Unique Properties of Yeast Probiotic Saccharomyces boulardii CNCM I-745: A Narrative Review

Abstract

Probiotics, both bacterial and yeast, have long been associated with a beneficial health history and human well-being. Among yeasts, Saccharomyces is a genus that is efficacious in rendering better human health, with Saccharomyces boulardii (S. boulardii) CNCM I-745 being classified as a probiotic agent. The present review highlights the unique properties of S. boulardii and its rolein the prevention of antibiotic-associated diarrhea (AAD) and pediatric acute gastroenteritis (PAGE) in comparison to bacterial probiotics. Its unique properties,such as viability over a wide pH range, inability to acquire antibiotic resistance genes, and property to achieve a steady state rapidly, have given S. boulardii an edge over bacterial probiotics. In AAD patients, prophylactic use of S. boulardii has shown a significantly lower risk of AAD (in comparison to controls) and restored the diversity of gut microbiota. Among Indian children with PAGE, S. boulardii CNCM I-745 was found superior to Lactobacillus rhamnosus GG and four strains of Bacillus clausii in shortening the duration of diarrhea and reducing the length of hospital stay. S. boulardii CNCM I-745 being considered a safe probiotic for use in children and adults also finds recommendations in several international guidelines for the management of acute diarrhea. The current review discusses evidence for the proven efficacy and safety of S. boulardii CNCM I-745 as a probiotic for preventing gastrointestinal disorders.

Keywords: antibiotic-associated diarrhoea; cncm i-745; paediatric acute gastroenteritis; probiotic; saccharomyces boulardii.

Figure 1. Advantages of yeasts as probiotics

Adapted from Shruthi et al., 2022 [6] (CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/))

Figure 2. Some beneficial effects of probiotics on human health

Adapted from Celebioglu et al., 2018 [8]. (Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)) GI: Gastrointestinal

Figure 3. Unique properties of S. boulardii CNCM I-745

Image Credits: All authors

Figure 4. Different potential mechanisms of action of Saccharomyces boulardii

Image Credits: All authors On the left various effects of different pathogenic microbes are shown. On the right, seven different protective effects of S. boulardii are mentioned. Within the lumen of the intestine, S. boulardii may degrade toxins of pathogens, interfere with pathogenic adherence, modulate normal microbiota, and preserve normal intestinal physiology. S. boulardii may also indirectly restore normal SCFA balance and increase secretory IgA levels or act as an immune regulator by influencing cytokine levels. LPS: Lipopolysaccharide; Sb: S. boulardii.