Microbial monotherapy with Prevotella histicola for patients with multiple sclerosis

Expert Rev Neurother. 2019 Jan;19(1):45-53. doi: 10.1080/14737175.2019.1555473. Epub 2018 Dec 10.


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; Tregs; bacteria as drug (brug); experimental autoimmune encephalomyelitis (EAE); gut dysbiosis; gut microbiota; immunomodulation; treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Dysbiosis / diet therapy*
  • Dysbiosis / microbiology
  • Gastrointestinal Microbiome*
  • Humans
  • Multiple Sclerosis / diet therapy*
  • Multiple Sclerosis / microbiology
  • Prevotella*
  • Probiotics / therapeutic use*

Supplementary concepts

  • Prevotella histicola