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Association between multiple sclerosis and Candida species: evidence from a case-control study


Candida infection among multiple sclerosis (MS) patients has not been studied in depth. We determined whether there is an association between serological evidence of Candida infection and MS. Blood specimens were obtained from 80 MS patients and 240 matched controls. Immunofluorescence analysis and ELISA were used to detect Candida species antibodies and slot-blot to detect antigens. Using immunofluorescence analysis, moderate to high concentrations of serum antibodies to Candida famata were present in 30 (37.5%) MS patients vs. 30 (12.5%) controls (p < 0.001). Results for Candida albicans were 47.5% (38/80) in MS patients vs. 21.3% (51/240) in controls (p < 0.001), for Candida parapsilosis 37% (28/80) vs. 17.1% (41/240) (p < 0.001) and for Candida glabrata 46.3% (37/80) vs. 17.5% (42/240) (p < 0.001), respectively. After adjusting for age and gender, the odds ratios (95% confidence intervals) for MS, according to the presence of Candida antigens were: 2.8 (0.3–23.1, p = 0.337) for Candida famata; 1.5 (0.7–3.4, p = 0.290) for Candida albicans; 7.3 (3.2–16.6, p < 0.001) for Candida parapsilosis; and 3.0 (1.5–6.1, p = 0.002) for Candida glabrata. The results were similar after excluding ten patients on immunosuppressants. The results of this single study suggest that Candida species infection may be associated with increased odds of MS.

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We wish to express our sincere thanks to Dr. Nancy Grajales Hernández and Gerardo García Perales, as well as other members of the Multiple Sclerosis association of Madrid (Spain). We also thank Drs. Mari Luz Borbolla and Manuel Algora (Transfusion Center of the Community of Madrid) for providing the control samples. Fátima Palomares is also acknowledged for her involvement during the early stages of this study. Finally, we also acknowledge the contribution provided by Dr. Elan D. Louis who critiqued late stage drafts of the paper. The study was supported by grants from the Fundación de Investigación Médica Mútua Madrileña and Fundación Ramón Areces. Dr. Benito-León is supported by NIH R01 NS024859 from the National Institutes of Health, Bethesda, MD, USA.

Competing interests

The authors declare that they have no competing interests.

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Correspondence to J. Benito-León.

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Authors’ contributions

JB-L and LC conceived, coordinated and designed the original study. JB-L conducted the analysis of data and drafted the manuscript. JBL, DP, RA, PC, and MDS collected data and samples. DP and RA conducted the serological testing. All authors offered critical input into the manuscript and all have read and approved the final version.

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Benito-León, J., Pisa, D., Alonso, R. et al. Association between multiple sclerosis and Candida species: evidence from a case-control study. Eur J Clin Microbiol Infect Dis 29, 1139–1145 (2010).

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  • Multiple Sclerosis
  • Multiple Sclerosis Patient
  • Candida Species
  • Glatiramer Acetate
  • Candida Glabrata