How probiotic bacteria influence the motor and mental behaviors as well as immunological and oxidative biomarkers in multiple sclerosis? A double blind clinical trial

Background and aims: This clinical trial was carried out to assess the effects of probiotic on mental and motor behaviors, metabolic profiles in patients with multiple sclerosis (MS). Methods: Forty-eight patients with MS were treated by probiotics or placebo for four months to determine clinical symptoms, mental health, and metabolic profiles. Results: Probiotic decreased expanded disability status scale (- 0.52 +/- 0.04 vs. + 0.16 +/- 0.07, P < 0.001), beck depression inventory (- 5.08 +/- 0.71 vs. - 2.62 +/- 0.78, P = 0.026), general health questionnaire-28 (- 6.7 +/- 1.17 vs. - 3.04 +/- 1.13, P = 0.03) and depression anxiety and stress scale (-12.54 +/- 1.81 vs. - 3.33 +/- 2.26, P = 0.003). Probiotic reduced malondialdehyde (P < 0.001) and 8-hydroxy-2'-deoxyguanosine (P < 0.001). Probiotic resulted in a significant reduction in IL-6 (P = 0.01) and high-sensitivity C-reactive protein (P = 0.03), and a significant increase in IL-10 (P < 0.001) and nitric oxide levels (P = 0.012). Conclusion: Through modulation of intestinal flora, the probiotic bacteria may improve clinical symptoms by balancing the inflammatory and anti-inflammatory responses, and adjusting the oxidative biomarkers in the MS patients.