REVIEW   Free access

International Angiology 2017 February;36(1):31-41

DOI: 10.23736/S0392-9590.16.03788-3

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

The place of Ruscus extract, hesperidin methyl chalcone, and vitamin C in the management of chronic venous disease

Arkadiusz JAWIEN ¹, Eliete BOUSKELA ², François A. ALLAERT ³, Andrew N. NICOLAÏDES ⁴ ✉

¹ Department of Vascular Surgery and Angiology, Collegium Medicum University of Nicolai Copernicus, Bydgoszcz, Poland; ² Laboratory of Clinical Experimental Research on Vascular Biology - BioVasc - State University of Rio de Janeiro, Brasil; ³ University of Burgundy, Dijon, France; ⁴ Department of Surgery, University of Nicosia Medical School, Nicosia, Cyprus

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.

KEY WORDS: Endothelial cells - Inflammation - Leukocytes - Receptors, muscarinic - Ruscus - Ascorbic acid