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Current evidence indicates that ROS are major mediators of tissue injury in MS, promoting OS that disrupts the structural and functional integrity of lipids, proteins, and nucleic acids ( Under pathological conditions, OS-induced disruption of the BBB facilitates the infiltration of inflammatory cells into the CNS, where they release cytokines and other mediators that amplify neuroinflammation, creating a self-perpetuating pathological cycle

Numerous other antioxidants, such as sulodexide, astaxanthin, lipoic acid, various vitamins (A, B1, C, E, D), and their derivatives like benfotiamine, are recognized for their favorable impact on oxidative stress [288,301]