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Belcaro G, Cesarone MR, Ricci A, 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;12:440-4. View abstract.

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Stanislavov, R., Nikolova, V., and Rohdewald, P. Improvement of seminal parameters with Prelox: a randomized, double-blind, placebo-controlled, cross-over trial. Phytother.Res 2009;23(3):297-302. View abstract.

Ledda, A., Belcaro, G., Cesarone, M. R., Dugall, M., and Schonlau, F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU.Int. 2010;106(7):1030-1033. View abstract.

Steigerwalt, R. D., Gianni, B., Paolo, M., Bombardelli, E., Burki, C., and Schonlau, F. Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects. Mol Vis 2008;14:1288-1292. View abstract.

Clark, C. E., Arnold, E., Lasserson, T. J., and Wu, T. Herbal interventions for chronic asthma in adults and children: a systematic review and meta-analysis. Prim.Care Respir.J 2010;19(4):307-314. View abstract.

Belcaro, G., Cesarone, M. R., Dugall, M., Hosoi, M., Ippolito, E., Bavera, P., and Grossi, M. G. Investigation of Pycnogenol(R) in combination with coenzymeQ10 in heart failure patients (NYHA II/III). Panminerva Med 2010;52(2 Suppl 1):21-25. View abstract.

Huynh, H. T. and Teel, R. W. Effects of pycnogenol on the microsomal metabolism of the tobacco-specific nitrosamine NNK as a function of age. Cancer Lett 10-23-1998;132(1-2):135-139. View abstract.

Huynh, H. T. and Teel, R. W. Effects of intragastrically administered Pycnogenol on NNK metabolism in F344 rats. Anticancer Res 1999;19(3A):2095-2099. View abstract.

Packer, L., Rimbach, G., and Virgili, F. Antioxidant activity and biologic properties of a procyanidin-rich extract from pine (Pinus maritima) bark, pycnogenol. Free Radic.Biol Med 1999;27(5-6):704-724. View abstract.

Hasegawa, N. Stimulation of lipolysis by pycnogenol. Phytother Res 1999;13(7):619-620. View abstract.

Kobayashi, M. S., Han, D., and Packer, L. Antioxidants and herbal extracts protect HT-4 neuronal cells against glutamate-induced cytotoxicity. Free Radic.Res 2000;32(2):115-124. View abstract.

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Peng, Q., Wei, Z., and Lau, B. H. Pycnogenol inhibits tumor necrosis factor-alpha-induced nuclear factor kappa B activation and adhesion molecule expression in human vascular endothelial cells. Cell Mol Life Sci 2000;57(5):834-841. View abstract.

Huynh, H. T. and Teel, R. W. Selective induction of apoptosis in human mammary cancer cells (MCF-7) by pycnogenol. Anticancer Res 2000;20(4):2417-2420. View abstract.

Cho, K. J., Yun, C. H., Yoon, D. Y., Cho, Y. S., Rimbach, G., Packer, L., and Chung, A. S. Effect of bioflavonoids extracted from the bark of Pinus maritima on proinflammatory cytokine interleukin-1 production in lipopolysaccharide-stimulated RAW 264.7. Toxicol Appl.Pharmacol 10-1-2000;168(1):64-71. View abstract.

Stefanescu, M., Matache, C., Onu, A., Tanaseanu, S., Dragomir, C., Constantinescu, I., Schonlau, F., Rohdewald, P., and Szegli, G. Pycnogenol efficacy in the treatment of systemic lupus erythematosus patients. Phytother Res 2001;15(8):698-704. View abstract.

Kim, H. C. and Healey, J. M. Effects of pine bark extract administered to immunosuppressed adult mice infected with Cryptosporidium parvum. Am J Chin Med 2001;29(3-4):469-475. View abstract.

Cho, K. J., Yun, C. H., Packer, L., and Chung, A. S. Inhibition mechanisms of bioflavonoids extracted from the bark of Pinus maritima on the expression of proinflammatory cytokines. Ann N Y Acad Sci 2001;928:141-156. View abstract.

Peng, Q. L., Buz'Zard, A. R., and Lau, B. H. Pycnogenol protects neurons from amyloid-beta peptide-induced apoptosis. Brain Res Mol Brain Res 7-15-2002;104(1):55-65. View abstract.

Kimbrough, C., Chun, M., dela, Roca G., and Lau, B. H. PYCNOGENOL chewing gum minimizes gingival bleeding and plaque formation. Phytomedicine 2002;9(5):410-413. View abstract.

Ni, Z., Mu, Y., and Gulati, O. Treatment of melasma with Pycnogenol. Phytother.Res. 2002;16(6):567-571. View abstract.

Roseff, S. J. Improvement in sperm quality and function with French maritime pine tree bark extract. J Reprod Med 2002;47(10):821-824. View abstract.

Devaraj, S., Vega-Lopez, S., Kaul, N., Schonlau, F., Rohdewald, P., and Jialal, I. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids 2002;37(10):931-934. View abstract.

Sharma, S. C., Sharma, S., and Gulati, O. P. Pycnogenol inhibits the release of histamine from mast cells. Phytother Res 2003;17(1):66-69. View abstract.

Hosseini, S., Pishnamazi, S., Sadrzadeh, S. M., Farid, F., Farid, R., and Watson, R. R. Pycnogenol((R)) in the Management of Asthma. J Med Food 2001;4(4):201-209. View abstract.

Maritim, A., Dene, B. A., Sanders, R. A., and Watkins, J. B., III. Effects of pycnogenol treatment on oxidative stress in streptozotocin-induced diabetic rats. J Biochem Mol Toxicol 2003;17(3):193-199. View abstract.

Zhang, D., Tao, Y., Gao, J., Zhang, C., Wan, S., Chen, Y., Huang, X., Sun, X., Duan, S., Schonlau, F., Rohdewald, P., and Zhao, B. Pycnogenol in cigarette filters scavenges free radicals and reduces mutagenicity and toxicity of tobacco smoke in vivo. Toxicol Ind Health 2002;18(5):215-224. View abstract.

Liu, X., Wei, J., Tan, F., Zhou, S., Wurthwein, G., and Rohdewald, P. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci 1-2-2004;74(7):855-862. View abstract.

Ahn, J., Grun, I. U., and Mustapha, A. Antimicrobial and antioxidant activities of natural extracts in vitro and in ground beef. J Food Prot. 2004;67(1):148-155. View abstract.

Siler-Marsiglio, K. I., Paiva, M., Madorsky, I., Serrano, Y., Neeley, A., and Heaton, M. B. Protective mechanisms of pycnogenol in ethanol-insulted cerebellar granule cells. J Neurobiol. 2004;61(2):267-276. View abstract.

Belcaro, G., Cesarone, M. R., Rohdewald, P., Ricci, A., Ippolito, E., Dugall, M., Griffin, M., Ruffini, I., Acerbi, G., Vinciguerra, M. G., Bavera, P., Di Renzo, A., Errichi, B. M., and Cerritelli, F. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl.Thromb.Hemost. 2004;10(4):373-377. View abstract.

Kim, Y. G. and Park, H. Y. The effects of Pycnogenol on DNA damage in vitro and expression of superoxide dismutase and HP1 in Escherichia coli SOD and catalase deficient mutant cells. Phytother.Res 2004;18(11):900-905. View abstract.

Nelson, A. B., Lau, B. H., Ide, N., and Rong, Y. Pycnogenol inhibits macrophage oxidative burst, lipoprotein oxidation, and hydroxyl radical-induced DNA damage. Drug Dev.Ind Pharm 1998;24(2):139-144. View abstract.

Berryman, A. M., Maritim, A. C., Sanders, R. A., and Watkins, J. B., III. Influence of treatment of diabetic rats with combinations of pycnogenol, beta-carotene, and alpha-lipoic acid on parameters of oxidative stress. J Biochem Mol Toxicol 2004;18(6):345-352. View abstract.

Dene, B. A., Maritim, A. C., Sanders, R. A., and Watkins, J. B., III. Effects of antioxidant treatment on normal and diabetic rat retinal enzyme activities. J Ocul.Pharmacol Ther 2005;21(1):28-35. View abstract.

Mochizuki, M. and Hasegawa, N. Therapeutic efficacy of pycnogenol in experimental inflammatory bowel diseases. Phytother Res 2004;18(12):1027-1028. View abstract.

Mochizuki, M. and Hasegawa, N. Pycnogenol stimulates lipolysis in 3t3-L1 cells via stimulation of beta-receptor mediated activity. Phytother Res 2004;18(12):1029-1030. View abstract.

Segger, D. and Schonlau, F. Supplementation with Evelle improves skin smoothness and elasticity in a double-blind, placebo-controlled study with 62 women. J Dermatolog.Treat. 2004;15(4):222-226. View abstract.

Huang, W. W., Yang, J. S., Lin, C. F., Ho, W. J., and Lee, M. R. Pycnogenol induces differentiation and apoptosis in human promyeloid leukemia HL-60 cells. Leuk.Res 2005;29(6):685-692. View abstract.

Cesarone, M. R., Belcaro, G., Rohdewald, P., Pellegrini, L., Ippolito, E., Scoccianti, M., Ricci, A., Dugall, M., Cacchio, M., Ruffini, I., Fano, F., Acerbi, G., Vinciguerra, M. G., Bavera, P., Di Renzo, A., Errichi, B. M., and Mucci, F. Prevention of edema in long flights with Pycnogenol. Clin Appl.Thromb.Hemost. 2005;11(3):289-294. View abstract.

Thornfeldt, C. Cosmeceuticals containing herbs: fact, fiction, and future. Dermatol.Surg. 2005;31(7 Pt 2):873-880. View abstract.

Torras, M. A., Faura, C. A., Schonlau, F., and Rohdewald, P. Antimicrobial activity of Pycnogenol. Phytother Res 2005;19(7):647-648. View abstract.

Baumann, L. How to prevent photoaging? J Invest Dermatol. 2005;125(4):xii-xiii. View abstract.

Belcaro, G., Cesarone, M. R., Errichi, B. M., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Rohdewald, P., Ippolito, E., Ricci, A., Cacchio, M., Ruffini, I., Fano, F., and Hosoi, M. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005;56(6):699-705. View abstract.

Schafer, A., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Inhibition of COX-1 and COX-2 activity by plasma of human volunteers after ingestion of French maritime pine bark extract (Pycnogenol). Biomed.Pharmacother. 2006;60(1):5-9. View abstract.

Grimm, T., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Inhibition of NF-kappaB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol). J Inflamm.(Lond) 2006;3:1. View abstract.

Chayasirisobhon, S. Use of a pine bark extract and antioxidant vitamin combination product as therapy for migraine in patients refractory to pharmacologic medication. Headache 2006;46(5):788-793. View abstract.

Trebaticka, J., Kopasova, S., Hradecna, Z., Cinovsky, K., Skodacek, I., Suba, J., Muchova, J., Zitnanova, I., Waczulikova, I., Rohdewald, P., and Durackova, Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur.Child Adolesc.Psychiatry 2006;15(6):329-335. View abstract.

Cesarone, M. R., 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., and Corsi, M. Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb.Hemost. 2006;12(2):205-212. View abstract.

Grimm, T., Skrabala, R., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Single and multiple dose pharmacokinetics of maritime pine bark extract (pycnogenol) after oral administration to healthy volunteers. BMC.Clin Pharmacol 2006;6:4. View abstract.

Ahn, J., Grun, I. U., and Mustapha, A. Effects of plant extracts on microbial growth, color change, and lipid oxidation in cooked beef. Food Microbiol. 2007;24(1):7-14. View abstract.

Belcaro, G., Cesarone, M. R., Errichi, B. M., 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., and Hosoi, M. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin.Appl.Thromb.Hemost. 2006;12(3):318-323. View abstract.

Voss, P., Horakova, L., Jakstadt, M., Kiekebusch, D., and Grune, T. Ferritin oxidation and proteasomal degradation: protection by antioxidants. Free Radic.Res 2006;40(7):673-683. View abstract.

Dvorakova, M., Sivonova, M., Trebaticka, J., Skodacek, I., Waczulikova, I., Muchova, J., and Durackova, Z. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox.Rep. 2006;11(4):163-172. View abstract.

Chovanova, Z., Muchova, J., Sivonova, M., Dvorakova, M., Zitnanova, I., Waczulikova, I., Trebaticka, J., Skodacek, I., and Durackova, Z. Effect of polyphenolic extract, Pycnogenol, on the level of 8-oxoguanine in children suffering from attention deficit/hyperactivity disorder. Free Radic.Res 2006;40(9):1003-1010. View abstract.

Cesarone, M. R., 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., and Corsi, M. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology 2006;57(5):569-576. View abstract.

Nikolova, V., Stanislavov, R., Vatev, I., Nalbanski, B., and Punevska, M. [Sperm parameters in male idiopathic infertility after treatment with prelox]. Akush.Ginekol.(Sofiia) 2007;46(5):7-12. View abstract.

Dvorakova, M., Jezova, D., Blazicek, P., Trebaticka, J., Skodacek, I., Suba, J., Iveta, W., Rohdewald, P., and Durackova, Z. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (pycnogenol). Nutr.Neurosci. 2007;10(3-4):151-157. View abstract.

Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. M., 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., and 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;22(4):518-523. View abstract.

Suzuki, N., Uebaba, K., Kohama, T., Moniwa, N., Kanayama, N., and 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;53(5):338-346. View abstract.

Cisar, P., Jany, R., Waczulikova, I., Sumegova, K., Muchova, J., Vojtassak, J., Durackova, Z., Lisy, M., and Rohdewald, P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother.Res. 2008;22(8):1087-1092. View abstract.

Ryan, J., Croft, K., Mori, T., Wesnes, K., Spong, J., Downey, L., Kure, C., Lloyd, J., and 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;22(5):553-562. View abstract.

Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. M., Vinciguerra, G., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Gizzi, G., Ippolito, E., Ricci, A., Cacchio, M., Cipollone, G., Ruffini, I., Fano, F., Hosoi, M., and Rohdewald, P. Variations in C-reactive protein, plasma free radicals and fibrinogen values in patients with osteoarthritis treated with Pycnogenol. Redox.Rep. 2008;13(6):271-276. View abstract.

Zibadi, S., Rohdewald, P. J., Park, D., and Watson, R. R. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr.Res. 2008;28(5):315-320. View abstract.

Rucklidge, J. J., Johnstone, J., and Kaplan, B. J. Nutrient supplementation approaches in the treatment of ADHD. Expert.Rev.Neurother. 2009;9(4):461-476. View abstract.

Belcaro, G., Cesarone, M., Silvia, E., Ledda, A., Stuard, S., G V, Dougall, M., Cornelli, U., Hastings, C., and Schonlau, F. Daily consumption of Reliv Glucaffect for 8 weeks significantly lowered blood glucose and body weight in 50 subjects. Phytother.Res. 4-29-2009; View abstract.

Steigerwalt, R., Belcaro, G., Cesarone, M. R., Di, Renzo A., Grossi, M. G., Ricci, A., Dugall, M., Cacchio, M., and Schonlau, F. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J.Ocul.Pharmacol.Ther. 2009;25(6):537-540. View abstract.

Belcaro, G., Cesarone, M. R., Errichi, B., Di, Renzo A., Grossi, M. G., Ricci, A., Dugall, M., Cornelli, U., Cacchio, M., and Rohdewald, P. Pycnogenol treatment of acute hemorrhoidal episodes. Phytother.Res. 2010;24(3):438-444. View abstract.

Cesarone, M. R., Belcaro, G., Stuard, S., Schonlau, F., Di, Renzo A., Grossi, M. G., Dugall, M., Cornelli, U., Cacchio, M., Gizzi, G., and Pellegrini, L. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants--a controlled study. J.Cardiovasc.Pharmacol.Ther. 2010;15(1):41-46. View abstract.

Cesarone, M. R., 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., and Corsi, M. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study. Phytomedicine. 2010;17(11):835-839. View abstract.

Stuard, S., Belcaro, G., Cesarone, M. R., Ricci, A., Dugall, M., Cornelli, U., Gizzi, G., Pellegrini, L., and Rohdewald, P. J. Kidney function in metabolic syndrome may be improved with Pycnogenol(R). Panminerva Med. 2010;52(2 Suppl 1):27-32. View abstract.

Grossi, M. G., Belcaro, G., Cesarone, M. R., Dugall, M., Hosoi, M., Cacchio, M., Ippolito, E., and Bavera, P. Improvement in cochlear flow with Pycnogenol(R) in patients with tinnitus: a pilot evaluation. Panminerva Med. 2010;52(2 Suppl 1):63-67. View abstract.

Reuter, J., Wolfle, U., Korting, H. C., and Schempp, C. Which plant for which skin disease? Part 2: Dermatophytes, chronic venous insufficiency, photoprotection, actinic keratoses, vitiligo, hair loss, cosmetic indications. J.Dtsch.Dermatol.Ges. 2010;8(11):866-873. View abstract.

Drieling, R. L., Gardner, C. D., Ma, J., Ahn, D. K., and Stafford, R. S. No beneficial effects of pine bark extract on cardiovascular disease risk factors. Arch.Intern.Med. 9-27-2010;170(17):1541-1547. View abstract.

Pavone, C., Abbadessa, D., Tarantino, M. L., Oxenius, I., Lagana, A., Lupo, A., and Rinella, M. [Associating Serenoa repens, Urtica dioica and Pinus pinaster. Safety and efficacy in the treatment of lower urinary tract symptoms. Prospective study on 320 patients]. Urologia. 2010;77(1):43-51. View abstract.

Henrotin, Y., Lambert, C., Couchourel, D., Ripoll, C., and Chiotelli, E. Nutraceuticals: do they represent a new era in the management of osteoarthritis? - a narrative review from the lessons taken with five products. Osteoarthritis.Cartilage. 2011;19(1):1-21. View abstract.

Dvorakova, M., Paduchova, Z., Muchova, J., Durackova, Z., and Collins, A. R. How does pycnogenol(R) influence oxidative damage to DNA and its repair ability in elderly people? Prague.Med.Rep. 2010;111(4):263-271. View abstract.

Ohkita, M., Kiso, Y., and Matsumura, Y. Pharmacology in health foods: improvement of vascular endothelial function by French maritime pine bark extract (Flavangenol). J.Pharmacol.Sci. 2011;115(4):461-465. View abstract.

Aoki, H., Nagao, J., Ueda, T., Strong, J. M., Schonlau, F., Yu-Jing, S., Lu, Y., and Horie, S. Clinical assessment of a supplement of Pycnogenol(R) and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother.Res. 2012;26(2):204-207. View abstract.

Errichi, B. M., Belcaro, G., Hosoi, M., Cesarone, M. R., Dugall, M., Feragalli, B., Bavera, P., Hosoi, M., Zulli, C., Corsi, M., Ledda, A., Luzzi, R., and Ricci, A. Prevention of post thrombotic syndrome with Pycnogenol(R) in a twelve month study. Panminerva Med. 2011;53(3 Suppl 1):21-27. View abstract.

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

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

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

Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., Frohlich, G. M., Kaiser, P., Hirt, A., Haile, S. R., Krasniqi, N., Matter, C. M., Uhlenhut, K., Hogger, P., Neidhart, M., Luscher, T. F., Ruschitzka, F., and Noll, G. 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;33(13):1589-1597. View abstract.

Mach, J., Midgley, A. W., Dank, S., Grant, R. S., and Bentley, D. J. The effect of antioxidant supplementation on fatigue during exercise: potential role for NAD+(H). Nutrients. 2010;2(3):319-329. View abstract.

Marini, A., Grether-Beck, S., Jaenicke, T., Weber, M., Burki, C., Formann, P., Brenden, H., Schonlau, F., and Krutmann, J. Pycnogenol(R) 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. View abstract.

Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol((R)) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;2:CD008294. View abstract.

Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol(R) (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;4:CD008294. View abstract.

Perera, N., Liolitsa, D., Iype, S., Croxford, A., Yassin, M., Lang, P., Ukaegbu, O., and van, Issum C. Phlebotonics for haemorrhoids. Cochrane.Database.Syst.Rev. 2012;8:CD004322. View abstract.

Furumura, M., Sato, N., Kusaba, N., Takagaki, K., and Nakayama, J. Oral administration of French maritime pine bark extract (Flavangenol((R))) improves clinical symptoms in photoaged facial skin. Clin.Interv.Aging 2012;7:275-286. View abstract.

Noda, Y., Anzai, K., Mori, A., Kohno, M., Shinmei, M., and Packer, L. Hydroxyl and superoxide anion radical scavenging activities of natural source antioxidants using the computerized JES-FR30 ESR spectrometer system. Biochem Mol Biol Int 1997;42(1):35-44. View abstract.

Macrides, T. A., Shihata, A., Kalafatis, N., and Wright, P. F. A comparison of the hydroxyl radical scavenging properties of the shark bile steroid 5 beta-scymnol and plant pycnogenols. Biochem Mol Biol Int 1997;42(6):1249-1260. View abstract.

Virgili, F., Kobuchi, H., and Packer, L. Procyanidins extracted from Pinus maritima (Pycnogenol): scavengers of free radical species and modulators of nitrogen monoxide metabolism in activated murine RAW 264.7 macrophages. Free Radic.Biol Med 1998;24(7-8):1120-1129. View abstract.

Wei, Z., Peng, Q., and Lau, B. Pycnogenol enhances endothelial cell antioxidant defenses. Redox Report 1997;3:219-224.

Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.

Hosseini, S., Lee, J., Sepulveda, R. T., Fagan, T., Rohdewald, P., and Watson, R. R. A randomized, double blind, placebo controlled, prospective 16 week crossover study to determine the role of Pycnogenol(R) in modifying blood pressure in mildly hypertensive patients. Nutr.Res. 2001;21(9):67-76.

Schmidtke I, Schoop W. Pycnogenol: stasis oedema and its medical treatment. Schweizerische Zeitschrift fur GanzheitsMedizin 1995;3:114-115.

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 Reproductive Med 2013;58(1):39-47.

Durackova, Z., Trebaticky, B., Novotny, V., Zitnanova, A., and Breza, J. Lipid metabolism and erectile dysfunction improvement by Pycnogenol(R), extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction -- a pilot study. Nutr.Res. 2003;23:1189-1198.

Hosseini S, Pishnamazi S Sadrzadeh SMH Farid F Farid R Watson RR. Pycnogenol in the management of asthma. J Medicinal Food 2001;4(4):201-209.

Durackova, B. Trebatický V. Novotný I. Žit®anová J. Breza. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction - a pilot study. Nutrition Research 2003;23(9):1189-1198.

Roseff SJ, Gulati R. Improvement of sperm quality by pycnogenol. Eur Bull Drug Res 1999;7:33-36.

Farid R, Mirfeizi Z Mirheidari M Z Rezaieyazdi Mansouri H Esmaelli H. Pycnogenol® supplementation reduces pain and stiffness and improves physical function in adults with knee osteoarthritis. Nutrition Research 2007;27(11):692-697.

Maritim AC, Sanders RA, Watkins JB 3rd. Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol 2003;17(1):24-38. View abstract.

Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress-a concise review. Saudi Pharma J 2015. Available at: http://dx.doi.org/10.1016/j.jsps.2015.03.013.

Belcaro G, Cornelli U, Luzzi R, et al. Pycnogenol supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res 2013;27(10):1572-8. View abstract.

Belcaro G, Dugall M, Luzzi R, Hosoi M, Corsi M. Improvements of venous tone with pycnogenol in chronic venous insufficiency: an ex vivo study on venous segments. Int J Angiol 2014;23(1):47-52. View abstract.

Belcaro G, Shu H, Luzzi R, et al. Improvement of common cold with Pycnogenol: a winter registry study. Panminerva Med 2014;56(4):301-8. View abstract.

Bottari A, Belcaro G, Ledda A, et al. Lady Prelox improves sexual function in generally healthy women of reproductive age. Minerva Ginecol 2013;65(4):435-44. View abstract.

Khurana H, Pandey RK, Saksena AK, Kumar A. An evaluation of vitamin E and pycnogenol in children suffering from oral mucositis during cancer chemotherapy. Oral Dis 2013;19(5):456-64. View abstract.

Vinciguerra G, Belcaro G, Bonanni E, et al. Evaluation of the effects of supplementation with Pycnogenol on fitness in normal subjects with the Army Physical Fitness Test and in performances of athletes in the 100-minute triathlon. J Sports Med Phys Fitness 2013;53(6):644-54. View abstract.

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Belcaro G, Dugall M, Ippolito E, et al. Pycnogenol and centella asiatica to prevent asymptomatic atherosclerosis progression in clinical events. Minerva Cardioangiol. 2017 Feb;65(1):24-31. View abstract.

Luzzi R, Belcaro G, Ippolito E. Carotid plaque stabilization induced by the supplement association Pycnogenol and centella asiatica (Centellicum). Minerva Cardioangiol. 2016 Dec;64(6):603-9. View abstract.

Belcaro G. A clinical comparison of pycnogenol, antistax, and stocking in chronic venous insufficiency. Int J Angiol. 2015 Dec;24(4):268-74. Epub 2015 Jul 15. View abstract.

Belcaro G, Gizzi G, Pellegrini L, et al. Pycnogenol supplementation improves the control of irritable bowel syndrome symptoms. Panminerva Med. 2018 Jun;60(2):65-89. View abstract.

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. View abstract.

Belcaro G, Dugall M. Preservation of muscular mass and strength in aged subjects with Pycnogenol supplementation. Minerva Ortopedica e Traumatologica 2016 Sept;67(3):124-30.

Belcaro G, Dugall M, Ippolito E, Hus 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.

Hosoi M, Belcaro G, Saggino A, Luzzi R, Dugall M, Feragalli B. Pycnogenol supplementation in minimal cognitive dysfunction. J Nuerosurg Sci. 2018 Jun;62(3):279-284. View abstract.

Valls RM, Llaurado E, Fernandez-Castillo S, et al. Effects of low molecular weight procyanidin rich extract from French maritime bark on cardiovascular disease risk factors in stage-1 hypertensive subjects: randomized, double-blind, crossover, placebo-controlled intervention trial. Phytomedicine. 2016 Nov 15;23(1):1451-61. View abstract.

Luzzi R, Belcaro G, Hosoi M, et al. Normalization of cardiovascular risk factors in pre-menopausal women with Pycnogenol. Minerva Ginecol. 2017 Feb;69(1):29-34. View abstract.

Sarikaki V, Rallis M, Tanojo H, et al. In vitro percutaneous absorption of pine bark extract (Pycnogenol) in human skin. J Toxicol 2004;23(3):149-158.

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. View abstract.

Matsumori A, Higuchi H, Shimada M. French maritime pine bark extract inhibits viral replication and prevents development of viral myocarditis. J Card Fail. 2007 Nov;13(9):785-91. View abstract.

Belcaro G, Cesarone R, Steigerwalt J, et al. Jet-lag: prevention with Pycnogenol. Preliminary report: evaluation in healthy individuals and in hypertensive patients. Minerva Cardioangiol. 2008 Oct;56(5 Suppl):3-9. View abstract.

Luzzi R, Belcaro G, Hu S, 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. View abstract.

Ikuyama S, Fan B, Gu J, Mukae K, Watanabe H. Molecular mechanism of intracellular lipid accumulation: suppressive effect of Pycnogenol in liver cells. Functional Foods in Health & Disease 203;3(9):353-364.

Belcaro G, Dugall M, Hosol M, et al. Pycnogenol and centella asiatica for asymptomatic atherosclerosis progression. Int Angiol. 2014 Feb;33(1):20-6. View abstract.

Belcaro G, Gizzi G, Pellegrini L, et al. Pycnogenol in postpartum symptomatic hemorrhoids. Minerva Ginecol. 2014 Feb;66(1):77-84. View abstract.

Belcaro G, Luzzi R, Hu S, et al. Improvement in signs and symptoms in psoriasis patients with Pycnogenol supplementation. Panminerva Med. 2014 Mar;56(1):41-8. View abstract.

Ezzikouri S, Nishimura T, Kohara M, et al. Inhibitor effects of Pycnogenol on hepatitis C virus replication. Antiviral Res. 2015 Jan;113:93-102. View abstract.

Belcaro G, Cornelli U, Dugall, M, Hosoi M, Cotllese R, Feragalli B. Long-haul flights, edema, and thrombotic events: prevention with stockings and Pycnogenol supplementation (LONFLIT Registry Study). Minverva Cardioangiologica. 2018 Apr;66(2):152-9. View abstract.

Belcaro G, Dugall M, Hu S, et al. Prevention of recurrent venous thrombosis and post-thrombotic syndrome. Minerva Cardioangiol. 2018;66(3):238-245. View abstract.

Feragalli B, Dugall M, Luzzi R, et al. Pycnogenol: supplementary management of symptomatic osteoarthritis with a patch. An observational registry study. Minerva Endocrinol. 2019;44(1):97-101. View abstract.

Hadi A, Pourmasoumi M, Mohammadi H, Javaheri A, Rouhani MH. The impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials. Phytother Res. 2019;33(2):276-287. View abstract.

Hu S, Belcaro G, Ledda A, et al. Behçet syndrome: effects of Pycnogenol supplementation during regression phases. Minerva Cardioangiol. 2018;66(4):386-390. View abstract.

Ledda A, Belcaro G, Feragalli B, et al. Benign prostatic hypertrophy: Pycnogenol supplementation improves prostate symptoms and residual bladder volume. Minerva Med. 2018;109(4):280-284. View abstract.

Luzzi R, Belcaro G, Hu S, et al. Efficacy of Pycnogenol supplementation in remission phases of Sjögren syndrome. Minerva Cardioangiol. 2018; 66(5):543-546. doi: 10.23736/S0026-4725.18.04638-8. View abstract.

Smetanka A, Stara V, Farsky I, Tonhajzerova I, Ondrejka I. Pycnogenol supplementation as an adjunct treatment for antidepressant-induced sexual dysfunction. Physiol Int. 2019;106(1):59-69. View abstract.

Fogacci F, Tocci G, Sahebkar A, Presta V, Banach M, Cicero AFG. Effect of Pycnogenol on Blood Pressure: Findings from a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Studies. Angiology. 2020;71(3):217-25. View abstract.

Pourmasoumi M, Hadi A, Mohammadi H, Rouhani MH. Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials. Phytother Res. 2020;34(1):67-76. View abstract.

Cesarone MR, Belcaro G, Scipione C, et al. Prevention of vaginal dryness in perimenopausal women. Supplementation with Lady Prelox®. Minerva Ginecol. 2019;71(6):434-41. View abstract.

Belcaro G, Cesarone MR, Cornelli U, et al. Xerostomia: prevention with Pycnogenol® supplementation: a pilot study. Minerva Stomatol. 2019;68(6):303-7. View abstract.

Vinciguerra G, Belcaro G, Feragalli B, et al. PycnoRacer®, a fitness drink including Pycnogenol®, improves recovery and training in the Cooper test. Panminerva Med 2019;61(4):457-63. View abstract.

Cesarone MR, Belcaro G, Hosoi M, et al. Supplementary management with Pycnogenol® in Parkinson's disease to prevent cognitive impairment. J Neurosurg Sci. 2020;64(3):258-62. View abstract.

Hu S, Hosoi M, Belcaro G, et al. Management of mild, primary Raynaud Syndrome: supplementation with Pycnogenol®. Minerva Cardioangiol. 2019;67(5):392-8. View abstract.

Cesarone MR, Belcaro G, Agus GB, et al. Chronic venous insufficiency and venous microangiopathy: management with compression and Pycnogenol®. Minerva Cardioangiol. 2019;67(4):280-7. View abstract.

Aldret RL, Bellar D. A Double-Blind, Cross-Over Study to Examine the Effects of Maritime Pine Extract on Exercise Performance and Postexercise Inflammation, Oxidative Stress, Muscle Soreness, and Damage. J Diet Suppl. 2020;17(3):309-20. View abstract.

Manabe K, Kaidzu S, Tsutsui A, et al. Effects of French maritime pine bark/bilberry fruit extracts on intraocular pressure for primary open-angle glaucoma. J Clin Biochem Nutr 2021;68(1):67-72. View abstract.

Navval-Esfahlan E, Rafraf M, Asghari S, Imani H, Asghari-Jafarabadi M, Karimi-Avval S. Effect of French maritime pine bark extract supplementation on metabolic status and serum vascular cell adhesion molecule-1 levels in patients with type 2 diabetes and microalbuminuria. Complement Ther Med 2021;58:102689. View abstract.

Lima PB, Dias JAF, Esposito ACC, Miot LDB, Miot HA. French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double-blind, randomized, placebo-controlled trial. J Eur Acad Dermatol Venereol 2021;35(2):502-8. View abstract.

Majidi Z, Ansari M, Maghbooli Z, et al. Oligopin supplementation mitigates oxidative stress in postmenopausal women with osteopenia: a randomized, double-blind, placebo-controlled trial. Phytomedicine 2021;81:153417. View abstract.

Zhao H, Wu J, Wang N, Grether-Beck S, Krutmann J, Wei L. Oral pycnogenol intake benefits the skin in urban Chinese outdoor workers: a randomized, placebo-controlled, double-blind, and crossover intervention study. Skin Pharmacol Physiol 2021;34(3):135-45. View abstract.

Ledda A, Hu S, Cesarone MR, et al. Pycnogenol® Supplementation Prevents Recurrent Urinary Tract Infections/Inflammation and Interstitial Cystitis. Evid Based Complement Alternat Med 2021;2021:9976299. View abstract.

Cotellese R, Hu S, Cesarone MR, et al. Pycnogenol® supplementation prevents inflammation and symptoms in recurrent, non-severe urinary infections. Panminerva Med 2021;63(3):343-348. View abstract.

Malekahmadi M, Shadnoush M, Islam SMS, et al. The effect of French maritime pine bark extract supplementation on inflammation, nutritional and clinical status in critically ill patients with traumatic brain injury: A randomized controlled trial. Phytother Res 2021;35(9):5178-5188. View abstract.

Cesarone MR, Hu S, Belcaro G, et al. Pycnogenol®-Centellicum® supplementation improves lung fibrosis and post-COVID-19 lung healing. Minerva Med 2022;113(1):135-140. View abstract.

Belcaro G, Cornelli U, Cesarone MR, et al. Preventive effects of Pycnogenol® on cardiovascular risk factors (including endothelial function) and microcirculation in subjects recovering from coronavirus disease 2019 (COVID-19). Minerva Med 2022;113(2):300-308. View abstract.

Cai C, Zeng B, Lin L, et al. An oral French maritime pine bark extract improves hair density in menopausal women: A randomized, placebo-controlled, double blind intervention study. Health Sci Rep 2023;6(1):e1045. View abstract.

Cesarone MR, Belcaro G, Scipione C, et al. Xerostomia and prevention of dryness with a Pycnogenol® mouth spray: a pilot study. Minerva Gastroenterol (Torino) 2023. View abstract.

Tian Y, Zhou Q, Li W, Liu M, Li Q, Chen Q. Efficacy of L-arginine and Pycnogenol ® in the treatment of male erectile dysfunction: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023;14:1211720. View abstract.

Belcaro G, Cesarone MR, Hu S, et al. Pycnogenol® supplementation alleviates symptoms of Parkinson's disease with mild cognitive impairment. J Neurosurg Sci 2022;66(4):371-377. View abstract.

Belcaro G, Rohdewald P, Cesarone MR, et al. Restless legs syndrome: prevention with Pycnogenol® and improvement of the venoarteriolar response. Panminerva Med 2022;64(2):253-258. View abstract.