Ellagic acid effects on disease severity, levels of cytokines and T-bet, RORγt, and GATA3 genes expression in multiple sclerosis patients: a multicentral-triple blind randomized clinical trial

Background Multiple sclerosis (MS) is a chronic autoimmune disease. Ellagic acid natural polyphenol and affects the fate of neurons through its anti-inflammatory antioxidant properties. The present study aimed to investigate ellagic effects on disease severity, expression involved genes in pathogenesis MS, levels related cytokines. Methods was triple-blind clinical trial. Eligible patients were randomly assigned two groups: (25 subjects) for 12 weeks, receiving 180 mg (Axenic, Australia) control group placebo, before main meals. Before after study, data including general information, foods intake, physical activity, anthropometric data, expanded disability status scale (EDSS), health questionnaire (GHQ) pain rating index (PRI), fatigue severity (FSS) assessed, as well serum interferon-gamma (IFNγ), interleukin-17 (IL-17), interleukin-4 (IL-4) transforming growth factor-beta (TGF-β), nitric-oxide (NO) using enzyme-linked immunoassay (ELISA) method T-box transcription factor (Tbet), GATA Binding Protein 3 (GATA3), retinoic acid-related orphan receptor-γt (RORγt) Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) determined Real-Time Quantitative Reverse Transcription PCR (RT-qPCR) method. Findings supplementation led reduction IFNγ, IL-17, NO increased IL-4 group, however placebo no such changes observed (−24.52 ± 3.79 vs. -0.05 0.02, p < 0.01; −5.37 0.92 2.03 1.03, −18.03 1.02 -0.06 0.05, 0.01, 14.69 0.47 -0.09 0.14, respectively). had effect TGF-β any groups ( > 0.05). Also, Tbet RORγt decreased, GATA3 gene compared significantly (0.52 0.29 1.51 0.18, 0.49 0.18 1.38 1.71 0.39 0.27 0.10, 0.01). significant decrease EDSS, FSS GHQ scores 0.05), PRI score Conclusion can improve MS by inflammatory cytokines expression, increment expression. Clinical trial registration : https://en.irct.ir/trial/53020 ), IRCT20120415009472N22.