Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii.
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.
Pothoulakis
C
C
Division of Digestive Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA. cpothoulakis@mednet.ucla.edu
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
Science. 2001 May 11;292(5519):1115-8
11352068
Z Gastroenterol. 1993 Feb;31(2):129-34
8465554
Trends Immunol. 2004 Jun;25(6):280-8
15145317
Pediatr Res. 2006 Jul;60(1):24-9
16690953
J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 1:S111-5
18806699
J Intern Med. 2008 Jun;263(6):591-6
18479258
Med Mycol. 2007 Dec;45(8):691-700
17885943
Infect Immun. 1999 Jan;67(1):302-7
9864230
Curr Pharm Des. 2003;9(14):1107-13
12769750
Gastroenterology. 2006 Dec;131(6):2009-12
17188964
Infect Immun. 1993 Jul;61(7):2755-62
8514377
J Pediatr Gastroenterol Nutr. 2005 Apr;40 Suppl 1:S32
15805842
Dig Dis Sci. 2009 Feb;54(2):255-63
18612822
Gastroenterology. 1993 Apr;104(4):1108-15
8462799
Eur J Gastroenterol Hepatol. 2003 Jun;15(6):697-8
12840682
J Clin Invest. 2000 Apr;105(8):1147-56
10772660
Infect Immun. 2003 Feb;71(2):766-73
12540556
N Engl J Med. 2000 Feb 10;342(6):390-7
10666429
Am J Physiol Gastrointest Liver Physiol. 2008 Mar;294(3):G599-609
18032477
Am J Physiol Cell Physiol. 2000 Mar;278(3):C451-62
10712233
J Immunol. 2007 Jun 15;178(12):8168-74
17548655
Curr Opin Cell Biol. 1997 Apr;9(2):180-6
9069255
Cell. 1996 Oct 4;87(1):13-20
8858144
Inflamm Bowel Dis. 2000 Aug;6(3):206-13
10961593
Infect Immun. 2002 May;70(5):2304-10
11953364
Ann N Y Acad Sci. 2006 Aug;1072:28-38
17057188
Cell Microbiol. 2005 Dec;7(12):1697-706
16309456
Clin Microbiol Rev. 1998 Jan;11(1):142-201
9457432
Curr Opin Gastroenterol. 2001 Jul;17(4):307-12
17031175
Gastroenterology. 2002 Apr;122(4):1048-57
11910356
Dig Dis Sci. 2000 Jul;45(7):1462-4
10961730
Mycoses. 1999;42(4):261-4
10424093
Infect Immun. 1996 Dec;64(12):5225-32
8945570
Am J Gastroenterol. 2006 Apr;101(4):812-22
16635227
Infect Immun. 1993 Nov;61(11):4569-74
8406853
Biochem Biophys Res Commun. 2006 Apr 28;343(1):69-76
16529714
Infect Immun. 2000 Oct;68(10):5998-6004
10992512
Gastroenterology. 2005 Dec;129(6):1875-88
16344056
Infect Immun. 2001 May;69(5):3315-22
11292754
Am J Physiol Gastrointest Liver Physiol. 2001 Feb;280(2):G178-83
11208538
J Biol Chem. 1999 Mar 26;274(13):8355-8
10085062
J Immunol. 2004 Sep 15;173(6):4197-206
15356171
J Biol Chem. 2000 Aug 4;275(31):23814-24
10781614
Gastroenterology. 2006 Dec;131(6):1812-25
17087945
J Immunol. 1999 Nov 15;163(10):5183-91
10553038
J Appl Bacteriol. 1996 Sep;81(3):251-6
8810053
Biochem Pharmacol. 2000 Oct 15;60(8):1109-14
11007948
Annu Rev Immunol. 1996;14:649-83
8717528
Infect Immun. 2001 Apr;69(4):2762-5
11254650
Korean J Gastroenterol. 2005 May;45(5):328-34
15908765
World J Gastroenterol. 2008 Jan 21;14(3):390-400
18200661
Trends Microbiol. 2001 May;9(5):214-8
11336837
J Immunol. 2000 Jul 15;165(2):903-14
10878365
J Biol Chem. 2006 Aug 25;281(34):24449-54
16816386
Cell Microbiol. 2002 Oct;4(10):635-48
12366401
Gut. 2006 Sep;55(9):1341-9
16905700
Am J Physiol Gastrointest Liver Physiol. 2008 Jan;294(1):G295-306
18032474