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.

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.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Acrocyanosis (lower limb ischemia), AIDS, allergies, angina (chest pain), anticoagulant (blood thinner), arthritis, autism, blood disorders (impaired plasma fibrinolytic activity), bursitis (inflamed bursa), cancer, circulatory disorders, dementia, gastrointestinal reflux disease, headaches, hemorrhoids, hypercholesterolemia (high cholesterol), immunomodulation, inflammation, kidney stones, macular degeneration (eye disease), obstetric and gynecological disorders, pelvic inflammatory disease, peripheral obstructive arterial disease, skin conditions (cutaneous necrotizing venulitis), ulcerative colitis (inflammatory bowel disease), wound healing

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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 (bleeding 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 antihypertensive 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

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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 progestinic) 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.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

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.

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2. 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. View Abstract

3. Bettini R, Maino C, Gorini M. [Effectiveness of mesoglycan in the prevention of cerebral ischemia]. Clin Ter 2003;154(1):13-16. View Abstract

4. 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. View Abstract

5. 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. View Abstract

6. 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. View Abstract

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9. 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. View Abstract

10. 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. View Abstract

11. 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. View Abstract

12. 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. View Abstract

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14. 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. View Abstract

15. 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. View Abstract