Published online May 14, 2019. doi: 10.3748/wjg.v25.i18.2188
Peer-review started: September 29, 2018
First decision: November 7, 2018
Revised: March 21, 2019
Accepted: March 29, 2019
Article in press: March 30, 2019
Published online: May 14, 2019
The yeast Saccharomyces boulardii CNCM I-745 is one of the probiotics recommended for the prevention of antibiotic-associated diarrhea. Studies conducted in vivo and in vitro demonstrated that in the case of infectious diseases there are two potential sites of action of Saccharomyces boulardii CNCM I-745: (1) An action on enteropathogenic microorganisms (adhesion of bacteria and their elimination or an effect on their virulence factors: Toxins, lipopolysaccharide, etc.); and (2) a direct action on the intestinal mucosa (trophic effects, effects on epithelial reconstitution, anti-secretory effects, anti-inflammatory, immunomodulators). Oral administration of Saccharomyces boulardii CNCM I-745 to healthy subjects does not alter their microbiota. However, in the case of diseases associated with the use of antibiotics or chronic diarrhea, Saccharomyces boulardii CNCM I-745 can restore the intestinal microbiota faster. The interaction of Saccharomyces boulardii CNCM I-745 with the innate immune system have been recently demonstrated thus opening up a new therapeutic potential of this yeast in the case of diseases associated with intestinal infections but also other pathologies associated with dysbiosis such as inflammatory diseases.
Core tip: The efficacy of lyophilized probiotic yeast Saccharomyces boulardii CNCM I-745 was clinically demonstrated with controlled studies of intestinal infections associated with antibiotics and acute diarrhea in children. This review summerizes scientific data describing the mechanism of Saccharomyces boulardii protection against infection and emphazises the diversity of potential mechanism of action that this probiotic yeast can have against pathogenic microorganisms. More recently, effects on the recovery of the intestinal microbiota as well as on the immune system have been demonstrated, thus opening up a new therapeutic potential of this yeast.