We appreciate the Letter to the Editor by Ong et al. and their interesting findings from the case series study.¹ Indeed, we noticed increased occurrence of microscopic colitis (MC) in our patients with Parkinson's disease (PD), but our study was not designed to investigate the specific role of anti-PD medications.² Thus, it is difficult for us to disentangle whether the excess MC occurrence may be explained by medications taken by patients with PD or pathological mechanisms underlying PD affecting the gut. We find the hypothesis that levodopa/dopa decarboxylase inhibitor might trigger onset of MC very interesting, but evidence is preliminary and further studies of the topic are needed. Although we hope that both our own and the findings by Ong et al. will increase awareness of this potential association among clinicians managing patients with PD, we also advocate for future large-scale pharmacoepidemiologic studies that carefully consider issues such as confounding by indication, lead time between start of drug treatment and MC onset, and dose–response relationships.

我们感谢 Ong 等人给编辑的信。以及他们从案例系列研究中获得的有趣发现。¹事实上，我们注意到帕金森病 (PD) 患者的显微镜下结肠炎 (MC) 发病率有所增加，但我们的研究并非旨在调查抗 PD 药物的具体作用。²因此，我们很难弄清楚过量 MC 的发生是否可以通过 PD 患者服用的药物或 PD 影响肠道的病理机制来解释。我们发现左旋多巴/多巴脱羧酶抑制剂可能引发 MC 发作的假设非常有趣，但证据是初步的，需要对该主题进行进一步研究。尽管我们希望我们自己和 Ong 等人的研究结果都是如此。将提高管理 PD 患者的临床医生对这种潜在关联的认识，我们还提倡未来进行大规模药物流行病学研究，仔细考虑诸如适应症混杂、药物治疗开始和 MC 发作之间的提前时间以及剂量-反应关系等问题.