Letter to the Editor
Comments on “Role of intestinal microbiota in the development of multiple sclerosis”
Comentario del artículo «Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple»
a Departamento de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain
b Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain
c Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
d Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain
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Benito-León, Á. Domingo-Santos" "autores" => array:2 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Benito-León" "email" => array:1 [ 0 => "jbenitol67@gmail.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Á." "apellidos" => "Domingo-Santos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario del artículo «Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It was with great interest that we read the review article by Drs Castillo-Álvarez and Marzo-Sola on the role of intestinal microbiota in the development of multiple sclerosis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> Their study constitutes a valuable contribution to the literature addressing the role of gut microbiota in multiple functions of the human body, especially immune response. However, we feel that the authors have not mentioned some of the topics addressed in other studies conducted by Spanish researchers and published in international journals. With a view to enriching the discussion and reflections on the role of microbiota in multiple sclerosis, and more specifically to complementing, if possible, the outstanding article by Castillo-Álvarez and Marzo-Sola,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> we will address the omitted subjects, particularly the association between <span class="elsevierStyleItalic">Candida</span> species and multiple sclerosis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The human microbiota has been reported to host some yeast species of the <span class="elsevierStyleItalic">Candida</span> genus.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a> Furthermore, several studies have suggested a link between cow milk and multiple sclerosis<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3,4</span></a> and it is a well-known fact that yeasts of the <span class="elsevierStyleItalic">Candida</span> genus can be isolated from some dairy products.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> Likewise, some rare cases of acute zonal occult outer retinopathy associated with multiple sclerosis and infections due to <span class="elsevierStyleItalic">Candida</span> species have been described in the literature.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">6–8</span></a> These observations led us to hypothesise that <span class="elsevierStyleItalic">Candida</span> species may be associated with multiple sclerosis.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> In that study, we obtained blood samples from 80 patients with multiple sclerosis and 240 age- and sex-matched controls.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> According to our results, presence of <span class="elsevierStyleItalic">Candida</span> antigens was significantly associated with multiple sclerosis. More specifically, odds ratios (95% CI) were as follows: 2.8 (0.3-23.1; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.337) for <span class="elsevierStyleItalic">Candida famata</span>, 1.5 (0.7-3.4; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.290) for <span class="elsevierStyleItalic">Candida albicans</span>, 7.3 (3.2-16.6; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) for <span class="elsevierStyleItalic">Candida parapsilosis</span>, and 3.0 (1.5-6.1; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.002) for <span class="elsevierStyleItalic">Candida glabrata</span>. Results were similar after excluding those patients receiving immunosuppressants.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> These findings led us to conclude that presence of <span class="elsevierStyleItalic">Candida</span> antigens was associated with increased risk of multiple sclerosis. Although the significance and scope of our results is difficult to determine, they lay the foundations for further research into this topic.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In any case, we wish to congratulate Castillo-Álvarez and Marzo-Sola on their excellent study and look forward to meeting them at a medical conference to further discuss these topics in person.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Benito-León J, Domingo-Santos Á. Comentario del artículo «Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple». Neurología. 2017;32:477–478.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii: S0213-4853(15)00180-2" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Castillo-Álvarez" 1 => "M.E. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 15 | 5 | 20 |
| 2024 September | 37 | 7 | 44 |
| 2024 August | 16 | 6 | 22 |
| 2024 July | 14 | 7 | 21 |
| 2024 June | 16 | 4 | 20 |
| 2024 May | 16 | 8 | 24 |
| 2024 April | 17 | 5 | 22 |
| 2024 March | 13 | 7 | 20 |
| 2024 February | 11 | 4 | 15 |
| 2024 January | 13 | 4 | 17 |
| 2023 December | 11 | 7 | 18 |
| 2023 November | 12 | 2 | 14 |
| 2023 October | 16 | 4 | 20 |
| 2023 September | 6 | 4 | 10 |
| 2023 August | 7 | 7 | 14 |
| 2023 July | 7 | 9 | 16 |
| 2023 June | 6 | 6 | 12 |
| 2023 May | 6 | 4 | 10 |
| 2023 April | 6 | 1 | 7 |
| 2023 March | 6 | 4 | 10 |
| 2023 February | 12 | 2 | 14 |
| 2023 January | 9 | 7 | 16 |
| 2022 December | 10 | 7 | 17 |
| 2022 November | 24 | 6 | 30 |
| 2022 October | 10 | 12 | 22 |
| 2022 September | 10 | 8 | 18 |
| 2022 August | 12 | 13 | 25 |
| 2022 July | 8 | 11 | 19 |
| 2022 June | 9 | 5 | 14 |
| 2022 May | 9 | 8 | 17 |
| 2022 April | 17 | 8 | 25 |
| 2022 March | 10 | 6 | 16 |
| 2022 February | 12 | 5 | 17 |
| 2022 January | 12 | 10 | 22 |
| 2021 December | 9 | 8 | 17 |
| 2021 November | 10 | 5 | 15 |
| 2021 October | 18 | 9 | 27 |
| 2021 September | 13 | 8 | 21 |
| 2021 August | 11 | 8 | 19 |
| 2021 July | 12 | 7 | 19 |
| 2021 June | 8 | 7 | 15 |
| 2021 May | 16 | 10 | 26 |
| 2021 April | 31 | 11 | 42 |
| 2021 March | 13 | 8 | 21 |
| 2021 February | 6 | 9 | 15 |
| 2021 January | 11 | 10 | 21 |
| 2020 December | 10 | 7 | 17 |
| 2020 November | 6 | 6 | 12 |
| 2020 October | 7 | 8 | 15 |
| 2020 September | 13 | 7 | 20 |
| 2020 August | 10 | 10 | 20 |
| 2020 July | 3 | 11 | 14 |
| 2020 June | 5 | 6 | 11 |
| 2020 May | 9 | 11 | 20 |
| 2020 April | 12 | 6 | 18 |
| 2020 March | 5 | 2 | 7 |
| 2020 February | 6 | 4 | 10 |
| 2020 January | 13 | 8 | 21 |
| 2019 December | 16 | 9 | 25 |
| 2019 November | 22 | 6 | 28 |
| 2019 October | 8 | 4 | 12 |
| 2019 September | 9 | 5 | 14 |
| 2019 August | 11 | 2 | 13 |
| 2019 July | 21 | 16 | 37 |
| 2019 June | 13 | 17 | 30 |
| 2019 May | 31 | 25 | 56 |
| 2019 April | 4 | 8 | 12 |
| 2019 March | 9 | 12 | 21 |
| 2019 February | 12 | 5 | 17 |
| 2019 January | 3 | 13 | 16 |
| 2018 December | 0 | 2 | 2 |
| 2018 November | 7 | 6 | 13 |
| 2018 October | 16 | 7 | 23 |
| 2018 September | 6 | 2 | 8 |
| 2018 August | 5 | 3 | 8 |
| 2018 July | 7 | 2 | 9 |
| 2018 June | 13 | 5 | 18 |
| 2018 May | 17 | 2 | 19 |
| 2018 April | 3 | 2 | 5 |
| 2018 March | 7 | 2 | 9 |
| 2018 February | 5 | 3 | 8 |
| 2018 January | 4 | 4 | 8 |
| 2017 December | 21 | 1 | 22 |
| 2017 November | 9 | 0 | 9 |
| 2017 October | 14 | 4 | 18 |
| 2017 September | 40 | 5 | 45 |
| 2017 August | 6 | 3 | 9 |
| 2017 July | 0 | 1 | 1 |
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