This review summarizes the effects of the standardized proprietary bark extract of the French maritime pine (Pycnogenol®) in mild
osteoarthritis (OA), stage 1 and 2. The extract exerts antioxidative, anti-inflammatory, and chondroprotective effects in vitro and in vivo. Its phenolic
acids as well as
catechin and
taxifolin are quickly absorbed. Active metabolites, produced by gut microbiota in the intestinal tract from oligomeric
procyanidins, appear in blood 6 h following ingestion and remain for at least 14 h, providing a long-lasting flow of anti-inflammatory substances for relief of OA symptoms. These constituents of
Pycnogenol could be detected in serum, blood cells, and synovial fluid of OA patients. The resulting inhibition of cartilage-destructing
proteases and
pain-producing cyclo-
oxygenases provides the basis for relief from
pain, improvement of stiffness, enhanced mobility, and well-being in three clinical studies with the pine bark extract as an adjunct supplement. Sparing the use of nonsteroidal anti-inflammatory drugs, supplementation with the pine bark extract reduced gastric complications and hospital admissions of OA patients. Because of its favorable safety profile and sustained anti-inflammatory action,
Pycnogenol represents an option as an add-on supplement for OA patients.