19.1 mg/dL to 201.1 ± 38 mg/dL), suggesting an increased cellular utilization of glucose at low dosages as well. By the end of the study, HbA1c levels had been reduced from 8.02 ± 1.04% to 7.37 ± 1.09%, the change becoming significant after completing three weeks at 200 mg/day. Insulin levels were not altered throughout the 12-week study.

The antioxidant effects of SPBE have been shown in humans and/or animal models to support the reduction of diabetic complications related to retinal health and vision,[9],[10] renal function,[11],[12] diabetic ulcers,[13] and nerve function.[14]

Dyslipidemia. Cholesterol balance also may be improved with routine oral supplementation of SPBE. In numerous human studies, supplementation with SPBE was shown to significantly lower total cholesterol and/or low-density lipoprotein (LDL) cholesterol, while high-density lipoprotein (HDL) cholesterol was either unaffected or increased. The effects on cholesterol, as well as the reduction of cholesterol accumulation in atherosclerotic plaques, are proposed to be mediated through toll-like receptor 4 and nuclear factor-kappaB (NFκB) pathways.[15],[16],[17] Doses ranging from 120 mg to 360 mg daily were shown to have this cholesterol-reducing effect, along with other health benefits.

In patients with mildly impaired cholesterol metabolism (having a primary complaint of erectile dysfunction), after three months of taking 120 mg of SPBE daily, total cholesterol decreased from 209 to 192 mg/dL and LDL cholesterol decreased from 133 to 107 mg/dL.[18] Plasma antioxidant activity and erectile function were simultaneously significantly improved. In another study, at a dosage of 150 mg daily, significant decreases in LDL cholesterol and increases in HDL cholesterol were seen in the majority of subjects after six weeks, along with a significant increase in antioxidant capacity.[19] Finally, patients with chronic venous insufficiency (CVI) who took 360 mg of SPBE daily not only experienced significant improvements in their CVI symptom scores, but also had improved cholesterol levels, with total cholesterol decreasing from 264 to 212 mg/dL and LDL cholesterol decreasing from 169 to 147 mg/dL after a period of only four weeks.[20]

Hypertension. As a monotherapy and as an adjunctive to pharmaceutical treatment, SPBE has been shown clinically to lower blood pressure and improve endothelial function. Antioxidants play an important role in nitric oxide (NO) production and release from endothelial cells, promoting vasodilation. In humans, SPBE has been shown to improve forearm blood flow via the increase in NO production.[21] Supplementation of SPBE also significantly improved flow-mediated dilation (as well as markers of oxidative stress) in patients with coronary artery disease[22] and individuals with borderline metabolic syndrome.[23] The benefits seen with supplementation of SPBE on blood vessel function also have been shown to translate to tinnitus and Meniere’s disease.[24],[25]

In mildly hypertensive patients, supplementation of 200 mg of SPBE daily led to a significant improvement in systolic blood pressure (SBP), with the SBP decreasing from 140 mmHg at baseline to 133 mmHg at eight weeks compared to only 139 mmHg with placebo.[26] Trends of improvement in diastolic blood pressure (DBP) were also seen. In the subset of individuals with more severe hypertension, a more dramatic effect was seen, with SBP being reduced from 150 mmHg to 134 mmHg.

Multiple studies have shown that supplementation with SPBE significantly reduces the need for anti-hypertensive medications, with stable blood pressures being maintained.[27],[28] In hypertensive patients with early signs of renal compromise, as an adjunctive support to medication, SPBE supplementation significantly decreased DBP and improved markers of kidney function as well.[29] SPBE also has been shown to reduce markers of edema, a potential side effect associated with anti-hypertensive medications.[30]

Abdominal adipose. SPBE also supports a healthy balance of brown and white adipose tissue, and related to this, a healthy waistline. SPBE has been shown to induce the browning of white adipose,[31] increasing levels of brown adipose tissue which is protective against obesity and diabetes.[32] In mice, treatment with the extract also reversed body weight and increases in white adipose tissue caused by high-fat and high-cholesterol diet feeding.31 Other studies have shown that SPBE inhibits adipogenesis and the production of reactive oxygen species by adipocytes, simultaneously increasing endogenous antioxidant transcription.[33],[34] In men and women with metabolic syndrome, supplementation of 150 mg of SPBE daily for 3 months significantly decreased waist circumference compared to placebo with reductions from 41.8 ± 0.9 inches to 38.9 ± 0.9 inches and 35.8 ± 0.6 inches to 33.3 ± 0.8 inches respectively.[35]

Within the subset of health conditions that impact us with aging, the issues associated with metabolic syndrome (hyperglycemia, dyslipidemia, hypertension, and abdominal obesity) tend to infiltrate gradually. Although much of the management, particularly in the early stages of onset, is to follow a healthy diet and increase exercise, nutritional supplements may also help tip the scales back in one’s favor. SPBE is a supplement that can impact many of these issues at once, simultaneously providing strong free radical-scavenging activity, making it worthy of consideration.

Dr. Carrie Decker, ND graduated with honors from the National College of Natural Medicine (now the National University of Natural Medicine) in Portland, Oregon. Dr. Decker sees patients remotely, with a focus on gastrointestinal disease, mood imbalances, eating disorders, autoimmune disease, and chronic fatigue. Prior to becoming a naturopathic physician, Dr. Decker was an engineer, and obtained graduate degrees in biomedical and mechanical engineering from the University of Wisconsin-Madison and University of Illinois at Urbana-Champaign respectively. Dr. Decker continues to enjoy academic research and writing and uses these skills to support integrative medicine education as a writer and contributor to various resources. Dr. Decker supports Allergy Research Group as a member of their education and product development team.
[1] Gulati OP. Pycnogenol® in Metabolic Syndrome and Related Disorders. Phytother Res. 2015 Jul;29(7):949-68.
[2] Packer L, Rimbach G, Virgili F. Antioxidant activity and biologic properties of a procyanidin-rich extract from pine (Pinus maritima) bark, pycnogenol. Free Radic Biol Med. 1999 Sep;27(5-6):704-24.
[3] Jankyova S, et al. The Effects of Pycnogenol® as Add-on Drug to Metformin Therapy in Diabetic Rats. Phytother Res. 2016 Aug;30(8):1354-61.
[4] Lee HH, et al. Effect of pycnogenol on glucose transport in mature 3T3-L1 adipocytes. Phytother Res. 2010 Aug;24(8):1242-9.
[5] Zhang TM, et al. Inhibitory effect of pycnogenol on generation of advanced glycation end products in vitro. Chinese Pharmacol Bull. 2003;19(4):437-40.
[6] Singh VP, et al. Advanced glycation end products and diabetic complications. Korean J Physiol Pharmacol. 2014 Feb;18(1):1-14.
[7] Liu X, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci. 2004 Oct 8;75(21):2505-13.
[8] Liu X, et al. French maritime pine bark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetic patients. Diabetes Care. 2004 Mar;27(3):839.
[9] Steigerwalt R, et al. Pycnogenol® improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocular Pharm Therap. 2009 Dec 1;25(6):537-40.
[10] Kamuren ZT, et al. Effects of low-carbohydrate diet and Pycnogenol® treatment on retinal antioxidant enzymes in normal and diabetic rats. J Ocu Pharma Therap. 2006 Feb 1;22(1):10-8.
[11] Kim YJ, et al. Pycnogenol modulates apoptosis by suppressing oxidative stress and inflammation in high glucose-treated renal tubular cells. Food Chem Toxicol. 2011 Sep 1;49(9):2196-201.
[12] Stuard S, et al. Kidney function in metabolic syndrome may be improved with Pycnogenol®. Panminerva Med. 2010 Jun;52(2 Suppl 1):27-32.
[13] Belcaro G, et al. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost. 2006 Jul;12(3):318-23.
[14] Jankyova S, et al. Pycnogenol® efficiency on glycaemia, motor nerve conduction velocity and markers of oxidative stress in mild type diabetes in rats. Phytother Res. 2009 Aug 1;23(8):1169-74.
[15] Luo H, et al. Pycnogenol attenuates atherosclerosis by regulating lipid metabolism through the TLR4-NF-κB pathway. Exp Mol Med. 2015 Oct 23;47:e191.
[16] Liu R, et al. Pycnogenol Reduces Toll-Like Receptor 4 Signaling Pathway-Mediated Atherosclerosis Formation in Apolipoprotein E-Deficient Mice. J Cardiovasc Pharmacol. 2016 Oct;68(4):292-303.
[17] Wang J, et al. Lipopolysaccharide promotes lipid accumulation in human adventitial fibroblasts via TLR4-NF-κB pathway. Lipids Health Dis. 2012 Oct 17;11:139.
[18] D̆uračková Z, et al. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile Dysfunction-a pilot study. Nutr Res. 2003 Sep 1;23(9):1189-98.
[19] Devaraj S, et al. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids. 2002 Oct;37(10):931-4.
[20] Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 Mar;16 Suppl 1:S1-5.
[21] Nishioka K, et al. Pycnogenol, French maritime pine bark extract, augments endothelium-dependent vasodilation in humans. Hypertens Res. 2007 Sep;30(9):775-80.
[22] Enseleit F, et al. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. Eur Heart J. 2012 Jul;33(13):1589-97.
[23] Hu S, et al. Effects of Pycnogenol® on endothelial dysfunction in borderline hypertensive, hyperlipidemic, and hyperglycemic individuals: the borderline study. Int Angiol. 2015 Feb;34(1):43-52.
[24] Luzzi R, et al. Improvement in symptoms and cochlear flow with pycnogenol in patients with Meniere’s disease and tinnitus. Minerva Med. 2014 Jun;105(3):245-54.
[25] Grossi MG, et al. Improvement in cochlear flow with Pycnogenol® in patients with tinnitus: a pilot evaluation. Panminerva Med. 2010 Jun;52(2 Suppl 1):63-7.
[26] Hosseini S, et al. A randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patients. Nutr Res. 2001 Sep 1;21(9):1251-60.
[27] Zibadi S, et al. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res. 2008 May;28(5):315-20.
[28] Liu X, et al. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004 Jan 2;74(7):855-62.
[29] Cesarone MR, et al. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants–a controlled study. J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):41-6.
[30] Belcaro G, et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol. Clin Appl Thromb Hemost. 2006 Oct;12(4):440-4.
[31] Cong H, et al. Pycnogenol® Induces Browning of White Adipose Tissue through the PKA Signaling Pathway in Apolipoprotein E-Deficient Mice. J Diabetes Res. 2018;2018.
[32] Cypess AM, Kahn CR. Brown fat as a therapy for obesity and diabetes. Curr Opin Endocrinol Diabetes Obes. 2010 Apr;17(2):143-9.
[33] Hasegawa N. Inhibition of lipogenesis by pycnogenol. Phytother Res. 2000 Sep;14(6):472-3.
[34] Lee OH, et al. Pycnogenol® inhibits lipid accumulation in 3T3-L1 adipocytes with the modulation of reactive oxygen species (ROS) production associated with antioxidant enzyme responses. Phytother Res. 2012 Mar;26(3):403-11.
[35] Belcaro G, et al. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res. 2013 Oct;27(10):1572-8.


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