Pycnogenol (French Maritime Pine Bark Extract)
1. Identity, Source, and Commercial Forms
Botanical and Chemical Identity
Pycnogenol® is a standardized bark extract of the French maritime pine Pinus pinaster, Aiton, subspecies Atlantica des Villar. Pinus pinaster (P. pinaster) and Pinus maritima (P. maritima) are understood to refer to the same organism; these terms are interchangeable. The trade name "Pycnogenol" is a registered trademark belonging to Horphag Research, Ltd.
The term "Pycnogenol" was originally intended to serve as a scientific name for a class of polyphenols, but now refers essentially to a specific blend of procyanidins extracted from the bark of the pine (Pinus pinaster), patented under the trade name Pycnogenol® (Horphag Research, Ltd., UK, Geneva, Switzerland). In 1979, Masquelier used the term Pycnogenol to refer to his product.
Geographic Source and Raw Material
Pycnogenol is not simply any pine bark extract; it is a proprietary blend sourced exclusively from the Landes de Gascogne forest in southwestern France. The multi-layered thick outer bark is harvested from 30-year-old cultivated trees grown for timber for furniture. The timber production generates far more bark as a by-product than is required for extraction of Pycnogenol. The forest is the largest found in Europe, with 2.5 million acres.
Extraction and Standardization
The extract is prepared by following a standardized procedure through extraction of fresh pine bark with ethanol and water, which affords a mixture of flavonoids as monomers — catechin and taxifolin — and condensed polymers (procyanidins), as well as several phenolic acids including gallic, caffeic, and ferulic acid as the minor constituents. Pycnogenol is standardized to contain 70 ± 5% procyanidins. The quality of this extract is specified in the United States Pharmacopeia (USP 28). The quality and purity of the raw bark are also assessed by the French Association of Norms (AFNOR).
Available Preparations and Forms
Pycnogenol is available in most countries as an over-the-counter product, in tablet or capsule form in doses varying from 20 to 100 mg, and has demonstrated good tolerability with very few side effects and a high level of safety. Topical formulations also exist. Pycnogenol formulations are available as oral supplements and topical creams, with dosages typically ranging from 30 mg to 450 mg daily, depending on the intended use.
A list of synonyms are currently adopted for Pycnogenol, including: French maritime pine bark extract, French Pinus maritime bark, leucoanthocyanidins, oligomeric proanthocyanidin complexes (OPCs), and various combination products such as Prelox® (a combination with L-arginine) and Evelle® (a multi-ingredient skin formula).
2. Historical and Traditional Use
Ancient and Pre-Modern Use
The medicinal use of pine bark from different pine species can be traced back to Hippocrates, 400 B.C., and was applied in many parts of the world. Traditionally, pine bark has been used for its anti-inflammatory and wound healing effects.
Jacques Cartier and the 16th-Century Account
The first recorded use of pine bark extracts dates to 1535, when French explorer Jacques Cartier and his crew escaped death by scurvy — a disease caused by a lack of vitamin C — by drinking tea made from the bark of a pine tree. Cartier's writing inspired the researcher Jacques Masquelier to identify the active ingredients in pine bark extracts. Pine bark extract from the European coastal pine (Pinus pinaster) was used by native Indians of Quebec, who introduced French explorer Jacques Cartier and his crew to the pine-bark tea during the winter of 1534, which proved effective in preventing scurvy. The tea was effective because the needles contained traces of vitamin C, and the bark provided large quantities of bioflavonoids.
Modern Discovery and Development (20th Century)
French scientist Dr. Jacques Masquelier discovered the potential health benefits of pine bark in the 1940s. He began studying oligomeric proanthocyanidins (OPCs), bioflavonoids in the tree, and found their antioxidant characteristics might protect the body from oxidative damage and inflammation. In the 1960s, Masquelier developed his patented extraction process to isolate proanthocyanidins from pine bark, producing Pycnogenol. Jack Masquelier is reported to have read the account of Jacques Cartier's learning of the beneficial effects of a tea made from a tree bark by the Native Americans, and on the basis of this account, looked to find the active ingredients. Various sources were looked into by Masquelier, and he found a suitable source in — and extracted proanthocyanidins from — the bark of the European maritime pine.
3. Key Constituents and Active Compounds
Procyanidins (Primary Constituents)
Between 65% and 75% of Pycnogenol are procyanidins comprising catechin and epicatechin subunits with varying chain lengths. Other constituents are polyphenolic monomers, phenolic or cinnamic acids and their glycosides.
Procyanidins represent a sub-category of proanthocyanidins. Proanthocyanidin is the "family name" for different condensed flavan-3-ol species: procyanidins, prodelphinidins, propelargonidins, and various other species.
Other Identified Compounds
Pycnogenol is a blend of several bioflavonoids, including catechin, epicatechin, taxifolin, oligomeric procyanidins, and phenolic fruit acids such as ferulic acid and caffeic acid.
Bioavailability and Synergy
As many studies indicate, Pycnogenol components are highly bioavailable. Uniquely, Pycnogenol displays greater biological effects as a mixture than its purified components do individually, indicating that the components interact synergistically. Bioavailability studies in humans show that Pycnogenol® constituents enter the bloodstream as early as 2 hours after consumption and significantly increase the oxygen radical absorbance capacity (ORAC). Some of the larger molecules get further processed in the gut into metabolites. Remarkably, these metabolites are also absorbed into the bloodstream, contributing to Pycnogenol's overall efficacy.
4. Established Mechanisms of Action
Antioxidant Activity
Owing to the basic chemical structure of its components, the most obvious feature of Pycnogenol is its strong antioxidant activity. The molecular bases of Pycnogenol's activity are various, but they appear mainly to depend on its capacity to efficiently scavenge reactive oxygen and reactive nitrogen species. Due to its antioxidant and various biomodulating effects, Pycnogenol acts as a potent free radical scavenger, protects DNA from damage, increases the synthesis of antioxidant enzymes, and protects other endogenous antioxidants — including vitamin C, vitamin E, and glutathione — from oxidative damage.
Anti-Inflammatory Mechanisms
Pycnogenol activates Nrf2-dependent transcription, increasing antioxidant defenses such as GSH and SOD, and suppresses ROS-sensitive NF-κB signaling, thereby reducing oxidative stress and associated pro-inflammatory responses. Mechanistically, Pycnogenol inhibits NF-κB activation, leading to decreased transcription of pro-inflammatory mediators such as TNF-α, ICAM-1, and vascular cell adhesion molecule-1, thereby modulating cytokine-driven inflammatory responses and endothelial activation.
Pycnogenol is thought to exert anti-inflammatory effects by blocking leukotrienes and other cytokines that increase inflammation. Pycnogenol treatment was found to be dose-dependently associated with significantly less release of nitric oxide (NO), TNF-α, IL-6 and IL-1β, and lower levels of intercellular adhesion molecule-1 (ICAM-1) and perilipin 2 (PLIN2) in lipopolysaccharide-stimulated microglia.
Endothelial Nitric Oxide and Vasodilation
Pycnogenol, in addition to its antioxidant activity, stimulates constitutive endothelial NOS (eNOS) activity to increase NO levels, which could counteract the vasoconstrictor effects of epinephrine and norepinephrine. Pycnogenol increases production of nitric oxide, which may be impaired in certain disease states such as diabetes, by stimulating endothelial nitric oxide synthase, and the nitric oxide produced relaxes constricted blood vessels.
Collagen Binding and Capillary Protection
Pycnogenol is a highly potent antioxidant with a high affinity for collagen. Larger procyanidins bind to proteins of damaged blood vessels to lower capillary permeability and reduce basement membrane leakage. Pycnogenol reduces leukocyte-mediated degeneration of retinal capillaries, and has also been shown to prevent increased platelet activity without increasing bleeding time.
Extracellular Matrix and Cartilage Effects
The oral intake of Pycnogenol downregulated the gene expression of various cartilage degradation markers in patients' chondrocytes; the decreases of MMP3, MMP13 and the pro-inflammatory cytokine IL-1β were statistically significant. Additionally, protein concentrations of ADAMTS-5 in serum were significantly reduced after three weeks of intake.
Microcirculation
A key property of Pycnogenol explaining its broad effects is the improved tissue perfusion by enhancing microcirculation and its effects on endothelial function, contributing to improved blood flow by relaxing blood vessels.
5. Scientific Evidence by Health Area
Overview of the Clinical Evidence Base
In 39 randomized double-blind, placebo-controlled (RDP) human clinical trials including 2,009 subjects, Pycnogenol® French maritime pine bark extract supplementation for two weeks to six months has been shown to beneficially affect cardiovascular health, chronic venous insufficiency, cognition, joint health, skin health, eye health, women's health, respiratory health and allergies, oral health, and sports performance.
It is critical to note that the Cochrane Collaboration conducted a systematic review of randomized controlled trials and reached a more cautious conclusion: due to small sample size, limited numbers of trials per condition, variation in outcomes evaluated and outcome measures used, as well as the risk of bias in the included studies, no definitive conclusions regarding the efficacy or safety of Pycnogenol® are possible. Current evidence is insufficient to support Pycnogenol® use for the treatment of any chronic disorder. This review covered trials up to 2010–2012; a number of additional trials have been conducted since.
5.1 Cardiovascular Health and Blood Pressure
A review of clinical studies demonstrated that supplementation with Pycnogenol reduces platelet activity, lowers high blood pressure, relaxes artery constriction, and improves blood circulation.
A meta-analysis of blood pressure trials found quantifiable, albeit modest, effects: a total of 12 clinical trials (922 participants) were included in the meta-analysis. Pooled analysis suggested that Pycnogenol supplementation can reduce systolic blood pressure (SBP) by −3.22 mmHg (95% CI [−5.52, −0.92]) and diastolic blood pressure (DBP) by −1.91 mmHg (95% CI [−3.64, −0.18]). Several studies investigated the impact of Pycnogenol on blood pressure; nevertheless, the results are inconclusive.
Clinical research on Pycnogenol has been performed for cardiovascular health and cardiometabolic parameters. According to a review in 2012, Pycnogenol was used for treatment of many chronic diseases, but there was insufficient evidence to support its use. Previous meta-analyses showed that Pycnogenol may lower blood pressure, reduce the level of CRP and inflammation in humans, and significantly increase HDL.
Evidence strength: Suggestive but modest; meta-analyses show small statistically significant effects on blood pressure, but reviewers note heterogeneity across trials and inconclusive results overall.
5.2 Chronic Venous Insufficiency (CVI) and Related Venous Disorders
A review provides an update of the biological profile of Pycnogenol in the light of its use in the treatment of chronic venous insufficiency (CVI) and related venous disorders such as deep vein thrombosis (DVT), post-thrombotic syndrome, long-haul air-travel-related leg oedema, venous ulcers, and acute haemorrhoids. Its strong antioxidant, anti-inflammatory, and vasodilator activities, antithrombotic effects, and collagen-stabilizing properties make it uniquely able to target the multifaceted pathophysiology of CVI and related venous disorders. Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long-haul flights, and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration.
Pycnogenol reduces edema of legs and lowers chances of developing deep venous thrombosis and skin ulceration. These properties further qualify Pycnogenol to be a useful food supplement for venous health, particularly in chronic venous insufficiency.
Evidence strength: Moderate, with multiple clinical trials supporting benefit in CVI-related outcomes (edema, DVT prevention, venous ulcers), though the Cochrane review noted that trial samples in this category were small (N = 60 across only two RCTs at time of review).
5.3 Cognitive Function and ADHD
In eight publications on RDP studies investigating the effects on cognitive function, Pycnogenol® has shown to have beneficial effects in all age groups, from children with attention deficit hyperactivity disorder (ADHD) to elderly people with memory-based cognitive challenges.
In a recently published RDP clinical trial, 88 children (aged six to twelve) with diagnosed ADHD received either Pycnogenol® (20 or 40 mg/day if < or ≥ 30 kg, respectively; 20 mg/day during the first two weeks), methylphenidate hydrochloride (20 or 30 mg/day if < or ≥ 30 kg, respectively; treatment started with 10 mg/day, increasing 10 mg per week) or placebo for ten weeks. Teachers reported more significant symptom improvement in children taking Pycnogenol or methylphenidate than those taking the placebo.
An earlier RCT (Trebatická et al., 2006) similarly found that, compared with placebo, there was a reduction in hyperactivity and inattention symptoms, and an improvement of cognitive function such as visuomotor coordination and concentration. No significant effects were observed in the placebo group.
Pycnogenol had been shown to decrease oxidative damage to DNA in children with attention deficit hyperactivity disorder.
For cognitive aging, a 2025 systematic review and network meta-analysis found that for cognitive function, measured as a standardized mean difference to harmonize various assessment scales, Pycnogenol showed the most significant effect and the highest probability of being the best intervention (Surface Under the Cumulative Ranking Curve, SUCRA: 98.8%) among eighteen botanical drug interventions for mild cognitive impairment.
In 20 men taking 400 mg Pycnogenol® per day for 30 days, the symptoms of Gulf War illness were significantly reduced compared to placebo. Assessed symptoms were categorized into six domains: fatigue, pain/discomfort, skin, gastrointestinal, respiratory, and neurological/cognitive/mood, including anxiety, depressive, and PTSD-related symptoms. The authors concluded that Pycnogenol® may be a promising candidate to further study the effects on Gulf War illness.
Evidence strength: Preliminary to moderate; individual RCTs show cognitive benefits but trial sizes are generally small. The network meta-analysis result for mild cognitive impairment is notable but the field requires larger confirmatory trials.
5.4 Osteoarthritis and Joint Health
Joint health is another essential factor for well-being. Osteoarthritis, especially in the knees, hips, and hands, is a very common joint problem with over half a billion people in the world living with this condition that can affect the ability to move freely.
The oral intake of Pycnogenol downregulated the gene expression of various cartilage degradation markers in patients' chondrocytes. The decreases of MMP3, MMP13, and the pro-inflammatory cytokine IL-1β were statistically significant. Additionally, protein concentrations of ADAMTS-5 in serum were significantly reduced after three weeks of intake of the pine bark extract. This was described as the first report of positive cellular effects of a dietary supplement on key catabolic and inflammatory markers in patients with severe OA, and the results provide a rational basis for understanding previously reported clinical effects of Pycnogenol on symptom scores of patients suffering from OA.
The Cochrane review noted that osteoarthritis was the most-studied indication in the trials it examined, encompassing three studies (N = 293 participants). However, due to small sample size, limited numbers of trials per condition, variation in outcomes evaluated and outcome measures used, as well as the risk of bias in the included studies, no definitive conclusions regarding efficacy or safety of Pycnogenol® are possible.
Evidence strength: Moderate-preliminary. Multiple RCTs and a mechanistic pilot study support anti-inflammatory and symptom-reducing effects; larger, higher-quality trials are needed for definitive conclusions.
5.5 Diabetic Retinopathy and Eye Health
Pycnogenol, a standardized extract of the bark of the French maritime pine, is known to increase capillary resistance. Pycnogenol has been tested for treatment and prevention of retinopathy in five clinical trials with a total number of 1,289 patients since the late 1960s. There were two open case studies and two double-blind studies (one controlled against calcium dobesilate and another against placebo) and, finally, one multi-center field study with 1,169 diabetics.
All of these studies unequivocally showed that Pycnogenol retains progression of retinopathy and partly recovers visual acuity. Treatment efficacy of Pycnogenol was at least as good as that of calcium dobesilate. Pycnogenol was shown to improve capillary resistance and reduce leakages into the retina.
A more recent RCT examined Pycnogenol specifically in early-stage retinopathy: the aim was to show protective effects of Pycnogenol in early stages of retinopathy, characterized by mild to moderate retinal edema in the absence of hemorrhages or hard exudates in the macula center. Following treatment with Pycnogenol (24 patients) for 3 months, retinal edema score (dilated ophthalmology) and retinal thickness (high-resolution ultrasound) showed statistically significant improvement compared to the placebo group (22 patients), which showed negligible changes to baseline. Pycnogenol taken at this early stage of retinopathy may enhance retinal blood circulation accompanied by regression of edema, which favorably improves vision of patients.
The RCT at 150 mg/day for 2 months used 24 patients in the Pycnogenol group; a limitation noted by independent commentary was that patients also underwent a diet and exercise program, so the benefits of Pycnogenol could not be entirely isolated. In addition, the study was limited by an extremely selective sample.
Evidence strength: Moderate, supported by multiple trials including a large multicenter study, though many older trials were conducted in French and German and have limited accessibility to independent reviewers. Mechanistic plausibility is high due to Pycnogenol's capillary-protective properties.
5.6 Respiratory Health: Asthma and Allergy
Pycnogenol (a proprietary mixture of water-soluble bioflavonoids extracted from French maritime pine) has been used for its anti-inflammatory properties in conditions such as asthma. The anti-inflammatory properties of Pycnogenol in the pulmonary context involve nuclear factor kappa B and mitogen-activated protein kinase signaling, and it suppressed asthmatic airway inflammation by modulating inflammatory mediators such as interleukin-4, -5, and -13, and inhibiting mucin-5AC in goblet cells.
The Cochrane review identified two studies in asthma (N = 86) and found insufficient evidence to draw conclusions. A double-blind exploratory study (Wilson et al., 2010) evaluated Pycnogenol for allergic rhinitis symptoms; it was small and exploratory in nature.
Evidence strength: Preliminary. Mechanistic evidence is plausible, but clinical RCTs for asthma and allergy are small and insufficient for definitive recommendations.
5.7 Skin Health
Research in a 2024 review suggests that Pycnogenol may increase the production of hyaluronic acid and collagen, which may explain its beneficial effects on skin hydration and elasticity. Marini et al. (2012) reported in a peer-reviewed study (Skin Pharmacology and Physiology) that Pycnogenol effects on skin elasticity and hydration coincided with increased gene expressions of collagen type I and hyaluronic acid synthase in women.
One study found that Pycnogenol prevented decreases in skin hydration and improved skin elasticity. Zhao et al. (2021) conducted a randomized, placebo-controlled, double-blind crossover study on Pycnogenol intake in urban Chinese outdoor workers, examining skin outcomes.
Evidence strength: Preliminary to moderate; RCTs confirm effects on objective skin parameters (elasticity, hydration), with a coherent mechanistic explanation involving collagen and hyaluronic acid upregulation. Additional large, independent RCTs are warranted.
5.8 Diabetes Mellitus and Metabolic Parameters
Four studies (N = 201) examined Pycnogenol in the context of diabetes mellitus within the Cochrane review but were deemed insufficient for conclusions. Additional meta-analytic work has since been published: one systematic review concluded that Pycnogenol could improve the signs and symptoms of metabolic syndrome. Previous meta-analyses showed that Pycnogenol may lower blood pressure, reduce the level of CRP and inflammation in humans, and significantly increase HDL.
Evidence strength: Preliminary; trials are individually small, and results require replication in larger independently designed RCTs before clinical guidance can be offered.
5.9 Erectile Dysfunction
One study (N = 21) examined Pycnogenol for erectile dysfunction in the Cochrane review. Additional studies have examined the combination product Prelox® (Pycnogenol plus L-arginine). Pycnogenol increases production of nitric oxide, which may be impaired in disease states such as diabetes, by stimulating endothelial nitric oxide synthase, and the nitric oxide produced relaxes constricted blood vessels — the mechanistic rationale for studying this application.
Evidence strength: Very preliminary; limited to small, single trials. No robust conclusions are currently possible.
5.10 Women's Health (Menopausal Symptoms, Dysmenorrhea)
Pycnogenol has been studied in RDP trials in the area of women's health, including perimenopausal symptoms. Kohama and Negami (2013), in a randomized, double-blind, placebo-controlled trial published in the Journal of Reproductive Medicine, examined the effect of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women.
For dysmenorrhea, 30 mg once or twice daily has been used in studies.
Evidence strength: Preliminary; individual RCTs are small and require independent replication.
5.11 Sports Performance and Muscle Recovery
The protective effects of Pycnogenol on DNA, protein, or lipid oxidation as well as its effects on blood antioxidant capacity were validated in several RDP studies on sports performance. Improved tissue perfusion by enhancing microcirculation and effects on endothelial function contribute to improved blood flow, which may explain sports performance effects.
Evidence strength: Preliminary; mechanistically plausible but clinical evidence is limited in size and scope.
6. Body Systems Associated with Pycnogenol
- Cardiovascular system: Blood pressure regulation, endothelial function, platelet aggregation, cholesterol (HDL)
- Venous and microcirculatory system: Chronic venous insufficiency, DVT prevention, capillary permeability
- Central nervous system / cognition: Working memory, attention, ADHD symptom management, mild cognitive impairment
- Musculoskeletal system: Osteoarthritis (knee, hip, hand), cartilage degradation markers
- Integumentary system (skin): Elasticity, hydration, collagen and hyaluronic acid gene expression, UV-related damage
- Ophthalmologic system: Diabetic retinopathy, retinal edema, capillary resistance in the retina
- Respiratory system: Asthma (airway inflammation, leukotriene suppression), allergic rhinitis
- Endocrine / metabolic system: Blood glucose, metabolic syndrome markers, HbA1c
- Reproductive and women's health: Perimenopausal symptoms, dysmenorrhea, endometriosis (preliminary)
- Urinary system: Recurrent urinary tract infections (preliminary)
7. Dosage Forms and Dosages Reported in Clinical Studies
The following dosages are drawn directly from published clinical study sources and monographs and are reported descriptively, not as prescriptive guidance:
- Chronic venous insufficiency: Forty patients with CVI and varices of the legs were randomly assigned to treatment with Pycnogenol 100 mg × 3/day or a placebo.
- Retinal disease / diabetic retinopathy: 50 mg three times daily has been used for diseases of the retina, including those related to diabetes. The double-blind Cesarone et al. study used 150 mg/day (24 patients) for 3 months for early diabetic retinopathy.
- Osteoarthritis/asthma: For osteoarthritis or asthma, 100 mg/day has been reported.
- Dysmenorrhea: For dysmenorrhea, 30 mg once or twice daily has been used.
- Poor circulation: 45–360 mg daily, or 50–100 mg three times daily has been reported for poor circulation.
- Asthma in children: 1 mg per pound of body weight given in two divided doses has been used for asthma in children.
- ADHD in children: 20 mg/day (for children <30 kg) or 40 mg/day (for children ≥30 kg), with 20 mg/day during the first two weeks, for ten weeks was used in the 2022 RCT comparing Pycnogenol to methylphenidate.
- Gulf War illness: 400 mg per day for 30 days was used in an RDP trial of 20 men.
- General over-the-counter availability: Tablet or capsule form in doses varying from 20 to 100 mg are typical commercial preparations.
8. Safety Profile and Clinically Noted Interactions
General Tolerability
Tolerance was generally very good and side effects were rare, mostly referring to gastric discomfort, in the five clinical trials on diabetic retinopathy reviewed by Schönlau and Rohdewald (2002).
Pycnogenol has demonstrated good tolerability with very few side effects and a high level of safety. Based on a recent update by the American Botanical Council, it is stated that an independent panel of toxicology experts has classified Pycnogenol as generally recognized as safe (GRAS) based on clinical safety and preclinical toxicology data.
Pycnogenol seems well-tolerated for use in adults for up to 6 months.
Platelet Activity and Anticoagulant Interactions
Pycnogenol's interaction with medications that slow blood clotting (anticoagulant/antiplatelet drugs) is rated as moderate. Pycnogenol might slow blood clotting. The antiplatelet activity of Pycnogenol, while demonstrated as not increasing bleeding time in studies, theoretically potentiates the effects of anticoagulant and antiplatelet medications. This is a pharmacodynamically plausible interaction that has been flagged in drug interaction databases.
Immunomodulatory Interactions
Pycnogenol seems to increase the immune system. By increasing the immune system, Pycnogenol might decrease the effectiveness of medications that decrease the immune system. Medications of concern include azathioprine, cyclosporine, tacrolimus, sirolimus, mycophenolate, and corticosteroids, among others.
Surgical Precaution
Pycnogenol might slow blood clotting. There is some concern that it might increase the chance of bleeding during and after surgery.
Vulnerable Populations
It is not known if Pycnogenol is safe for children or for women who are pregnant or breastfeeding. Although the ADHD trials discussed above enrolled children, long-term pediatric safety data are not established.
Cancer and Oncology Context
Evidence indicates that Pycnogenol may reduce treatment-related adverse effects and improve quality of life when used alongside conventional therapies, including in chronic inflammatory conditions and oncology settings, provided careful monitoring for drug–nutrient interactions. Advancing clinical translation will require well-powered, indication-specific randomized trials, systematic evaluation of pharmacodynamic interactions, and establishment of evidence-based dosing guidelines. These studies are crucial to validate Pycnogenol's in vivo antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects.
Cochrane Assessment of Safety Evidence
Due to small sample size, limited numbers of trials per condition, variation in outcomes evaluated and outcome measures used, as well as the risk of bias in the included studies, no definitive conclusions regarding the efficacy or safety of Pycnogenol® are possible based on the pre-2012 trial base. The Cochrane reviewers called for well-designed, adequately powered RCTs with careful attention to standardized outcomes.
References
- Weichmann F, Rohdewald P. Pycnogenol® French maritime pine bark extract in randomized, double-blind, placebo-controlled human clinical studies. Frontiers in Nutrition. 2024;11:1389374. PMC11096518.
- Buz'Zard AR, Lau BH. Pycnogenol: a blend of procyanidins with multifaceted therapeutic applications? Fitoterapia. 2010;81(7):724-736. PubMed PMID: 20598812.
- Schoonees A, Visser J, Musekiwa A, Volmink J. Pycnogenol® for the treatment of chronic disorders. Cochrane Database of Systematic Reviews. 2012;(4):CD008294.
- Gulati OP. Pycnogenol® in chronic venous insufficiency and related venous disorders. Phytotherapy Research. 2014;28(3):348-362. PubMed PMID: 23775628.
- Hosseini S et al. Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials. Phytotherapy Research. 2019.
- Cesarone MR et al. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. Journal of Ocular Pharmacology and Therapeutics. 2009. PubMed PMID: 19916788.
- Schönlau F, Rohdewald P. Pycnogenol for diabetic retinopathy. A review. International Ophthalmology. 2001;24(3):161-171. PubMed PMID: 12498513.
- Jessberger S et al. Cellular pharmacodynamic effects of Pycnogenol® in patients with severe osteoarthritis: a randomized controlled pilot study. BMC Complementary Medicine and Therapies. 2017. PMC5732384.
- Luzzi R et al. Assessing the Efficacy and Mechanisms of Pycnogenol® on Cognitive Aging From In Vitro Animal and Human Studies. Frontiers in Pharmacology. 2019;10:694.
- Therapeutic potential of pycnogenol: antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects. Frontiers in Pharmacology. 2026.
- Fitzpatrick DF, Bing B, Rohdewald P. Endothelium-dependent vascular effects of Pycnogenol. Journal of Cardiovascular Pharmacology. 1998;32(4):509-515. PubMed PMID: 9781917.
- Grimm T et al. Pycnogenol Attenuates the Release of Proinflammatory Cytokines and Expression of Perilipin 2 in Lipopolysaccharide-Stimulated Microglia in Part via Inhibition of NF-κB and AP-1 Activation. PMC4569068.
- Verlaet A et al. Toll-Like Receptor-Dependent Immunomodulatory Activity of Pycnogenol®. Nutrients. 2019. PMC6412808.
- Weyns AS et al. Effect of Pycnogenol® on attention-deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial. PMC5370458.
- Pycnogenol: A blend of procyanidins with multifaceted therapeutic applications? Fitoterapia. 2010.
- A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract. Journal of Ethnopharmacology. 2010.
- American Botanical Council. Pycnogenol Scientific and Clinical Monograph.
- Wikipedia. Maritime pine bark extract.
- Pycnogenol® Supplementation Prevents Recurrent Urinary Tract Infections/Inflammation and Interstitial Cystitis. PMC8249140.
- Comparative efficacy and safety of botanical drugs for mild cognitive impairment: a systematic review and network meta-analysis. PMC12665759.
- Beneficial Effects of Pycnogenol® on Attention Deficit Hyperactivity Disorder (ADHD): A Review of Clinical Outcomes and Mechanistic Insights. Gavin Publishers. 2024.
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