title: Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii.
abstract: BACKGROUND
  Saccharomyces boulardii, a well-studied probiotic, can be effective in inflammatory gastrointestinal diseases with diverse pathophysiology, such as inflammatory bowel disease (IBD), and bacterially mediated or enterotoxin-mediated diarrhoea and inflammation.
  
  
  OBJECTIVE
  To discuss the mechanisms of action involved in the intestinal anti-inflammatory action of S. boulardii.
  
  
  METHODS
  Review of the literature related to the anti-inflammatory effects of this probiotic.
  
  
  RESULTS
  Several mechanisms of action have been identified directed against the host and pathogenic microorganisms. S. boulardii and S. boulardii secreted-protein(s) inhibit production of proinflammatory cytokines by interfering with the global mediator of inflammation nuclear factor kappaB, and modulating the activity of the mitogen-activated protein kinases ERK1/2 and p38. S. boulardii activates expression of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) that protects from gut inflammation and IBD. S. boulardii also suppresses 'bacteria overgrowth' and host cell adherence, releases a protease that cleaves C. difficile toxin A and its intestinal receptor and stimulates antibody production against toxin A. Recent results indicate that S. boulardii may interfere with IBD pathogenesis by trapping T cells in mesenteric lymph nodes.
  
  
  CONCLUSIONS
  The multiple anti-inflammatory mechanisms exerted by S. boulardii provide molecular explanations supporting its effectiveness in intestinal inflammatory states.
authors.affiliation: Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA. cpothoulakis@mednet.ucla.edu
authors.forename: C
authors.initials: C
authors.lastname: Pothoulakis
mesh_terms: D001424:Bacterial Infections / Q000178:diet therapy*; D002450:Cell Communication / Q000502:physiology; D016360:Clostridioides difficile / Q000502:physiology; D054324:Enterohemorrhagic Escherichia coli / Q000502:physiology; D005759:Gastroenteritis / Q000178:diet therapy*; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use*; D012440:Saccharomyces; D012760:Shigella / Q000502:physiology; D016896:Treatment Outcome
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