title: Influence of Saccharomyces boulardii on the intestinal permeability of patients with Crohn's disease in remission.
abstract: OBJECTIVE
  Crohn's disease (CD) is characterized by a reduction in mucosal integrity that permits antigen penetration into the intestinal tissue. The administration of probiotics has been suggested to improve the barrier function of the mucosa. The objective of this study was to evaluate the influence of Saccharomyces boulardii on the intestinal permeability in CD.
  
  
  METHODS
  Thirty-four patients were randomized according to the Vienna classification for treatment with either placebo or Saccharomyces boulardii. Baseline medications (mesalamine, azathioprine, prednisone, metronidazole and/or thalidomide) were maintained. Intestinal permeability (lactulose/mannitol ratio) was evaluated immediately before the beginning of treatment and at the end of the first and third treatment month. Fifteen healthy volunteers were also submitted for the intestinal permeability test.
  
  
  RESULTS
  In volunteers, the lactulose/mannitol ratio was 0.005+/-0.0037, whereas this value was 0.021+/-0.01 in patients with CD (p=0.001). In the placebo group, there was an increase in lactulose/mannitol ratio by 0.004+/-0.010 (p=0.12) at the end of the third month. In the S. boulardii group, there was an improvement in intestinal permeability, with a decrease in the lactulose/mannitol ratio by 0.008+/-0.006 (p=0.0005) in the same period.
  
  
  CONCLUSIONS
  Patients with CD in remission present alterations in the integrity of the intestinal mucosal barrier according to lactulose/mannitol ratio. S. boulardii added to baseline therapy improved intestinal permeability in these patients, even though complete normalization was not achieved.
authors.affiliation: Alfa Institute of Gastroenterology-Clinic Hospital of the Federal University of Minas Gerais, Belo Horizonte, Brazil. evilela@medicina.ufmg.br
authors.forename: Eduardo
authors.initials: E
authors.lastname: Garcia Vilela
authors.forename: Maria
authors.initials: M
authors.lastname: De Lourdes De Abreu Ferrari
authors.forename: Henrique
authors.initials: H
authors.lastname: Oswaldo Da Gama Torres
authors.forename: Ademar
authors.initials: A
authors.lastname: Guerra Pinto
authors.forename: Ana
authors.initials: A
authors.lastname: Carolina Carneiro Aguirre
authors.forename: Fabiana
authors.initials: F
authors.lastname: Paiva Martins
authors.forename: Eugênio
authors.initials: E
authors.lastname: Marcos Andrade Goulart
authors.forename: Aloísio
authors.initials: A
authors.lastname: Sales Da Cunha
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000378:metabolism* / Q000628:therapy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose / Q000494:pharmacology; D008297:Male; D008353:Mannitol / Q000493:pharmacokinetics; D008875:Middle Aged; D010539:Permeability; D019936:Probiotics / Q000627:therapeutic use*; D012074:Remission Induction; D012440:Saccharomyces
chemical_list: D008353:Mannitol; D007792:Lactulose