Aortic acid

Background:

Interest in aortic acid began in the 1960s and focused on atherosclerosis (hardening of the artieries). This was a logical place to begin research, as aortic extract is usually manufactured from the hearts of animals, usually sheep, cows, or pigs. In this extract are many substances, including aortic acid, which is a broad term encompassing several constituents. Mesoglycan, a preparation of glycosaminoglycans, is the most studied of these constituents.
Although mesoglycan is found in great quantities in the heart, it is found throughout the body, primarily in the cardiovascular system. It is in all three layers of blood vessels, and is responsible for maintaining vessel structure and flexibility. One of the glycosaminoglycans in mesoglycan is heparin sulfate, which may explain why mesoglycan has shown anticoagulation effects in some clinical studies.
Because mesoglycan and aortic acid are extracted from the heart, preliminary studies have focused on cardiovascular disorders, such as atherosclerosis, deep vein thrombosis, lower limb ischemia, and cutaneous necrotizing venulitis. Mesoglycan has shown the most promise in treating chronic venous ulcers and intermittent claudication. Other areas of future interest may be hypercholesterolemia (high cholesterol), impaired fibrinolytic activity, and general wound healing. However, more high quality research is needed in all of these areas.

Related Terms:

Acid esterase, aortic acid esterase, aortic acid extract, aortic acid mucopolysaccharides, aortic acid phosphatase, aortic extract, aortic GAGs, aortic glandular extract, aortic glycosaminoglycans, chondroitin, chondroitin polysulfate, chondroitin sulfate A, CSA, dermatan, GAGs, glycoproteins, glycosaminoglycans, heparinoid fraction, heparinoids, heparan sulfate, mesoglycan, mucopolysaccharide, sulfomucoploysaccharide.
Note: This monograph does not include clinical information on chondroitin sulfate.

Evidence Table:

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.	Grade*
Chronic venous ulcers Mesoglycan, an aortic acid, is a structural component of blood vessels. In the case of venous ulcers, mesoglycan may be able to improve venous health. Additional study is needed to confirm early findings.	B
Intermittent claudication Intermittent claudication is part of late stage atherosclerosis, and mesoglycan has shown some therapeutic ability in preliminary atherosclerosis studies in humans. In addition, mesoglycan is a heparin-like substance that has shown anticoagulation ("blood thinning") properties in clinical studies. Additional study is needed.	B
Atherosclerosis Mesoglycan is a structural aspect of cardiovascular vessels and organs. One preliminary study indicates that mesoglycan may reduce blood vessel thickening, however, additional research is needed in this field.	C
Cerebral ischemia Mesoglycan has shown activity in anticoagulation ("blood thinning") and increasing blood vessel health. Preliminary studies also indicate that it may be helpful in reducing recurring ischemic cerebral attacks and improving quality of life.	C
Vein clots (deep vein thrombosis) Currently, there is insufficient available evidence to recommend for or against aortic acid for deep vein thrombosis.	C
Venous disorders Mesoglycan has shown activity in anticoagulation ("blood thinning") and increasing blood vessel health. Low quality research shows that mesoglycan may be helpful in various venous disorders, including postphlebitic syndrome, venous insufficiency, and varicose syndrome. Additional study is needed.	C

Dosing:

Adults (18 years and older):

Mesoglycan is likely safe when taken by mouth in doses less than or equal to 200 milligrams daily for 18 months. There is no proven effective dose. However, 96 or 100 milligrams mesoglycan daily by mouth for six months for cerebrovascular disease and hyperlipidemia (high cholesterol) has been used. For intermittent claudication (leg pain), one 24-milligram mesoglycan tablet twice daily for six months has been used. For phlebitis, two 12-milligram mesoglycan capsules three times a day for 30 days has been used. For postphlebitic syndrome, 50 milligrams mesoglycan twice a day for three months has been used.
Mesoglycan is also likely safe when 90 milligrams is injected for 10 days under the supervision of a qualified healthcare professional, including a pharmacist.

Children (younger than 18 years):

There is no proven safe or effective dose for aortic acid in children.

Safety:

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

There are currently no reported allergic reactions available. Due to the heparan sulfate content of mesoglycan, patients with an allergy to heparin or heparinoid derivatives should use caution.

Side Effects and Warnings

Aortic acid, including mesoglycan, has been well-tolerated for up to 18 months in the available human trials. However, the U.S. Food and Drug Administration (FDA) cautions against the consumption of any dietary supplement made from animal glands or organs, especially from cows and sheep from countries with known cases of bovine spongiform encephalitis (BSE, or "mad cow" disease) or scrapie. It is thought that these extracts may contain viable prions that could infect humans. Currently, there are no available reports of transmission of BSE through aortic acid.
Mesoglycan (injection or taken by mouth) has caused minor side effects including diarrhea, headache.
Use cautiously in patients with coagulation disorders or taking anticoagulation therapy. Use cautiously in patients with an allergy to heparin or heparinoid derivatives.
Use cautiously in patients with hypertension (high blood pressure) or taking antihypertension drugs.

Pregnancy and Breastfeeding

Aortic acid is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Although not well studied in humans, hormonal changes may affect aortic acid levels.

Interactions:

Interactions with Drugs

Aortic extract may inhibit vascularization and caution is advised when taking aortic acid with any antiangiogenic drugs, which prevent new vessel growth.
Aortic acid may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Aortic acid may lower total cholesterol and VLDL-triglyceride levels while raising HDL cholesterol and lipoprotein lipase activity. Caution is advised in patients taking cholesterol-lowering medications, such as statins (simvastatin).
Although not well studied in humans, aortic extract may alter blood pressure. Patients with high or low blood pressure or those taking blood-pressure lowering agents should use cautiously.
Aortic extracts may inhibit the growth of tumors. In theory, aortic acid may have additive effects when used concomitantly with other antitumor agents. Consult with a qualified healthcare professional, including a pharmacist, to check for interactions.
Cigarette smoke may reduce the activity of aortic acid.
Mesoglycan may decrease fibrinogen concentration and regulate fibrinolysis. Caution is advised in patients taking any fibrinolytics agents, which act to dissolve blood clots.
Although not well studied in humans, female sex hormones may affect aortic acid mucopolysaccharides' effect on atherosclerosis. Caution is advised in patients taking hormone replacement therapy or birth control pills.
Mesoglycan may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Bovine aorta extract may inhibit immune response. Caution is advised in patients taking any herbs or supplements with immunomodulating activity because in theory, there may be interactions.
Thyroid drugs may affect aortic acid mucopolysaccharides' effect on atherosclerosis. In theory, combination of aortic acid with herbs or supplements used for thyroid disorders may cause an interaction.

Interactions with Herbs and Dietary Supplements

Aortic acid may reduce the formation of blood clots, and mesoglycan may regulate fibrinolysis. In theory, aortic acid may interact with herbs with anticoagulating ("blood thinning") effects. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Aortic acid may lower total cholesterol and VLDL-triglyceride levels while raising HDL cholesterol and lipoprotein lipase activity. Caution is advised when taking aortic acid with herbs that have cholesterol-lowering effects, such as red yeast rice.
Although not well studied in humans, aortic extract may alter blood pressure. Patients taking herbs for high blood pressure or patients with low blood pressure should use with caution.
Aortic extracts may inhibit the growth of tumors. Caution is advised in patients taking any herb that has antitumor effects.
Female sex hormones may affect aortic acid mucopolysaccharides' effect on atherosclerosis. Caution is advised in patients taking herbs or supplements with hormonal (estrogenic or progestic) effects.
Mesoglycan may slightly lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Bovine aorta extract may exert significant dose-dependent inhibition of lymphocyte response. Caution is advised when taking aortic extract in combination with other immunomodulating herbs or supplements.
Thyroid drugs may affect aortic acid mucopolysaccharides' effect on atherosclerosis.
Administration of vitamin C during copper deficiency may lead to an increase in aortic acid. However, copper deficiency itself may lead to an increase in aortic acid.

Attribution:

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Brent Bauer, MD (Mayo Clinic); Ashley Brigham, PharmD (Northeastern University); J. Kathryn Bryan, BA (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Juliann Goodfriend, PharmD (Northeastern University); Thuy-Duong Le, PharmD (Oregon State University); Jason Mahoney, BA (Natural Standard Research Collaboration); Audrey Nealon, PharmD (Northeastern University); Todd Porter, PhD (University of Kentucky); Rebecca Strauss, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Kenneth Triptow, PharmD (Drake University); Wendy Weissner, BA (Natural Standard Research Collaboration).

References:

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Ambrosio LA, Marchese G, Filippo A, et al. The effect of mesoglycan in patients with cerebrovascular disease: a psychometric evaluation. J Int Med Res 1993;21(3):138-146.
Arosio E, Ferrari G, Santoro L, et al. A placebo-controlled, double-blind study of mesoglycan in the treatment of chronic venous ulcers. Eur J Vasc Endovasc Surg 2001;22(4):365-372.
Bettini R, Maino C, Gorini M. [Effectiveness of mesoglycan in the prevention of cerebral ischemia]. Clin Ter 2003;154(1):13-16.
Blardi P, Messa G, Puccetti L, et al. [Effects on the coagulation-fibrinolysis system of a single oral dose of mesoglycan at the beginning and at the end of a prolonged treatment in man]. Recenti Prog.Med. 1995;86(7-8):282-289.
Giorgetti PL, Marenghi MC, Bianciardi P. [Heparan sulfate in the therapy of postphlebitic syndrome. Evaluation of the efficacy and tolerability as compared to mesoglycan]. Minerva Cardioangiol. 1997;45(6):279-284.
Kobayashi T, Osakabe T, Seyama Y. Comparison of elastolytic activity between experimental aneurysm and experimental diabetes mellitus. Biol Pharm Bull. 1998;21(7):775-777.
La Marca G, Pumilia G, Martino A. [Effectiveness of mesoglycan topical treatment of leg ulcers in subjects with chronic venous insufficiency]. Minerva Cardioangiol. 1999;47(9):315-319.
Laurora G, Ambrosoli L, Cesarone MR, et al. Treatment of intermittent claudication with defibrotide or mesoglycan. A double blind study. Panminerva Med. 1994;36(2):83-86.
Maehira F, Zaha F, Miyagi I, et al. Effects of passive smoking on the regulation of rat aortic cholesteryl ester hydrolases by signal transduction. Lipids 2000;35(5):503-511.
Messa G, Blardi P, La Placa G, et al. [Effects of 2 single oral doses of mesoglycan on the coagulation-fibrinolysis system in man. A pharmacodynamic study]. Recenti Prog.Med. 1995;86(7-8):272-281.
Nenci GG, Gresele P, Ferrari G, et al. Treatment of intermittent claudication with mesoglycan--a placebo-controlled, double-blind study. Thromb.Haemost. 2001;86(5):1181-1187.
Raso AM, Maggio D, Trogolo M, et al. [Effectiveness of mesoglycan therapy in patients with ischemia of the lower limbs. Preliminary results of a new therapeutic protocol]. Minerva Cardioangiol. 1997;45(7-8):383-392.
Scondotto G, Catena G, Aloisi D. [Use of mesoglycan in venous pathology]. Minerva Med. 1997;88(12):537-541.
Tardieu M, Bourin MC, Desgranges P, et al. Mesoglycan and sulodexide act as stabilizers and protectors of fibroblast growth factors (FGFs). Growth Factors 1994;11(4):291-300.
Tovar AM, Cesar DC, Leta GC, et al. Age-related changes in populations of aortic glycosaminoglycans: species with low affinity for plasma low-density lipoproteins, and not species with high affinity, are preferentially affected. Arterioscler.Thromb.Vasc.Biol. 1998;18(4):604-614.

Disclaimer :

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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