ascorbic-acid and hesperidin-methylchalcone

With our increasing knowledge of the epidemiology, pathophysiology, investigation and clinical aspects of chronic venous disease (CVD) and new data on the various therapies available, an update of the recommendations on CVD and its management appears to be necessary. The symposium New Data on Chronic Venous Disease: A New Place for Cyclo 3® Fort, held during the annual meeting of the European Venous Forum on June 30th, 2017 in Porto, Portugal, reported the recent developments on the Ruscus, hesperidin methyl chalcone (HMC), and vitamin C combination (Cyclo 3® Fort), including the results of a series of in-vivo pharmacological experiments and a recent meta-analysis. Additionally, the symposium provided first-hand information on the process, rules, main findings, and expected contents of the prospective 2018 CVD guidelines. Analysis of the evidence showed that the effect of the Ruscus, HMC, and vitamin C combination on pain, heaviness, feeling of swelling, tingling, ankle circumference and global symptoms score reached Grade A. Therefore, the new guidelines should specify that the Ruscus, HMC, and vitamin C combination merits a Grade 1A recommendation.

Topics: Animals; Ascorbic Acid; Chalcones; Chronic Disease; Congresses as Topic; Drug Therapy, Combination; Hesperidin; Humans; Phytotherapy; Plant Extracts; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Ruscus; Venous Insufficiency

Despite continuous improvement in our knowledge and management of chronic venous disease (CVD), certain areas, such as the role of muscarinic receptors in the pathology and treatment of CVD, remain unexplored. The symposium "The place of Ruscus extract, hesperidin methyl chalcone, and vitamin C in the management of CVD", held at the Annual Meeting of the European Venous Forum on 7-9 July 2016 in London, presented an update on the pathophysiology of CVD and highlighted how the combination of Ruscus extract, hesperidin methyl chalcone, and vitamin C (Ruscus/HMC/VitC; Cyclo 3® Fort), may counteract the deleterious processes underlying CVD. The data presented during this symposium are reported here. The pathophysiology of CVD is driven by a complex process involving numerous factors, with the two key players being venous hypertension and the inflammatory response. The cascade of reactions induced by disturbed venous flow, inflammation, and tissue alterations results in the early appearance of symptoms and progressive development of clinical signs of disease. Previous studies have shown that Ruscus extract acts at three levels: on the veins, capillaries and lymphatics, and has anti-inflammatory properties. A series of recent experiments has shed new light on the mechanism of action of the combination of Ruscus/HMC/VitC. The efficacy of Ruscus/HMC/VitC in CVD is supported by clinical studies, while two meta-analyses have confirmed a significant decrease of several symptoms and ankle circumference in response to treatment with this agent, leading to the conclusion that Ruscus/HMC/VitC deserves a Grade A rating.

Topics: Ascorbic Acid; Chalcones; Chronic Disease; Congresses as Topic; Drug Therapy, Combination; Hesperidin; Humans; London; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic; Ruscus; Treatment Outcome; Vascular Diseases; Veins

This paper focuses on Ruscus aculeatus extract (Ruscus extract) and its combination with hesperidin methyl chalcone (HMC) and ascorbic acid (AA), which have been safely and effectively used in CVD treatment for more than 50 years in some European countries. It presents the effects of that drug on veins and on venous hypertension, its effect on microcirculation and on lymphatics demonstrated by preclinical studies and the clinical evidence issued from clinical trials supporting its use to relieve the symptoms of venous disease. In addition to its venoconstrictive effect on veins, its pharmacological action is on the microcirculation impairment caused by venous hypertension that is at the heart of the pathophysiological mechanism underlying venous disease.

Topics: Ascorbic Acid; Chalcones; Chronic Disease; Drug Therapy, Combination; Hesperidin; Humans; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic; Ruscus; Vascular Diseases; Veins

The aim of this study was to compare the change in functional signs of venous insufficiency and venous refilling time measured by mercury strain-gauge plethysmography under the effects of the combination of Ruscus aculeatus, hesperidin methylchalcone and ascorbic acid (Cyclo 3 Fort).. An open-label clinical trial conducted in 65 women presenting with CEAP class C2s and C3s assessment criteria. At D0 and D28, functional signs were measured on a visual analog scale (VAS), venous refilling time by mercury strain-gauge plethysmography and venous reflux by echo-Doppler method.. Under treatment, venous refilling time increased from 11.7±4 s to 13.8±4.4 s with Δ of 26% (P<0.0001) and the percentage of patients showing improvement of functional symptoms ≥30% was significantly correlated (P=0.04) with the percentage of patients presenting an improvement in venous refilling time ≥10%.. Improvement in subjective functional signs under treatment with Cyclo 3 Fort was correlated with objective plethysmographic parameter improvement. There-fore, this study contributes to objectively document the benefit of prescribing this venoactive drug to active women with CEAP class C2s to C3s.

Topics: Activities of Daily Living; Analysis of Variance; Ascorbic Acid; Cardiovascular Agents; Chalcones; Chi-Square Distribution; Drug Therapy, Combination; Female; France; Hesperidin; Humans; Plant Extracts; Plethysmography; Predictive Value of Tests; Recovery of Function; Ruscus; Treatment Outcome; Ultrasonography, Doppler; Venous Insufficiency

The present study assessed the effect of Ruscus aculeatus, hesperidin methyl-chalcone and ascorbic acid (HMC-AA), in the treatment of chronic venous disorders (CVD) in Latin American patients.. This study is an observational, single arm, multicentric and prospective trial. Patients suffering from CVD and belonging to C0s-C3 Clinical Etiological Anatomical and Physiopathological (CEAP) classes were included. Patient profiles, risk factors, clinical symptomatology and quality of life (QoL) assessed by SF-12 and CIVIQ questionnaires were evaluated at inclusion and after 12-week treatment.. The main factors influencing the previous management of patients were age, gender, body mass index (BMI), familial history, physical activity, exposure to heat, heavy loads lifting, profession and clinical characteristics. All clinical symptoms significantly improved with treatment and, as BMI and CEAP classes increased. Ankle circumferences decreased over time, correlating with BMI and CEAP classes. The physical and psychological dimensions of the SF-12 score significantly increased over time and improved within each CEAP class. The CIVIQ score significantly improved over time, correlating with age and CEAP classes.. A 12-week treatment with Ruscus aculeatus HMC-AA showed a significant decrease in the clinical symptoms and a significant improvement in the QoL of patients with CVD.

Topics: Adult; Aged; Argentina; Ascorbic Acid; Cardiovascular Agents; Chalcones; Chronic Disease; Drug Combinations; Female; Hesperidin; Humans; Logistic Models; Male; Mexico; Middle Aged; Odds Ratio; Plant Preparations; Prospective Studies; Quality of Life; Risk Assessment; Risk Factors; Ruscus; Surveys and Questionnaires; Time Factors; Treatment Outcome; Venous Insufficiency

Besides actions including their venotonic, anti-inflammatory, and anti-oxidant effects, venoactive drugs are expected to act on edema via their action on lymphatics. The objective of this study was to evaluate the effect of the combination of Ruscus, hesperidin methyl chalcone and Vitamin C (Ruscus/HMC/Vit C) on intracellular calcium mobilization and contraction of human lymphatic smooth muscle cells (LSMCs) to better characterize the mechanism of its lymphotonic activity.. Ruscus/HMC/Vit C induced a strong and reproducible concentration-dependent calcium mobilization in LSMCs. On the contrary, another venoactive drug used as comparator, micronized purified flavonoid fraction (MPFF), did not induce calcium mobilization whatever the tested concentration.. Although alternative mechanisms of action may result in potential lymphotonic effects, the efficacy of lymphotonic products is nonetheless related to their stimulating effect on the contractile activity of the smooth muscle cells surrounding lymphatic vessels. In the light of the results obtained in this study, the direct effect of Ruscus/HMC/Vit C on LSMC contraction may partially explain its clinical efficacy on lymphotonic activity, as has been observed in terms of objective signs of edema as reported in the recent guidelines on chronic venous disease.

Topics: Ascorbic Acid; Calcium; Calcium Signaling; Cells, Cultured; Chalcones; Diosmin; Dose-Response Relationship, Drug; Drug Combinations; Gene Expression Regulation; Hesperidin; Humans; Lymphatic Vessels; Male; Middle Aged; Muscle Contraction; Myocytes, Smooth Muscle; Plant Extracts; Ruscus; Time Factors

To assess patients' satisfaction from the therapy of advanced chronic venous disorders (CVD) in everyday clinical practice in Poland, and to compare the efficacy of various venoactive drugs (VADs) in venous ulcers healing process.. Seven hundred and eighty unselected adult patients with active (N.=441) or healed (N.=339) venous ulcers participated in the non-interventional observational 6-week study.. Compression therapy and VADs were utilized by 81.5% and 89.2% of patients respectively: 31.2% of all patients underwent surgical procedures for vein incompetence, 61.3% were satisfied with surgical methods, 43% with compression therapy, and 32.6% with VADs ‑ with highest rate of satisfied patients in the group taking Ruscus aculeatus and HMC and ascorbic acid (51.4%). Of 377 patients with active venous ulcers smaller than 200 cm2, adherent to VADs, 18.0% have been cured, and 66.6% have improved during 6-week period of observation. Multiple logistic regression analysis revealed that the compression therapy (OR=2.74), the size of ulcer ≤10 cm2 (OR=2.70) were increasing the change of ulcer healing. No VADs was better than another in the healing process.. 1) Compression therapy and VADs are highly utilized by patients with advanced CVD. 2) Patients are more satisfied with surgical than conservative treatment of advanced CVD. 3) More than half of the patients with the advanced stage CVD taking Ruscus aculeatus and HMC and ascorbic acid is satisfied with the obtained improvement. 4) Ruscus aculeatus and HMC and ascorbic acid is similarly effective as other frequently used VADs in venous ulcer healing. 5) Ruscus aculeatus and HMC and ascorbic acid exerting effects on veins, capillaries and lymphatic vessels may explain the positive results observed in this study.

Topics: Aged; Ascorbic Acid; Chalcones; Chronic Disease; Female; Hesperidin; Humans; Male; Middle Aged; Patient Satisfaction; Phytotherapy; Plant Extracts; Ruscus; Severity of Illness Index; Varicose Ulcer; Wound Healing

Clinical and capillaroscopic evaluation of an association of Ruscus aculeatus, hesperidin methylchalcone (HMC) and ascorbic acid in chronic venous insufficiency. A prospective, multicenter and open clinical study. Chronic venous insufficiency patients were studied using clinical, etiological, anatomical, physiological classification (CEAP) symptom scale. Symptomatology, CEAP scale, and baseline, 2-, 4-, 6- and 8-week skin capillaroscopy were assessed. Treatment consisted of two capsules per day of Ruscus aculeatus 150 mg/HMC 150 mg/ascorbic acid 100 mg during 8 weeks.. A total of 124 patients were studied, 109 female (89.28%), with a mean age of 52.5 (33-80+9.8). Initial intense reports were 79% pain, 85% heaviness, 74% cramps, 82% edema, decreasing to 20%, 12%, 8% and 14%, respectively, within two weeks, and symptomatology being absent at the end of treatment. Capillaroscopy changes at treatment completion were: 98% to 20% inter-capillary fluid decrease; 80% to 20% efferent loop thickening; 5% to 2% peri-capillary bed, and 5% to 4% mega-capillaries.. Severe symptom decrease started from the second week until there were no symptoms at the end of treatment. It is the first time morphologic changes were observed in chronic venous insufficiency through capillaroscopy following a pharmacological intervention. Capillary-level effect was proportional to symptom decrease. Improvement was seen from the second week of treatment.

Topics: Adult; Aged; Aged, 80 and over; Antioxidants; Ascorbic Acid; Chalcones; Chronic Disease; Female; Hesperidin; Humans; Leg; Male; Microscopic Angioscopy; Middle Aged; Phytotherapy; Plant Extracts; Ruscus; Venous Insufficiency

Topics: Administration, Oral; Aniline Compounds; Ascorbic Acid; Chalcones; Coloring Agents; Flavonoids; Hemophilia A; Hesperidin; Hypoprothrombinemias; Leukemia; Prothrombin; Purpura; Purpura, Thrombocytopenic; Tolonium Chloride; Vitamins