Microbial monotherapy with Prevotella histicola for patients with multiple sclerosis

ABSTRACT

Introduction: The gut microbiome helps to maintain a person’s healthy state while perturbations in its function often leading to the development of inflammatory diseases including multiple sclerosis (MS). Consequently, gut-commensals which restore homeostasis have the potential to become novel therapeutic options for treating MS. MS patients have presented gut dysbiosis with a reduction in bacteria belonging to the Prevotella genus. Notably, increased levels of Prevotella are observed when disease-modifying therapies are used. Additionally, Prevotella histicola, an anaerobic bacterium derived from the human, can suppress disease in mice with experimental autoimmune encephalomyelitis, a preclinical MS model.

Areas covered: This review compares MS microbiome studies from different geographical regions to identify common gut bacteria. Literature on the potential use of P. histicola as a therapy for MS and the next steps for developing microbial monotherapies in MS is also discussed.

Expert commentary: Recent findings presenting an inverse correlation between Prevotella and MS disease severity and ability of P. histicola to suppress disease in preclinical models suggest that P. histicola might provide an additional treatment option for MS patients. However, rigorous testing in well-designed control trials should be performed to determine the safety and efficacy P. histicola in MS patients.

KEYWORDS:

• Multiple sclerosis
• gut microbiota
• Prevotella
• immunomodulation
• Prevotella histicola
• experimental autoimmune encephalomyelitis (EAE)
• gut dysbiosis
• bacteria as drug (brug)
• Tregs
• treatment

Declaration of interest

A.M. receives research support from the National Multiple Sclerosis Society (RG 5138A1/1) and the NIH (R01AI137075). A.M. and J.M. have a patent on the use of Prevotella histicola for treatment of autoimmune condition (Licensed to Evelo Biosciences) and receive royalties from Mayo Clinic (paid by Evelo Biosciences). J.M. also serves as a consultant for Evelo Biosciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.