Horse Chestnut Seed Extract: An Opportunity for Creating Evidencebased New Natural Products

For centuries, herbal remedies have been used to prevent and treat disease. Horse chestnut seeds are an abundant source of phytoconstituents containing triterpenoid saponins, with thirty molecules isolated and characterized. Escin, which is a combination of acylated triterpene glycosides composed of α- and β-escin, is the major biologically active component of horse chestnut seed extract. Escin is the most researched veno-active compound with anti-inflammatory, anti-oedematous, and antioxidant properties. Due to their unique three pharmacological actions, escin is a well-established molecule for the management of venous diseases such as chronic venous insufficiency (CVI) and hemorrhoids. The available treatments for CVI have some disadvantages, including severe side effects, expensive surgical options, long duration of treatment, and limited accessibility to allopathic drugs. As a result, phytoconstituents and lifestyle changes can be seen as safe and effective therapy options for CVI management because they have no major side effects and can simultaneously function on several targets. This review article focuses on the chemical components of horse chestnut extract, particularly the phytoconstituents escin, and proanthocyanidins, which have been extensively studied in preclinical and clinical studies. The review article provides a comprehensive overview of their potential therapeutic benefits in managing symptoms of CVI and their regulatory status.