ProVens^® in the Therapy of Glaucoma and Ocular Hypertension

Czech version

Authors: M. Karhanová ¹; M. Eliášová ²; T. Kuběna ³; H. Pešková ⁴; P. Mlčák ¹; Z. Fryšák ¹; K. Marešová ¹; J. Zapletalová ⁵
Authors‘ workplace: Oční klinika LF UP a FN Olomouc, přednosta prof. MUDr. Jiří Řehák, CSc., FEBO ¹; Oční oddělení Nemocnice Pardubického kraje, a. s., Litomyšlská nemocnice primář MUDr. Vladimír Liška, Ph. D. ²; Oční ordinace Zlín ³; Oční ordinace Praha ⁴; Ústav lékařské biofyziky LF UP a FN Olomouc, přednosta prof. RNDr. Hana Kolářová, CSc. ⁵
Published in: Čes. a slov. Oftal., 71, 2015, No. 6, p. 288-292
Category: Original Article

Prezentováno na Kongresu České glaukomové společnosti v Praze, 10.–12. 4. 2014 a na XX. Výročnom kongrese Slovenskej oftalmologickej spoločnosti v Hornom Smokovci, 23.–25. 10. 2014

Overview

Objective:
To assess the effect of the ProVens^®dietary supplement administration on intraocular pressure in patients with glaucoma and ocular hypertension.

Material and Methods:
The patients included in the trial were given the ProVens^®dietary supplement once daily. One ProVens^®tablet contains: 50 mg of maritime pine bark extract, 100 mg of green tea extract, and 3 mg of blueberry extract. The main ProVens^®components are proanthocyanins from the bark of the maritime pine tree Pinus pinaster, polyphenols from green tea, and anthocyanins from blueberries. The total number of patients included in the trial was 46. Out of these, 35 patients were monitored for asymptomatic ocular hypertension and 11 patients for open-angle glaucoma treated with prostaglandin analogs. Intraocular pressure was measured by applanation tonometry in the beginning of the trial, after one month, and after three months of their inclusion in the trial, always at the same time of the day.

Results:
In the group of patients with ocular hypertension, there was a statistically significant reduction in the intraocular pressure from the baseline values of 24.2 ± 2.1 mm Hg to 20.9 ± 2.5 mm Hg within the period of three months (p < 0.0001). In the group of patients with open-angle glaucoma, there was a statistically significant reduction of the intraocular pressure from the baseline values of 18.4 ± 3.2 mm Hg to 17.0 ± 3.1 mm Hg within the period of three months since the beginning of administration of the product (p = 0.022). When comparing both groups, we observed a significantly higher reduction in intraocular pressure (p = 0.0001) in the group of patients with ocular hypertension. In the whole group, no adverse effects were reported during the intake of this dietary supplement.

Conclusion:
Intake of the ProVens^®dietary supplement containing proanthocyanins from the bark of the maritime pine tree Pinus pinaster together with a mixture of herbal antioxidants appears to be one of the methods of how to improve the control of intraocular pressure, particularly in patients with ocular hypertension.

Key words:
glaucoma, ocular hypertension, ProVens^®, proanthocyanins, antioxidants, maritime pine bark extract

Sources

1. Casseli, L.: Clinic, electroretinographic trial on the action of anthocyanosides. Arch Med Interma, 1985; 37: 29–35.

2. Cesarone, M.R., Belcaro, G., Rohdewald, P. et al.: Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology, 2008; 59: 385.

3. Coleman, A., Stone, K., Kodjebacheva, G. et al.: Glaucoma risk and the consumption of fruits and vegetables among older women in the study of osteoporotic fractures. Am J Ophthalmol, 2008; 145: 1081–1089.

4. Emre, M., Orgül, S., Haufschild, T. et al.: Increased plasma endothelin-1 levels in patients with progressive open angle glaucoma. Br J Ophthalmol, 2005; 89(1): 60–63.

5. Falsini, B., Marangoni, D., Salgarello, T. et al.: Effect of epigallocatechin-gallate on inner retinal function in ocular hypertension and glaucoma: A short-term study by pattern electroretinogram. Graefes Arch Clin Exp Ophthalmol, 2009; 247(9): 1223–33.

6. Galvano, F., La Fauci, L., Vitaglione, P. et al.: Bioavailability, antioxidant and biological properties of the natural free-radical scavengers cyanidin and related glycosides. An Ist Super Sanita, 2007; 43: 382–93.

7. Giaconi, J., Yu, F., Stone, K.et al.: The association of consumption of fruits/vegetables with decreased risk of glaucoma among older African-American women in the study of osteoporotic fractures. Am J Ophthalmol, 2012; 154: 635–644.

8. Grimm, T., Schäfer, A., Högger, P.: Antioxidant activity and inhibition of matrix metalloproteinases by metabolites of maritime pine bark extract (pycnogenol). Free Radic Biol Med, 2004; 36: 811–822.

9. Hanneken, A., Lin, F., Johnson, J. et al.: Flavonoids protect human retinal pigment epithelial cells from oxidative-stress-induced death. Invest Ophthalmol Vis Sci 2006; 47: 3164–3177.

10. Hosseini, S., Lee, J., Sepulveda, R.T. 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; 21: 67–76.

11. Chen, F., Jiang, L., Shen, C. et al.: Neuroprotective effect of epigallocatechin-3-gallate against N-methyl-D-aspartate-induced excitotoxicity in the adult rat retina. Acta Oftalmol, 2012; 90: e609–e615.

12. Iravani, S., Zolfaghari, B.: Pharmaceutical and nutraceutical effects of Pinus pinaster bark extract. Res Pharm Sci, 2011; 6: 1–11.

13. Jain, S., Kaur, S., Sachdev, N.: Brief Communication: French Maritime Pine Bark Extract (Pinus Pinaster) and Its Ophthalmic Use. J Clin Exp Ophthalmol, 2014; 5: 353.

14. Kang, J., Pasquale, L., Willett W. et al.: Antioxidant intake and primary open-angle glaucoma: a prospective study. Am J Epidemiol, 2003; 158: 337–346.

15. Kang, J., Willett, W., Rosner, B. et al.: Caffeine consumption and the risk of primary open-angle glaucoma: a prospective cohort study. Invest Ophthalmol Vis Sci, 2008; 49: 1924–1931.

16. Leske, M.C., Heijl, A., Hussein, M. et al.: Factors for glaucoma progression and the effect of treatment: the Early Manifest Glaucoma Treatment Trial. Arch Ophthalmol, 2003; 121: 48–56.

17. Liu, X., Wei, J., Tan, F. et al.: Antidiabetic Effect of Pycnogenol French Maritime Pine Bark Extract in patient with diabetes type II. Life Sci, 2004; 75: 2505-13.

18. Maimoona, A., Naeem, I., Saddiqe, Z. et al.: A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract. J Ethnopharmacol, 2011; 33: 261–277.

19. Morazzoni, P., Bombardelli, E.: Vaccinum myrtillus L. Fitoterapia, 1996; 67: 3–29.

20. Nakanishi-Ueda, T., Kamegawa, M., Ishigaki, S. et al.: Inhibitory effect of lutein and Pycnogenol on lipid peroxidation in porcine retinal homogenate. J Clin Biochem Nutr, 2006; 38: 204–210.

21. Nishioka, K., Hidaka, T., Nakamura, S. et al.: Pycnogenol, French maritime pine bark extract, augments endothelium-dependent vasodilation in humans. Hypertens Res, 2007; 30: 775-780.

22. Orsucci, P.L., Rossi, M., Sabbatini, G. et al.: Trattamento della retinopatia diabetica noc antocianosidi. Indagine preliminare. Clin Ocul, 1983; 4: 77–81.

23. Pasquale, L., Wiggs, J., Willett, W. et al.: (2012) The relationship between caffeine and coffee consumption and exfoliation glaucoma or glaucoma suspect: a prospective study in two cohorts. Invest Ophthalmol Vis Sci, 2012; 53: 6427–6433.

24. Rohdewald, P.: A rewiev of the French maritime pine bark extract (Pycnogenol®), a herbal medication with a diverse pharmacology. Int J Clin Pharmacol Ther, 2002; 40: 158–68.

25. Rohdewald, P.: Pycnogenol®, French Maritime Pine Bark Extract. In: Dekker, M., ed. Encyclopedia of Dietary Supplement. Informa Healthcare: New York, 2005; 545–553.

26. Schönlau, F., Rohdewald, P.: Pycnogenol for diabetic retinopathy. A review. Int Ophthalmol, 2001; 24: 161–171.

27. Spadea, L., Balestrazzi, E.: Treatment of vascular retinopathies with Pycnogenol. Phytother Res, 2001; 15: 219–223.

28. Steigerwalt Jr., R.D., Gianni, B., Morazzoni, P. at al.: Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects. Molecular Vision, 2008; 14: 1288-1292.

29. Steigerwalt, R., Belcaro, G., Cesarone, M.R. et al.: Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocul Pharmacol Ther, 2009; 25: 537–540.

30. Steigerwalt Jr., R.D., Gianni, B., Morazzoni, P. et al.: Mirtogenol potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects. Clinical Ophthalmology, 2010; 4: 471–476.

31. Veach J.: Functional dichotomy: glutathione and vitamin E in homeostasis relevant to primary open-angle glaucoma. Br J Nutr, 2004; 91: 809–829.

32. Virno, M., Pecori, G.J., Auriemma, L.: Antacianosidi di mirtillo e permeabilita dei vasi del corpo ciliare. Boll Ocul, 1986; 65: 789–95.

33. Wan, M., Daniel, S., Kassam, F. et al.: Survey of complementary and alternative medicine use in glaucoma patients. J Glaucoma, 2012; 21: 79–82.

34. Wang, S., Singh, K., Lin, S.: The association between glaucoma prevalence and supplementation with the oxidants calcium and iron. Invest Ophthalmol Vis Sci 2012; 53: 725–731.

35. West, A., Oren, G., Moroi, S.: Evidence for the use of nutritional supplements and herbal medicines in common eye diseases. Am J Ophthalmol, 2006; 141: 157–166.

36. Xie, J., Jiang, Y., Zhang, T. et al.: Neuroprotective effect of Epigallocatechin-gallat (EGCG) in optic nerve crush model in rats. Neurosci Lett, 2010; 479: 26–30.