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''Saccharomyces boulardii'' is a tropical yeast first isolated from lychee and mangosteen fruit peel in 1923 by French scientist Henri Boulard. Although early reports claimed distinct
taxonomic Taxonomy is the practice and science of categorization or classification. A taxonomy (or taxonomical classification) is a scheme of classification, especially a hierarchical classification, in which things are organized into groups or types. ...
, metabolic, and genetic properties, ''S. boulardii'' is genetically a grouping of '' S. cerevisiae'' strains, sharing >99% genomic relatedness, giving the synonym ''S. cerevisiae'' var. ''boulardii''. ote on source: The authors assign strain names based on the supplier of the probiotic. Of these suppliers, Biocodex and EDRL both claim to use the CNCM I-745 strain on their website./ref> ''S. boulardii'' is sometimes used as a probiotic with the purpose of introducing beneficial microbes into the large and small
intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
s and conferring protection against pathogens. It grows at 37 °C (98.6 °F). In addition, the popular genome-editing tool
CRISPR-Cas9 Cas9 (CRISPR associated protein 9, formerly called Cas5, Csn1, or Csx12) is a 160 kilodalton protein which plays a vital role in the immunological defense of certain bacteria against DNA viruses and plasmids, and is heavily utilized in geneti ...
was proven to be effective in ''S. boulardii''. Boulard first isolated this yeast after he observed natives of Southeast Asia chewing on the skin of lychee and mangosteen in an attempt to control the symptoms of
cholera Cholera is an infection of the small intestine by some strains of the bacterium ''Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting and ...
. In healthy patients, ''S. boulardii'' has been shown to be nonpathogenic and nonsystemic (it remains in the
gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...
rather than spreading elsewhere in the body).


Biology

''S. boulardii'' was characterized as a species separate from ''S. cerevisiae'' because it does not digest galactose and does not undergo sporulation. It also tolerates human body temperature, gastric acid, and digestive enzymes better. Despite all these phenotypic differences, its genomic sequence defines it as a clade under ''S. cerevisiae'', closest to those found in wine. Like ordinary ''S. cerevisiae'', it has 16 chromosomes, a 2-micron circle plasmid, and is diploid with genes for both mating types, MATa and MATα. However, the MATa locus contains some likely disabling mutations relative to spore-forming ''S. cerevisiae''. Both ''S. boulardii'' and ordinary ''S. cerevisiae'' produce proteins that inhibit pathogenic bacteria and their toxins, specifically 63-kDa phosphatase ''pho8'' (inhibiting ''E. coli'' endotoxin) and 54-kDa serine protease ''ysp3'' (hydrolyzing ''C. difficile'' toxins A and B). A yet-unidentified 120 kDa protein also inhibits changes in cAMP levels induced by cholera toxin. ''S. boulardii'' encodes extra copies of yeast adhesion proteins called flocculins that help to stick to pathogenic bacteria and stop them from binding to the intestinal mucus.


Medical uses

The best-characterized "type" CBS 5926 strain is also deposited as ATCC 74012 and
CNCM The Pasteur Institute (french: Institut Pasteur) is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases, and vaccines. It is named after Louis Pasteur, who invented pasteurization and vaccin ...
I-745. A CNCM I-1049 strain is also used; it is unclear whether it is the same as CBS 5926.


Antibiotic-associated diarrhea

Evidence exists for its use in the preventive treatment of antibiotic-associated diarrhea (AAD) in adults. Further evidence indicates its use to prevent AAD in children. The potential efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage. A 2015 meta-analysis of 21 randomised controlled trials (4780 participants) confirmed that ''S. boulardii'' is effective in reducing the risk of AAD in children and adults. '' Lactobacillus rhamnosus'' or ''Saccharomyces'' ''boulardii'' at high doses (more than 5 billion
colony-forming units In microbiology, colony-forming unit (CFU, cfu or Cfu) is a unit which estimates the number of microbial cells (bacteria, fungi, viruses etc.) in a sample that are viable, able to multiply via binary fission under the controlled conditions. Count ...
/day) is moderately effective (with no serious side effects) for the prevention of AAD in children and might also reduce the duration of diarrhea.


''Clostridium difficile'' infection

''S. boulardii'' showed reduction of relapses in some specific patients with recurrent ''Clostridium difficile'' infection and may be effective for secondary prevention of ''C. difficile'' infection.


HIV/AIDS-associated diarrhea

''S. boulardii'' has been shown to significantly increase the recovery rate of stage IV
AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...
patients with diarrhea versus placebo. On average, patients receiving ''S. boulardii'' gained weight, while the placebo group lost weight over the 18-month trial. No adverse reactions were observed in these immunocompromised patients.


Elimination of ''Helicobacter pylori'' infection

The addition of ''S. boulardii'' to the standard triple medication protocol for elimination of '' Helicobacter pylori'' infection showed a significant increase in eradication rates in a meta-analysis, though eradication rates were still not exceptional. The supplement also significantly decreased usual side effects of'' H. pylori'' eradication therapy including diarrhea and nausea.


Blastocystosis

Also, some evidence shows potential benefits of ''S. boulardii'' in treatment of blastocystosis.


Acute gastroenteritis

A position paper published by ESPGHAN Working Group for Probiotics and Prebiotics based on a systematic reviews and randomized controlled trials suggested that ''S. boulardii'' (low quality of evidence, strong recommendation) may be considered in the management of children with acute gastroenteritis in addition to rehydration therapy.


Other uses


Veterinary use


Food and drinks

''S. c.'' var. ''boulardii'' is usable in beer brewing, with live yeast remaining in the finished product. It can coexist alongside other ''S. cerevisiae'' in mixed starter cultures. It can be also used for
baking Baking is a method of preparing food that uses dry heat, typically in an oven, but can also be done in hot ashes, or on hot stones. The most common baked item is bread but many other types of foods can be baked. Heat is gradually transferred " ...
, where its ability to deter bacteria translates into inhibition of
rope spoilage A rope is a group of yarns, plies, fibres, or strands that are twisted or braided together into a larger and stronger form. Ropes have tensile strength and so can be used for dragging and lifting. Rope is thicker and stronger than similarly c ...
, a bread defect caused by '' Bacillus subtilis'' or ''
B. licheniformis B is the second letter of the Latin alphabet. B may also refer to: Science, technology, and mathematics Astronomy * Astronomical objects in the Barnard list of dark nebulae (abbreviation B) * Latitude (''b'') in the galactic coordinate syste ...
'' contamination.


Research

''S. boulardii'' has been shown to reduce body weight in an animal model of type 2 diabetes.


Safety

In immunocompromised individuals, ''S. boulardii'' has been associated with
fungemia Fungemia is the presence of fungi or yeasts in the blood. The most common type, also known as candidemia, candedemia, or systemic candidiasis, is caused by '' Candida'' species; candidemia is also among the most common bloodstream infections of a ...
or localized infection, which may be fatal. Overall, ''S. boulardii'' is safe for use in otherwise healthy populations and fungemia with ''S. boulardii'' has not been reported, to the best of the recent evidences in immunocompetent patients. A review of HIV-1-infected patients given therapy with ''S. boulardii'' indicated it was safe. A retrospective study on 32,000 oncohematological hospitalized patients showed no occurrence of fungal sepsis with ''S. boulardii'' use.


References


External links

* {{Portal bar , Medicine boulardii Yeasts Probiotics