With 42 clinical studies to its credit, ac-11® epitomizes what it means to be an evidence-based ingredient. Browse the referenced studies to learn more about our patented Cat’s Claw extract. We have included the studies that are most relevant to our products. Enjoy!

DNA Repair, Cellular Health, Anti Aging, Life Span, & Health Span

1. Sheng Y, Li L, Holmgren K, Pero RW. DNA repair enhancement of aqueous extracts of Uncaria tomentosa in a human volunteer study. Phytomedicine. 2001 Jul;8(4):275-82. doi: 10.1078/0944-7113-00045. PMID: 11515717. View Study

2. Pero, R. W., Hoppe, C., & Sheng, Y. (2000). Serum Thiols as a Surrogate Estimate of DNA Repair Correlates to Mammalian Life Span. Journal of Anti-Aging Medicine. View Study

3. Banne AF, Amiri A, Pero RW. Reduced level of serum thiols in patients with a diagnosis of active disease. J Anti Aging Med. 2003;6(4):327-34. doi: 10.1089/109454503323028920. PMID: 15142434. View Study

4. Tilstra JS, Robinson AR, Wang J, Gregg SQ, Clauson CL, Reay DP, Nasto LA, St Croix CM, Usas A, Vo N, Huard J, Clemens PR, Stolz DB, Guttridge DC, Watkins SC, Garinis GA, Wang Y, Niedernhofer LJ, Robbins PD. NF-κB inhibition delays DNA damage-induced senescence and aging in mice. J Clin Invest. 2012 Jul;122(7):2601-12. doi: 10.1172/JCI45785. Epub 2012 Jun 18. PMID: 22706308; PMCID: PMC3386805.  View Study

5. Akesson Ch, Pero RW, Ivars F. C-Med 100, a hot water extract of Uncaria tomentosa, prolongs lymphocyte survival in vivo. Phytomedicine. 2003 Jan;10(1):23-33. doi: 10.1078/094471103321648629. PMID: 12622460.  View Study

6. Pero RW, Amiri A, Sheng Y, Welther M, Rich M. Formulation and in vitro/in vivo evaluation of combining DNA repair and immune enhancing nutritional supplements. Phytomedicine. 2005 Apr;12(4):255-63. doi: 10.1016/j.phymed.2004.01.008. PMID: 15898702.  View Study

7. Pero, R. W., Giampapa, V. C., & Vojdani, A. (2002). Comparison of a Broad Spectrum Anti-Aging Nutritional Supplement with and without the Addition of a DNA Repair Enhancing Cat’s Claw Extract. Journal of Anti-Aging Medicine. View Study

8.Pero, R. W. (2009, September 1). In vivo treatment of humans with quinic acid enhances DNA repair and reduces the influence of lifestyle factors on risk to disease. Document – Gale Academic OneFile.  View Study

9. Guthrie OW. Dynamic compartmentalization of DNA repair proteins within spiral ganglion neurons in response to noise stress. Int J Neurosci. 2012 Dec;122(12):757-66. doi: 10.3109/00207454.2012.721828. Epub 2012 Oct 16. PMID: 22900489.  View Study

Immune Health, Inflammation Response, Apoptosis, & Cellular Senescence

10. Sheng Y, Pero RW, Amiri A, Bryngelsson C. Induction of apoptosis and inhibition of proliferation in human tumor cells treated with extracts of Uncaria tomentosa. Anticancer Res. 1998 Sep-Oct;18(5A):3363-8. PMID: 9858909.  View Study

11. Sheng Y, Bryngelsson C, Pero RW. Enhanced DNA repair, immune function and reduced toxicity of C-MED-100, a novel aqueous extract from Uncaria tomentosa. J Ethnopharmacol. 2000 Feb;69(2):115-26. doi: 10.1016/s0378-8741(99)00070-7. PMID: 10687868.  View Study

12. Sheng Y, Pero RW, Wagner H. Treatment of chemotherapy-induced leukopenia in a rat model with aqueous extract from Uncaria tomentosa. Phytomedicine. 2000 Apr;7(2):137-43. doi: 10.1016/S0944-7113(00)80086-0. PMID: 10839217.  View Study

13. Lamm S, Sheng Y, Pero RW. Persistent response to pneumococcal vaccine in individuals supplemented with a novel water soluble extract of Uncaria tomentosa, C-Med-100. Phytomedicine. 2001 Jul;8(4):267-74. doi: 10.1078/0944-7113-00046. PMID: 11515716. View Study

Brain Health, Neurological Support, Cognitive Function, Hearing

14. Guthrie OW, Gearhart CA, Fulton S, Fechter LD. Carboxy alkyl esters of Uncaria tomentosa augment recovery of sensorineural functions following noise injury. Brain Res. 2011 Aug 17;1407:97-106. doi: 10.1016/j.brainres.2011.06.044. Epub 2011 Jun 24. PMID: 21762882. View Study

15. Guthrie, O. W., & Xu, H. (2013b). Reduced Phosphorylation of Histone Variant H2Ax in the Organ of Corti is Associated with Otoprotection from Noise Injury. Otolaryngology, 03(01).  View Study

16. Guthrie OW. Preservation of Neural Sensitivity after Noise-Induced Suppression of Sensory Function. J Am Acad Audiol. 2016 Jan;27(1):49-61. doi: 10.3766/jaaa.15047. PMID: 26809326.  View Study

17. Shi Z, Lu Z, Zhao Y, Wang Y, Zhao-Wilson X, Guan P, Duan X, Chang YZ, Zhao B. Neuroprotective effects of aqueous extracts of Uncaria tomentosa: Insights from 6-OHDA induced cell damage and transgenic Caenorhabditis elegans model. Neurochem Int. 2013 Jun;62(7):940-7. doi: 10.1016/j.neuint.2013.03.001. Epub 2013 Mar 14. PMID: 23500604.  View Study

Safety, Efficacy, Functionality

18. Montoro P, Carbone V, Quiroz Jde D, De Simone F, Pizza C. Identification and quantification of components in extracts of Uncaria tomentosa by HPLC-ES/MS. Phytochem Anal. 2004 Jan-Feb;15(1):55-64. doi: 10.1002/pca.740. PMID: 14979528.  View Study

19. Akesson C, Lindgren H, Pero RW, Leanderson T, Ivars F. Quinic acid is a biologically active component of the Uncaria tomentosa extract C-Med 100. Int Immunopharmacol. 2005 Jan;5(1):219-29. doi: 10.1016/j.intimp.2004.09.028. PMID: 15589483.  View Study

20. Sheng Y, Akesson C, Holmgren K, Bryngelsson C, Giamapa V, Pero RW. An active ingredient of Cat’s Claw water extracts identification and efficacy of quinic acid. J Ethnopharmacol. 2005 Jan 15;96(3):577-84. doi: 10.1016/j.jep.2004.10.002. Epub 2004 Dec 8. PMID: 15619581.  View Study

21. Historical Development of Uncaria Preparations and Their Related bioactive Components. novapublishers.com.(Pero: Nova Sciences Publishers, Chapter 10, 2010). View Study

22. McDonnell AM, Dang CH. Basic review of the cytochrome p450 system. J Adv Pract Oncol. 2013 Jul;4(4):263-8. doi: 10.6004/jadpro.2013.4.4.7. PMID: 25032007; PMCID: PMC4093435.  View Study

Antioxidant Potential

23. Brunswick Labs, Certificate of Analysis, ORAC Value results for ac-11®. View Study

24. Pero RW, Lund H, Leanderson T. Antioxidant metabolism induced by quinic acid. Increased urinary excretion of tryptophan and nicotinamide. Phytother Res. 2009 Mar;23(3):335-46. doi: 10.1002/ptr.2628. PMID: 18844285. View Study

25. Pero RW, Lund H. Dietary quinic acid supplied as the nutritional supplement AIO + AC-11® leads to induction of micromolar levels of nicotinamide and tryptophan in the urine. Phytother Res. 2011 Jun;25(6):851-7. doi: 10.1002/ptr.3348. Epub 2010 Nov 22. PMID: 21104945.  View Study

The subject of 70 clinical studies, AstaReal® stands as the scientifically supported astaxanthin extract. Dive into the references to explore our patented formulation. We’ve selected the most relevant studies for our products. Enjoy the journey of discovery!

Skin Health

1. Tominaga K, Hongo N, Karato M, Yamashita E. Cosmetic benefits of astaxanthin on humans subjects. Acta Biochim Pol. 2012;59(1):43-7. Epub 2012 Mar 17. PMID: 22428137. View Study

2. Phetcharat L, Wongsuphasawat K, Winther K. The effectiveness of a standardized rose hip powder, containing seeds and shells of Rosa canina, on cell longevity, skin wrinkles, moisture, and elasticity. Clin Interv Aging. 2015 Nov 19;10:1849-56. doi: 10.2147/CIA.S90092. PMID: 26604725; PMCID: PMC4655903.

Antioxidant Support

3. Hashimoto H, Arai K, Takahashi J, Chikuda M. The effect of aging on the antioxidative activity of astaxanthin in human aqueous humor. J Clin Biochem Nutr. 2021 Mar;68(2):169-172. doi: 10.3164/jcbn.20-87. Epub 2020 Sep 17. PMID: 33879969; PMCID: PMC8046000.  View Study

4. Hashimoto H, Arai K, Takahashi J, Chikuda M. Effects of astaxanthin on VEGF level and antioxidation in human aqueous humor: difference by sex. J Clin Biochem Nutr. 2019 Jul;65(1):47-51. doi: 10.3164/jcbn.18-110. Epub 2019 Apr 18. PMID: 31379413; PMCID: PMC6667389. View Study

5. Hashimoto H, Arai K, Hayashi S, Okamoto H, Takahashi J, Chikuda M. The effect of astaxanthin on vascular endothelial growth factor (VEGF) levels and peroxidation reactions in the aqueous humor. J Clin Biochem Nutr. 2016 Jul;59(1):10-5. doi: 10.3164/jcbn.15-137. Epub 2016 May 21. PMID: 27499573; PMCID: PMC4933686.  View Study

6. Hashimoto H, Arai K, Hayashi S, Okamoto H, Takahashi J, Chikuda M, Obara Y. Effects of astaxanthin on antioxidation in human aqueous humor. J Clin Biochem Nutr. 2013 Jul;53(1):1-7. doi: 10.3164/jcbn.13-6. Epub 2013 May 18. PMID: 23874063; PMCID: PMC3705160.  View Study

Brain Health & Cognitive Function

7. Ito N, Saito H, Seki S, Ueda F, Asada T. Effects of Composite Supplement Containing Astaxanthin and Sesamin on Cognitive Functions in People with Mild Cognitive Impairment: A Randomized, Double-Blind, Placebo-Controlled Trial. J Alzheimers Dis. 2018;62(4):1767-1775. doi: 10.3233/JAD-170969. Erratum in: J Alzheimers Dis. 2019;68(2):839. PMID: 29614679; PMCID: PMC5900571.  View Study

8. Imai A, Oda Y, Ito N, Seki S, Nakagawa K, Miyazawa T, Ueda F. Effects of Dietary Supplementation of Astaxanthin and Sesamin on Daily Fatigue: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study. Nutrients. 2018 Feb 28;10(3):281. doi: 10.3390/nu10030281. PMID: 29495607; PMCID: PMC5872699.  View Study

Active Lifestyle, Muscle & Sports Performance

9. Baralic I, Andjelkovic M, Djordjevic B, Dikic N, Radivojevic N, Suzin-Zivkovic V, Radojevic-Skodric S, Pejic S. Effect of Astaxanthin Supplementation on Salivary IgA, Oxidative Stress, and Inflammation in Young Soccer Players. Evid Based Complement Alternat Med. 2015;2015:783761. doi: 10.1155/2015/783761. Epub 2015 Jun 18. PMID: 26167194; PMCID: PMC4488551.  View Study

10. Wong SK, Ima-Nirwana S, Chin KY. Effects of astaxanthin on the protection of muscle health (Review). Exp Ther Med. 2020 Oct;20(4):2941-2952. doi: 10.3892/etm.2020.9075. Epub 2020 Jul 29. PMID: 32855659; PMCID: PMC7444411.  View Study

Immune & Gut Health

11. Baralic I, Andjelkovic M, Djordjevic B, Dikic N, Radivojevic N, Suzin-Zivkovic V, Radojevic-Skodric S, Pejic S. Effect of Astaxanthin Supplementation on Salivary IgA, Oxidative Stress, and Inflammation in Young Soccer Players. Evid Based Complement Alternat Med. 2015;2015:783761. doi: 10.1155/2015/783761. Epub 2015 Jun 18. PMID: 26167194; PMCID: PMC4488551.  View Study

12. Park JS, Chyun JH, Kim YK, Line LL, Chew BP. Astaxanthin decreased oxidative stress and inflammation and enhanced immune response in humans. Nutr Metab (Lond). 2010 Mar 5;7:18. doi: 10.1186/1743-7075-7-18. PMID: 20205737; PMCID: PMC2845588.  View Study

13. Wu L, Lyu Y, Srinivasagan R, Wu J, Ojo B, Tang M, El-Rassi GD, Metzinger K, Smith BJ, Lucas EA, Clarke SL, Chowanadisai W, Shen X, He H, Conway T, von Lintig J, Lin D. Astaxanthin-Shifted Gut Microbiota Is Associated with Inflammation and Metabolic Homeostasis in Mice. J Nutr. 2020 Oct 12;150(10):2687-2698. doi: 10.1093/jn/nxaa222. PMID: 32810865; PMCID: PMC8023541.  View Study

Eye Health & Vision

14. Saito M, Yoshida K, Saito W, Fujiya A, Ohgami K, Kitaichi N, Tsukahara H, Ishida S, Ohno S. Astaxanthin increases choroidal blood flow velocity. Graefes Arch Clin Exp Ophthalmol. 2012 Feb;250(2):239-45. doi: 10.1007/s00417-011-1843-1. Epub 2011 Nov 10. PMID: 22072378.  View Study

Cardiovascular Health

14. Miyawaki H, Takahashi J, Tsukahara H, Takehara I. Effects of astaxanthin on human blood rheology. J Clin Biochem Nutr. 2008 Sep;43(2):69-74. doi: 10.3164/jcbn.2008048. PMID: 18818755; PMCID: PMC2533721.  View Study

15. Iwabayashi, M., Fujioka, N., Nomoto, K., Miyazaki, R., Takahashi, H., Hibino, S., Takahashi, Y., Nishikawa, K., Nishida, M., & Yonei, Y. (2009). Efficacy and safety of eight-week treatment with astaxanthin in individuals screened for increased oxidative stress burden. Anti-Aging Medicine, 6(4), 15–21.  View Study

16. Tsukahara, H., Koikeda, T., Arai, T., Hayashi, H., Ohno, S., & Suzuki, N. (2008). Supplementation Effect of Astaxanthin on Blood Flow and Shoulder Stiffness -A Preliminary Pilot Study-. Japanese Journal of Complementary and Alternative Medicine.  View Study

With over 150 clinical studies, Pycnogenol® sets the gold standard for evidence-based ingredients. Explore the references to delve into our patented French maritime pine bark extract. We’ve included the most relevant studies for our products. Discover the impressive stats behind Pycnogenol®!

Skin Health, Anti-Aging, Beauty From Within 

1. Belcaro G, Luzzi R, Hu S, Cesarone MR, Dugall M, Ippolito E, Corsi M, Caporale S. Improvement in signs and symptoms in psoriasis patients with Pycnogenol® supplementation. Panminerva Med. 2014 Mar;56(1):41-8. PMID: 24637472.  View Study

2. Marini A, Grether-Beck S, Jaenicke T, Weber M, Burki C, Formann P, Brenden H, Schönlau F, Krutmann J. Pycnogenol® effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacol Physiol. 2012;25(2):86-92. doi: 10.1159/000335261. Epub 2012 Jan 21. PMID: 22270036.  View Study

3. Ni Z, Mu Y, Gulati O. Treatment of melasma with Pycnogenol. Phytother Res. 2002 Sep;16(6):567-71. doi: 10.1002/ptr.1085. PMID: 12237816.  View Study

4. Saliou C, Rimbach G, Moini H, McLaughlin L, Hosseini S, Lee J, Watson RR, Packer L. Solar ultraviolet-induced erythema in human skin and nuclear factor-kappa-B-dependent gene expression in keratinocytes are modulated by a French maritime pine bark extract. Free Radic Biol Med. 2001 Jan 15;30(2):154-60. doi: 10.1016/s0891-5849(00)00445-7. PMID: 11163532.  View Study

Brain Health & Cognitive Function, Neurological Support, Hearing 

5. Trebatická J, Kopasová S, Hradecná Z, Cinovský K, Skodácek I, Suba J, Muchová J, Zitnanová I, Waczulíková I, Rohdewald P, Duracková Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006 Sep;15(6):329-35. doi: 10.1007/s00787-006-0538-3. Epub 2006 May 13. PMID: 16699814.  View Study

6. Grossi MG, Belcaro G, Cesarone MR, Dugall M, Hosoi M, Cacchio M, Ippolito E, Bavera P. Improvement in cochlear flow with Pycnogenol® in patients with tinnitus: a pilot evaluation. Panminerva Med. 2010 Jun;52(2 Suppl 1):63-7. PMID: 20657537.  View Study

7. Belcaro G, Luzzi R, Dugall M, Ippolito E, Saggino A. Pycnogenol® improves cognitive function, attention, mental performance and specific professional skills in healthy professionals aged 35-55. J Neurosurg Sci. 2014 Dec;58(4):239-48. Epub 2014 Mar 28. PMID: 24675223.  View Study

8. Belcaro G, Dugall M, Ippolito E, Hu S, Saggino A, Feragalli B. The COFU3 Study. Improvement in cognitive function, attention, mental performance with Pycnogenol® in healthy subjects (55-70) with high oxidative stress. J Neurosurg Sci. 2015 Dec;59(4):437-46. PMID: 26635191.  View Study

9. Luzzi R, Belcaro G, Zulli C, Cesarone MR, Cornelli U, Dugall M, Hosoi M, Feragalli B. Pycnogenol® supplementation improves cognitive function, attention and mental performance in students. Panminerva Med. 2011 Sep;53(3 Suppl 1):75-82. PMID: 22108481.  View Study

10. Ryan J, Croft K, Mori T, Wesnes K, Spong J, Downey L, Kure C, Lloyd J, Stough C. An examination of the effects of the antioxidant Pycnogenol on cognitive performance, serum lipid profile, endocrinological and oxidative stress biomarkers in an elderly population. J Psychopharmacol. 2008 Jul;22(5):553-62. doi: 10.1177/0269881108091584. PMID: 18701642.  View Study

Cardiovascular Health: Heart, Veins, Blood Pressure, Circulation, Endothelium, Nitric Oxide

11. Arcangeli P. Pycnogenol in chronic venous insufficiency. Fitoterapia. 2000 Jun;71(3):236-44. doi: 10.1016/s0367-326x(99)00164-1. PMID: 10844161.  View Study

12. Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Rohdewald P, Ippolito E, Ricci A, Cacchio M, Ruffini I, Fano F, Hosoi M. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology. 2005 Nov-Dec;56(6):699-705. doi: 10.1177/000331970505600607. PMID: 16327946.  View Study

13. Belcaro G, Dugall M, Luzzi R, Ippolito E, Cesarone MR. Postpartum Varicose Veins: Supplementation with Pycnogenol or Elastic Compression-A 12-Month Follow-Up. Int J Angiol. 2017 Mar;26(1):12-19. doi: 10.1055/s-0033-1363784. Epub 2014 May 29. PMID: 28255210; PMCID: PMC5330748.  View Study

14. Belcaro G. A Clinical Comparison of Pycnogenol, Antistax, and Stocking in Chronic Venous Insufficiency. Int J Angiol. 2015 Dec;24(4):268-74. doi: 10.1055/s-0035-1556060. Epub 2015 Jul 15. PMID: 26648668; PMCID: PMC4656166.  View Study

15. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Gizzi G, Ippolito E, Fano F, Dugall M, Acerbi G, Cacchio M, Di Renzo A, Hosoi M, Stuard S, Corsi M. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology. 2006 Oct-Nov;57(5):569-76. doi: 10.1177/0003319706291392. Erratum in: Angiology. 2008 Jun-Jul;59(3):385. PMID: 17067979.  View Study

16. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Gizzi G, Ippolito E, Fano F, Dugall M, Acerbi G, Cacchio M, Di Renzo A, Hosoi M, Stuard S, Corsi M. Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb Hemost. 2006 Apr;12(2):205-12. doi: 10.1177/107602960601200209. PMID: 16708123.  View Study

17. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Ippolito E, Fano F, Dugall M, Cacchio M, Di Renzo A, Hosoi M, Stuard S, Corsi M. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study. Phytomedicine. 2010 Sep;17(11):835-9. doi: 10.1016/j.phymed.2010.04.009. Epub 2010 Jun 25. PMID: 20579863.  View Study

18. Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 Mar;16 Suppl 1:S1-5. doi: 10.1002/ptr.1010. PMID: 11933130.  View Study

19. Petrassi C, Mastromarino A, Spartera C. PYCNOGENOL in chronic venous insufficiency. Phytomedicine. 2000 Oct;7(5):383-8. doi: 10.1016/S0944-7113(00)80059-8. PMID: 11081989.  View Study

20. Riccioni C, Sarcinella R, Izzo A, Palermo G, Liguori M. Efficacia della Troxerutina associata al Pycnogenol nel trattamento farmacologico dell’insufficienza venosa [Effectiveness of Troxerutin in association with Pycnogenol in the pharmacological treatment of venous insufficiency]. Minerva Cardioangiol. 2004 Feb;52(1):43-8. Italian. PMID: 14765037.  View Study

21. Schmidtke I, Schoop W. Pycnogenol—stasis edema and its medical treatment [in German]. Z Ganzheits Med. 1995;3:114-115.

22. Belcaro G, Cesarone MR, Rohdewald P, Ricci A, Ippolito E, Dugall M, Griffin M, Ruffini I, Acerbi G, Vinciguerra MG, Bavera P, Di Renzo A, Errichi BM, Cerritelli F. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl Thromb Hemost. 2004 Oct;10(4):373-7. doi: 10.1177/107602960401000410. PMID: 15497024.  View Study

23. Errichi BM, Belcaro G, Hosoi M, Cesarone MR, Dugall M, Feragalli B, Bavera P, Hosoi M, Zulli C, Corsi M, Ledda A, Luzzi R, Ricci A. Prevention of post thrombotic syndrome with Pycnogenol® in a twelve month study. Panminerva Med. 2011 Sep;53(3 Suppl 1):21-7. PMID: 22108473.  View Study

24. Rodriguez P, Belcaro G, Dugall M, Hu S, Luzzi R, Ledda A, Ippolito E, Corsi M, Ricci A, Feragalli B, Cornelli U, Gizzi C, Hosoi M. Recurrence of retinal vein thrombosis with Pycnogenol® or Aspirin® supplementation: a registry study. Panminerva Med. 2015 Sep;57(3):121-5. PMID: 25971329.  View Study

25. Belcaro G, Cesarone MR, Ricci A, Cornelli U, Rodhewald P, Ledda A, Di Renzo A, Stuard S, Cacchio M, Vinciguerra G, Gizzi G, Pellegrini L, Dugall M, Fano F. 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. doi: 10.1177/1076029606292248. PMID: 17000888.

26. Cesarone MR, Belcaro G, Stuard S, Schönlau F, Di Renzo A, Grossi MG, Dugall M, Cornelli U, Cacchio M, Gizzi G, Pellegrini L. 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. doi: 10.1177/1074248409356063. Epub 2010 Jan 22. PMID: 20097689.  View Study

27. 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. (n.d.). University of Arizona.  View Study

28. Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004 Jan 2;74(7):855-62. doi: 10.1016/j.lfs.2003.07.037. PMID: 14659974.  View Study

29. Stuard S, Belcaro G, Cesarone MR, Ricci A, Dugall M, Cornelli U, Gizzi G, Pellegrini L, Rohdewald PJ. Kidney function in metabolic syndrome may be improved with Pycnogenol®. Panminerva Med. 2010 Jun;52(2 Suppl 1):27-32. PMID: 20657531.  View Study

30. Hu S, Belcaro G, Cornelli U, Luzzi R, Cesarone M, Dugall M, Feragalli B, Errichi B, Ippolito E, Grossi M, Hosoi M, Gizzi G, Trignani M. Effects of Pycnogenol® on endothelial dysfunction in borderline hypertensive, hyperlipidemic, and hyperglycemic individuals: the borderline study. Int Angiol. 2015 Feb;34(1):43-52. Epub 2014 Nov 13. PMID: 25391252.  View Study

31.) Belcaro G, Cornelli U, Luzzi R, Cesarone MR, Dugall M, Feragalli B, Errichi S, Ippolito E, Grossi MG, Hosoi M, Cornelli M, Gizzi G. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res. 2013 Oct;27(10):1572-8. doi: 10.1002/ptr.4883. Epub 2013 Jan 28. PMID: 23359520.  View Study

Inflammation Response, Immune Function, Respiratory Health, Lung Function, Allergy & Sinus

32. Belcaro G, Luzzi R, Cesinaro Di Rocco P, Cesarone MR, Dugall M, Feragalli B, Errichi BM, Ippolito E, Grossi MG, Hosoi M, Errichi S, Cornelli U, Ledda A, Gizzi G. Pycnogenol® improvements in asthma management. Panminerva Med. 2011 Sep;53(3 Suppl 1):57-64. PMID: 22108478.  View Study

33. Hosseini S, Pishnamazi S, Sadrzadeh SM, Farid F, Farid R, Watson RR. Pycnogenol((R)) in the Management of Asthma. J Med Food. 2001 Winter;4(4):201-209. doi: 10.1089/10966200152744472. PMID: 12639402.  View Study

34. Lau BH, Riesen SK, Truong KP, Lau EW, Rohdewald P, Barreta RA. Pycnogenol as an adjunct in the management of childhood asthma. J Asthma. 2004;41(8):825-32. doi: 10.1081/jas-200038433. PMID: 15641632.  View Study

35. Wilson D, Evans M, Guthrie N, Sharma P, Baisley J, Schonlau F, Burki C. A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms. Phytother Res. 2010 Aug;24(8):1115-9. doi: 10.1002/ptr.3232. PMID: 20549654.  View Study

36. Otorinolaringologia 2013 September;63(3):151-61. (n.d.).  View Study

37. Belcaro G, Cesarone MR, Genovesi D, Ledda A, Vinciguerra G, Ricci A, Pellegrini L, Gizzi G, Ippolito E, Dugall M, Cacchio M, Di Renzo A, Stuard S. Pycnogenol may alleviate adverse effects in oncologic treatment. Panminerva Med. 2008 Sep;50(3):227-34. PMID: 18927527.  View Study

Blood Sugar, Glucose Metabolism, & Kidney Function

38. Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Gizzi G, Rohdewald P, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost. 2006 Jul;12(3):318-23. doi: 10.1177/1076029606290133. PMID: 16959685.  View Study

39. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Gizzi G, Ippolito E, Fano F, Dugall M, Cipollone G, Acerbi G, Cacchio M, Del Boccio G, Di Renzo A, Stuard S, Corsi M. Improvement of diabetic microangiopathy with pycnogenol: A prospective, controlled study. Angiology. 2006 Aug-Sep;57(4):431-6. doi: 10.1177/0003319706290318. PMID: 17022378.  View Study

40. Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci. 2004 Oct 8;75(21):2505-13. doi: 10.1016/j.lfs.2003.10.043. PMID: 15363656.  View Study

41. Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetic patients. Diabetes Care. 2004 Mar;27(3):839. doi: 10.2337/diacare.27.3.839. PMID: 14988316.  View Study

42. Zibadi S, Rohdewald PJ, Park D, Watson RR. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res. 2008 May;28(5):315-20. doi: 10.1016/j.nutres.2008.03.003. PMID: 19083426.  View Study

Joint Health

43. Belcaro G, Cesarone MR, Errichi S, Zulli C, Errichi BM, Vinciguerra G, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Errichi S, Gizzi G, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M, Rohdewald P. Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytother Res. 2008 Apr;22(4):518-23. doi: 10.1002/ptr.2376. PMID: 18386255.  View Study

44. Cisár P, Jány R, Waczulíková I, Sumegová K, Muchová J, Vojtassák J, Duraćková Z, Lisý M, Rohdewald P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother Res. 2008 Aug;22(8):1087-92. doi: 10.1002/ptr.2461. PMID: 18570266.  View Study

45. 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. (n.d.). University of Arizona.  View Study

Eye Health

46. Spadea L, Balestrazzi E. Treatment of vascular retinopathies with Pycnogenol. Phytother Res. 2001 May;15(3):219-23. doi: 10.1002/ptr.853. PMID: 11351356.  View Study

Active Lifestyle & Sports Performance

47. Vinciguerra G, Belcaro G, Cesarone MR, Rohdewald P, Stuard S, Ricci A, Di Renzo A, Hosoi M, Dugall M, Ledda A, Cacchio M, Acerbi G, Fano F. Cramps and muscular pain: prevention with pycnogenol in normal subjects, venous patients, athletes, claudicants and in diabetic microangiopathy. Angiology. 2006 May-Jun;57(3):331-9. doi: 10.1177/000331970605700309. PMID: 16703193.  View Study

Oral Care

48. Kimbrough C, Chun M, dela Roca G, Lau BH. PYCNOGENOL chew-ing gum minimizes gingival bleeding and plaque formation. Phytomedicine. 2002;9(5):410-413.  View Study

Men’s Health

49. D̆Uračková, Z. (2003). Lipid metabolism and erectile function improvement by pycnogenol®, extract from the bark of pinus pinaster in patients suffering from erectile dysfunction-a pilot study. AGRIS: International Information System for the Agricultural Science and Technology.  View Study

Women’s Health

50. Errichi S, Bottari A, Belcaro G, Cesarone MR, Hosoi M, Cornelli U, Dugall M, Ledda A, Feragalli B. Supplementation with Pycnogenol® improves signs and symptoms of menopausal transition. Panminerva Med. 2011 Sep;53(3 Suppl 1):65-70. PMID: 22108479.  View Study

51. Kohama T, Negami M. Effect of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women: a randomized, double-blind, placebo-controlled trial. J Reprod Med. 2013 Jan-Feb;58(1-2):39-46. PMID: 23447917.  View Study

52. Maia H Jr, Haddad C, Casoy J. Combining oral contraceptives with a natural nuclear factor-kappa B inhibitor for the treatment of endometriosis-related pain. Int J Womens Health. 2013 Dec 21;6:35-9. doi: 10.2147/IJWH.S55210. PMID: 24379702; PMCID: PMC3873204.  View Study

53. Maia H Jr, Haddad C, Casoy J. The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives. Int J Womens Health. 2014 Dec 11;6:1019-22. doi: 10.2147/IJWH.S75389. PMID: 25525393; PMCID: PMC4266261.  View Study

54. Yang HM, Liao MF, Zhu SY, Liao MN, Rohdewald P. A randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women. Acta Obstet Gynecol Scand. 2007;86(8):978-85. doi: 10.1080/00016340701446108. PMID: 17653885.  View Study

55. Kohama T, Suzuki N, Ohno S, Inoue M. Analgesic efficacy of French maritime pine bark extract in dysmenorrhea: an open clinical trial. J Reprod Med. 2004 Oct;49(10):828-32. PMID: 15568408.  View Study

56. Suzuki N, Uebaba K, Kohama T, Moniwa N, Kanayama N, Koike K. French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study. J Reprod Med. 2008 May;53(5):338-46. PMID: 18567279.  View Study

57. Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007 Aug;52(8):703-8. PMID: 17879831.  View Study

58. Kohama T, Inoue M. Pycnogenol alleviates pain associated with pregnancy. Phytother Res. 2006 Mar;20(3):232-4. doi: 10.1002/ptr.1840. PMID: 16521117.  View Study

Hemorrhoid Support

59. Belcaro G, Gizzi G, Pellegrini L, Dugall M, Luzzi R, Corsi M, Ippolito E, Ricci A, Cesarone MR, Ledda A, Bottari A, Errichi BM. Pycnogenol® in postpartum symptomatic hemorrhoids. Minerva Ginecol. 2014 Feb;66(1):77-84. PMID: 24569406.  View Study

Edema on Long Flights

60. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ippolito E, Scoccianti M, Ricci A, Dugall M, Cacchio M, Ruffini I, Fano F, Acerbi G, Vinciguerra MG, Bavera P, Di Renzo A, Errichi BM, Mucci F. Prevention of edema in long flights with Pycnogenol. Clin Appl Thromb Hemost. 2005 Jul;11(3):289-94. doi: 10.1177/107602960501100307. PMID: 16015414.  View Study