less pain medication at the end. 18 of study. This study points to an important complication, the gas- trointestinal pro
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PYCNOGENOL : RESTORES JOINT HEALTH FROM THE INSIDE
J
oint problems touch a majority of the population with increasing age. The knee joints are most commonly affected by osteoarthritis, though incidences for hip- and finger arthritis are on the rise [Prieto-Alhambra, 2014]. Tissue regenerative processes in the joints are much lower than in other organs owed to anatomical reasons. Joints lack vascularisation, instead, joint tissues are nourished passively with oxygen and nutrients with fluids released from the joint capsule. This represents the fundamental reason why joints take long to recover from injury. Movement is essential for oxygen and nutrients to reach joint cartilage. In result the paradox
situation exists for individuals with knee aches. While resting aches less, only movement will improve healing process of the knees, at the expense of pain. Moderate movement carried out in water is currently discussed as option for improving delivery of oxygen and nutrients to arthritic joints, while minimising cartilage friction, without further compromising joint integrity [Waller et al. 2014].
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More recently, a standardised dietary supplement, Pycnogenol® French maritime pine bark extract (Horphag Research), was demonstrated to reach the interior of knee joints of individuals, following daily supplementation for three weeks [Mülek et al., 2017]. The study participants were scheduled for knee arthroscopy, which allowed for detailed joint investigation subsequent to supplementation with Pycnogenol®. The synovial fluid in joints was identified to bear quantities of Pycnogenol®, which was already expected because previous studies pointed to significant pain relief and mobility increase following supplementation with Pycnogenol®. Investigation of joint cartilage tissue samples collected from arthritis patients discovered that Pycnogenol® extinguishes inflammation of joint chondrocytes. The chondrocytes are joint cells embedded in cartilage, which orchestrate the rejuvenation of cartilage, removing old tissue and replacing it with renewed cartilage. In inflamed joints the chondrocytes dissolve more cartilage than they replace, thus contributing to the deterioration of joint integrity. With Pycnogenol®
the chondrocyte inflammation gets extinguished, setting the stage for synthesis of juvenile cartilage collagen as well as proteoglycans, the latter serving as lubricant in joints.
It is a fact that supplementation with Pycnogenol® improves health of arthritic joints, repeatedly demonstrated in controlled clinical trials. A first double-blind, placebo-controlled study demonstrated that daily supplementation with Pycnogenol® soothes joint pain already after 30 days, with maximum pain relief found after 60 days [Farid et al., 2007]. The total symptom score, comprising joint-pain, -stiffness and -function,
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all showed improvement after 30 days with maximum results after 60 days, which persisted until trial end at 90 days. Subjects in clinical trials were permitted to utilise pain medication for ethical reasons. The amount of medication taken was recorded by each study participant. The amount of non-steroidal anti-inflammatory drug intake thus gives an indication of the pain severity. Study participants in the placebo group
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increased pain medication, whereas the group supplementing with Pycnogenol significantly lowered pain medication, with no medication increase required [Farid et al., 2007]. Another randomised, placebo-controlled, double-blind study with 100 osteoarthritis patients stage 1-2, explored the possibility for reducing pain medication while supplementing with Pycnogenol® [Cisar et al., 2008]
Arthritis symptom relief after 3 months Pycnogenol® relative to baseline (* after 2 months) Number of patients
PainJ
oint stiffness
Farid et al.
37
- 43 %
- 35 %+
Cisar et al.
100
- 40 %
- 40 %*
Belcaro et al.
156
- 55 %
- 53 %+
Study
Symptoms evaluated in four week intervals, employing a visual analogue scale, demonstrated pain reduction after four weeks, with progressively further pain relief after eight and twelve weeks. During this time period study participants supplementing with Pycnogenol® gradually decreased the dosage of their preferred pain medication by 38%, because it was no longer re-
Physical function 52 % +
22 %* 56 %
quired. The placebo control-group, however, increased medication with non-steroidal analgesics, in order to cope with their situation. The virtues of Pycnogenol® for improving health and function of arthritic joints was further explored in a clinical trial with 156 subjects with osteoarthritis [Belcaro et al., 2008].
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Third clinical trial with Pycnogenol® for 156 osteoarthritis patients severe pain
start -11%
moderate
slight -56% no pain
3 months treatment Placeb o
Pycnogeno l®
Study participants supplementing with Pycnogenol® for three months presented with significantly decreased joint pain. Correspondingly, study participants taking Pycnogenol® regained greater mobility, being able to walk longer distances on a treadmill, in average from baseline 68 m to 198 m after three months supplementation with Pycnogenol. Subject in this study likewise were permitted to take pain medication when required. Whereas the control group continued same pain medication dosage at the end of the three month trial, as at trial start, participants taking Pycnogenol required 57% less pain medication at the end
of study. This study points to an important complication, the gastrointestinal problems related to continuous self-medication with non-steroidal drugs, such as ibuprofen, diclofenac and others. The group supplementing with Pycnogenol® were able to significantly decrease daily pain medication intake, coinciding with a 63% reduction of gastrointestinal problem [Belcaro et al., 2008] leading finding highlights an important subject with osteoarthritis; people affected commonly develop gastrointestinal problems in response to continuous medication with anti-inflammatory drugs. Supplementation with Pycnogenol® follows a novel approach, quenching inflammatory processes in the joints, supporting joint cartilage regeneration with corresponding mobility restoration.
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