In addition, a randomized, double-blind, placebo-controlled clinical trial of 40 participants with a diagnosis of major depressive disorder (MDD) showed that probiotic capsules containing strains of Lactobacillus acidophilus (2 × 109 CFU/g), Lactobacillus casei (2 × 109 CFU/g) and Bifidobacterium bifidum (2 × 109 CFU/g) increased antioxidant biomarkers including plasma GSH levels and decreased serum high-sensitivity C-reactive protein (hs-CRP) and insulin levels compared to the placebo after 8 weeks [239]. This evidence concerns the gene INS and major depressive disorder.