Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii

Aliment Pharmacol Ther. 2009 Oct 15;30(8):826-33. doi: 10.1111/j.1365-2036.2009.04102.x. Epub 2008 Jul 23.


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.

Aim: 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bacterial Infections / diet therapy*
  • Cell Communication / physiology
  • Clostridioides difficile / physiology
  • Enterohemorrhagic Escherichia coli / physiology
  • Gastroenteritis / diet therapy*
  • Humans
  • Probiotics / therapeutic use*
  • Saccharomyces*
  • Shigella / physiology
  • Treatment Outcome