Complementary/Alternative Medicine Category: Dietary Supplement

Treatment/Therapy: Oligomeric Proanthocyanidins

About the Treatment/Therapy

Oligomeric Proanthocyanidins (OPCs) are naturally occurring polyphenolic compounds (flavanoids) in the plant kingdom, and an integral part of the human diet.1

Proanthocyanidins are the main precursors of the blue-violet and red pigment in plants.2 They are known to have free radical scavenging, antioxidant, anti-cancer, anti-inflammatory, antiviral and perhaps nerve tissue protective properties. They may modify and influence the immune system.1-5

Proanthocyanidins can help maintain a good vascular system.1,2 Although there are multiple sources of OPCs—grape seed, pine bark, and red wine extracts are the most common and abundant sources. However, bilberry, cranberry, black currant, green tea, black tea and other plants also contain these flavonoids.1-8

Grape seed proanthocyanidin extract may be a better inhibitor tissue damage due to harmful “free radicals” (reactive oxygen particles or species) than vitamin C and vitamin E succinate combined and beta carotene. Grape seed and blueberry flavonoids have been found to be involved in the process that inhibits the break down of healthy tissue.3,7,8 It may also help mitochondrial decay.

With these properties, it is conceivable that OPCs would be very effective at preventing migraines (decreasing frequency, duration, intensity, use of abortive therapy, etc) and their use in migraine does need further studies.

However, one uncontrolled, open-label study showed that the use of pine bark extract along with antioxidants vitamin C and E improved disability scores in migraineurs who had failed multiple prophylaxis therapy.9 We hypothesized a daily dosing of OPCs will decrease the number of migraine days and decrease disability associated with migraine in patients with episodic migraine.

Potential Use In Headaches

: Prevention/ Prophylaxis in Migraine

Dosing Issues

OPCs currently do not have widespread acceptance and need further evaluation. There is no standard for recommended doses, however OPCs in general have very low bioavailability (the amount of the bioactive ingredients the body can absorb from a particular dose). Some formulations may absorb better than others. It is important for the user to understand their products absorption rate when considering dosing efficacy and potential side effects.

Cautions

Currently, the author believes they should be at least avoided in people with the following:

    • Hypersensitivity or serious adverse reaction to grape seed extract, bilberry, red wine extract, citrus extract, and/or pine bark extract products.
    • History of thrombocytopenia or bleeding disorder.
    • Known history of severe renal or hepatic impairment.
    • Current use of chemotherapeutic agents, radiation therapy, tacrolimus, cyclosporine, antiplatelets or anticoagulant agents.
    • Women of childbearing potential who are not using or willing to use medically accepted means of contraception (e.g. intrauterine device, vaginal ring, barrier devices with spermicide, female condom or sterilization) when engaging in sexual intercourse and/or pregnant and/or breast-feeding.
    • Medical history of alcohol or substance abuse within the past year (i.e. illegal drugs, prescription and over the counter medications causing significant emotional, physical, and social problems) requiring medical treatment.
    • Any other significant medical condition that, in the opinion of the patient’s physician, would significantly jeopardize the safety of the patient.
    • Onset of migraine above age 50.

Always consult your doctor before beginning any conventional, alternative, and/or complementary treatments or therapies.

Bibliography:
1. Monograph. Oligomeric Proanthocyanidins. Alternative Medicine Review, 2003; 8(4):442-450

2. Fine A M. Oligomeric Proanthocyanidin Complexes: History, Structure, and Phytopharmaceutical Applications. Alternative Medicine Review, 2000; 5(2):144-151

3. Nandakumar V, Singh T, Katiyar S Multi-targeted prevention and therapy of cancer by proanthocyanidins. Cancer Letters, 2008; 269:378-387

4. Deshane J, Chaves L, Sarikonda KV, Isbell S, Wilson L, Kirk Marion, Grubbs C, Barnes S, Meleth S, Kim H. Proteomics Analysis of Rat Brain Protein Modulations by Grape Seed Extract. Journal of Agricultural and Food Chemistry, 2004; 52:7872-7883

5. Logan A, Wong C. Chronic Fatigue Syndrome: Oxidative Stress and Dietary Modifications Alternative Medicine Review, 2001; 6(5):450-459

6. Matchett MD,. MacKinnon SL Sweeney ML, Gottschall-Pass KT, Hurta AR. Blueberry flavonoids inhibit matrix metalloproteinase activity in DU145 human prostate cancer cells. Biochem Cell Biol, 2005; 83:637–643.

7. Terra X, Valls J, Vitrac X, Merrillon J, Arola L, Ardevol A, Blade C, Fernandez-Larrea J,
Pujadas G, Salvado J, Blay M. Grape-Seed Procyanidins Act As Antiinflammatory Agents In Endotoxin-Stimulated Raw 264.7 Macrophages By Inhibiting Nfkb Signaling Pathway. Journal of Agricultural and Food Chemistry, 2007; 55:4357-4365

8. P.K. Vayalil, A. Mittal, S.K. Katiyar, Proanthocyanidins from grape seeds inhibit expression of matrix metalloproteinases in human prostate carcinoma cells which is associated with the inhibition of activation of MAPK and NFkB. Carcinogenesis, 2004; 25:987–995.

9. 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; 46:788-793