Meta-analysis of the efficacy and safety of Saccharomyces boulardii versus Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea / 中国药房

OBJECTIVE To compare the efficacy and safety of Saccharomyces boulardii and Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CBM， Wanfang data， CNKI and VIP， randomized controlled trials （RCTs） about S. boulardii （S. boulardii group） versus Bifidobacterium triple liver bacteria （Bifidobacterium group） were collected. After screening the literature， extracting data and evaluating the quality， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 9 RCTs were included， involving 898 patients. Results of meta-analysis showed there was no statistical significance in total response rate [OR＝1.69， 95%CI （0.93， 3.09）， P＝0.09]， duration of diarrhea [MD＝－1.39， 95%CI （－3.35， 0.57）， P＝0.16]， the time of abdominal pain disappearance [MD＝0.09， 95%CI（－0.87， 1.05），P＝0.86] or the incidence of adverse reactions [OR＝0.65， 95%CI （0.05， 8.03）， P＝0.74]. The number of stools in S. boulardii group was significantly less than Bifidobacterium group [MD＝－0.91， 95%CI （－1.80， －0.02）， P＝0.04]. The results of subgroup analysis showed that the duration of diarrhea in children with antibiotic-associated diarrhea in S. boulardii group was significantly shorter than Bifidobacterium group （P＜0.05）. CONCLUSIONS The efficacy and safety of S. boulardii are similar to those of Bifidobacterium in the treatment of diarrhea， but S. boulardii is better than Bifidobacterium in terms of stool number， the duration of diarrhea in children with antibiotic-associated diarrhea.

Impact of Saccharomyces boulardii on jaundice in premature infants undergoing phototherapy

Abstract Objectives To evaluate the therapeutic effect of Saccharomyces boulardii supplementation on jaundice in premature infants undergoing phototherapy. Methods In this article, the authors reviewed 100 hospitalized jaundiced premature infants under 35 weeks of gestational age. All infants were assigned to a control group (n= 45) and a treatment group (n= 55) randomly. The infants in the treatment group received S. boulardii supplementation by undergoing phototherapy and the infants in the control group were only treated by phototherapy. The total serum bilirubin levels were detected before and at the end of phototherapy, and transcutaneous bilirubin levels were measured on the 1st, 4th, 8th and 15th day of treatment. The duration of jaundice resolution and phototherapy, stool frequency, and characteristics were compared after phototherapy. Results The duration of jaundice resolution and phototherapy were shortened. Total serum bilirubin level was lower than the control group at the end of phototherapy (p < 0.05). Transcutaneous bilirubin levels decreased more significantly on the 8th and 15th day of treatment (p < 0.05), while there were no significant differences on the post-treatment 1st and 4th day (p > 0.05). In addition, bowel movements including stool frequency and Bristol Stool Form Scale ratings of stools also improved after treatment. Conclusions S. boulardii in combination with phototherapy is effective and safe in reducing bilirubin levels and duration of phototherapy, accelerating jaundice resolution in premature infants with jaundice. The procedure also provided an ideal therapeutic effect of diarrhea induced by phototherapy to promote compliance and maternal-infant bonding.

Probiotic Saccharomyces boulardii Alleviates Lung Injury by Reduction of Oxidative Stress and Cytokine Response Induced by Supraceliac Aortic Ischemia-Reperfusion Injury in Rats

Abstract Objectives: Ischemia-reperfusion injury is an important cause of multiple organ failure in cardiovascular surgery. Our aim is to investigate the effect of the probiotic Saccharomyces boulardii on oxidative stress, inflammatory response, and lung injury in an experimental model of aortic clamping. Methods: Twenty-one Wistar rats were randomized into three groups (n=7). Control group animals received saline gavage for a week before undergoing median laparotomy. In other groups, supraceliac aorta was clamped for 45 minutes to induce ischemia followed by reperfusion for 60 minutes. In the ischemia-reperfusion group, saline gavage was given preoperatively for one week. Ischemia-reperfusion+probiotic group rats received probiotic gavage for seven days before aortic clamping. The levels of oxidative stress markers and pro-inflammatory cytokines were determined in both serum and lung tissue samples. Ileum and lung tissues were harvested for histological examination. Results: Ischemia-reperfusion caused severe oxidative damage and inflammation evident by significant increases in malondialdehyde and cytokine levels (tumor necrosis factor alpha and interleukin-1 beta) and decreased glutathione levels in both serum and lung tissues. There was severe histological tissue damage to the lung and ileum in the ischemia-reperfusion group. Probiotic pretreatment before aortic clamping caused significant suppression of increases in serum and lung tissue malondialdehyde and tumor necrosis factor alpha levels. Histological damage scores in tissue samples decreased in the ischemia-reperfusion+probiotic group (P<0,005). Conclusions: Oral supplementation of probiotic S. boulardii before supraceliac aortic ischemia-reperfusion in rats alleviates lung injury by reducing oxidative stress, intestinal cellular damage, and modulation of inflammatory processes.

Research progress of mechanism of action of Saccharomyces boulardii and its application in ulcerative colitis / 国际生物医学工程杂志

Saccharomyces boulardii is a subspecies of Saccharomyces cerevisiae and is a fungal probiotic. It can regulate the intestinal flora and enhance the barrier function of the intestinal tract. Compared with bacterial probiotics, Saccharomyces boulardii is more resistant to acid and oxidation, does not transmit genetic material with bacteria, and can be used in combination with antibiotics. Saccharomyces boulardii can function through a variety of mechanisms, and many proteases secreted by it have antitoxin effects; its own bacteria contain more polyamines, which can nourish the intestinal mucosal cells and regulate the body's metabolic balance. Besides, it can regulate multiple signal pathways to enhance intestinal immunity. Saccharomyces boulardii has been used in the treatment of ulcerative colitis (UC). The results of animal experiments and clinical studies have shown that the application of Saccharomyces boulardii can improve intestinal inflammation and enhance the therapeutic effect of mesalazine. Saccharomyces boulardii can be used as an auxiliary drug for the treatment of UC.

Selenium-Enriched Probiotic Saccharomyces boulardii CCT 4308 Biomass Production Using Low-Cost Sugarcane Molasses Medium

Abstract Food supplements have been increasingly investigated. Probiotics have several benefits for human and animal health and selenium (Se) is widely recommended against oxidative stress. In this context, the aim of this study was to develop a low-cost bioprocess to produce a functional food product comprising both probiotic and Se accumulation. Yeast cells of Saccharomyces boulardii CCT 4308 were cultivated using sugarcane molasses as substrate. Optimization studies were performed to evaluate the best medium composition for biomass production and Se-accumulation in batch and fed-batch systems. Optimized conditions were defined with a medium composed of 150 g L-1 sugarcane molasses and 12 g L-1 yeast extract, with feeding of 100 g L-1 sugarcane molasses and 100 μg mL-1 of Se incorporation after 4 h and 10 h of fermentation, respectively, during 48 h in STR (stirred tank reactor). Best biomass production reached 14.52 g L-1 with 3.20 mg Se g-1 biomass at 12 h. Process optimization led to 4.82-fold increase in biomass production compared to initial condition. A final Se-enriched S. boulardii CCT 4308 biomass was obtained, which is comparable to commercial products. An alternative probiotic yeast biomass was efficiently produced as a new food-form of Se supplement in a sustainable process using an inexpensive agro-industrial residue.

Expression in Saccharomyces boulardii of recombinant Toxin-coregulated pilus A subunit (TcpA) of Vibrio cholerae O1

Cholera is endemic in over 50 countries with an estimated mortality of 100,000-120,000. Vaccination is considered the complementary key to prevent and control cholera; therefore, alternative vaccine preparations are needed. Toxin Co-regulated Pilus is part of the toxR virulence regulon, which is necessary for colonization in the intestinal mucosa. In order to express Vibrio cholerae TcpA protein in Saccharomyces boulardii, the expression plasmid pYES2 was constructed by inserting tcpA gene isolated from local Vibrio cholerae Eltor Inaba isolates. The new construct was transferred into Saccharomyces boulardii cells and the expression of tcpA gene was induced from the GAL1 promoter by adding galactose to the medium. The SDS-PAGE and Western blot analysis showed the presence of TcpA in yeast. These results showed that Saccharomyces boulardii is a promising host to express Vibrio cholerae toxin TcpA as the first step in attempt to produce an oral Vibrio cholerae vaccine(AU)

El cólera es endémico en más de 50 países. Se estima una mortalidad entre 100.000 - 120.000 debido a esta enfermedad. La vacunación se considera una medida complementaria para prevenir y controlar el cólera, por lo tanto, se necesitan preparaciones vacunales alternativas a las existentes. El Pili corregulado con la toxina, es parte del regulón de virulencia toxR, y es necesario para la colonización en la mucosa intestinal. Para expresar la proteína tcpA de Vibrio cholerae en Saccharomyces boulardii, se construyó el plásmido de expresión pYES2 insertando el gen tcpA obtenido a partir de aislamientos locales de Vibrio cholerae El Tor Inaba. La nueva construcción se transfirió a las células de Saccharomyces boulardii y se indujo la expresión del gen tcpA a partir del promotor GAL1 mediante la adición de galactosa al medio. El análisis mediante SDS-PAGE y Western blot demostró la presencia de TcpA en levaduras. Los resultados demostraron que Saccharomyces boulardii es un hospedero prometedor para expresar el gen tcpA de Vibrio cholerae como el primer paso en el intento de producir una vacuna oral contra Vibrio cholerae(AU)

Clinical Efficacy on Chaihu Shugansan Combined with Saccharomyces boulardii in Treatment of Functional Dyspepsia in Children / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of Chaihu Shugansan combined with saccharomyces boulardii in treating functional dyspepsia (FD) in children and the effect on serum cytokines and gastrointestinal hormones expression. Method:Totally 120 cases were divided into control group (60 cases) and observation group (60 cases)．The control group was treated with Duopanlitong Pian 0.3 mg·kg-1, po， tid， and Saccharomyces boulardii 0.25 g，po，bid. The observation group was treated with Chaihu Shugansan, po，qd， and saccharomyces boulardii 0.25 g，po，bid. Four weeks was a course of treatment．The changes of serum Gastric Hunger Hormone and cytokines, Hamilton depression scale (HAMD) score, symptoms improvement time and clinical effect in the two groups were observed. And the recurrence rate was observed after 6 months follow-up. Result:The total effective rate was compared between control group (76.67%，46/60) and observation group (96.15%，57/60)，with significant differences (P<0.01). After treatment, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in both groups were decreased, while serum levels of ghrelin of both group were increased. However，the decreasing range and the increasing range of observation group were statistically obvious than those of control group (P<0.01). HAMD score and disappearance time of clinical symptoms in observation group was significantly different from those in control group (P<0.01). In adverse reactions during treatment, the control group was inferior to the observation group (P<0.05). After the 6-month follow-up, the recurrence rate in observation group was lower than that in control group (P<0.01). Conclusion:Chaihu Shugansan combined with Saccharomyces boulardii was effective in treatment of FD in children, with a low recurrence rate and good compliance. The mechanism may be related to the effective regulation of brain-intestinal axis, balance of intestinal flora, inhibition of inflammatory reaction, regulation of cytokines and gastrointestinal hormone levels.

Therapeutic Effect and Mechanism of Saccharomyces boulardii on Inflammatory Bowel Disease / 胃肠病学

The prevalence of inflammatory bowel disease (IBD) has increased significantly worldwide. Under the situation that some conventional drugs have significant side effects, and biological and immunosuppressive agents are expensive, exploring the safe and effective probiotics to improve the effect of traditional drugs may become a reliable way to ease the economic burden of patients and improve the quality of life. As a probiotic, Saccharomyces boulardii has a long history of use, and has shown some effectiveness in animal models with colitis and in clinical trials. This article reviewed the therapeutic effect and mechanism of Saccharomyces boulardii on IBD.

Protective effect of Saccharomyces boulardii on intestinal mucosal barrier of dextran sodium sulfate-induced colitis in mice / 中华医学杂志(英文版)

Background@#The effect and mechanism of Saccharomyces boulardii (Sb) in inflammatory bowel disease are unclear. The objective of the study was to evaluate the impact of Sb on intestinal mucosal barrier and intestinal flora in a colitis mouse model.@*Methods@#Forty C57BL/6J male mice were randomly assigned to five groups: normal control group (A), pathologic control group (B), Sb treatment group (C), mesalazine treatment group (D), and Sb combined with mesalazine treatment group (E). Colitis was induced by the addition of 2.5% (wt/vol) dextran sodium sulfate (DSS) in the drinking water ad libitum for 7 days. The general condition, weight change, stool property, and bloody stool level of mice were observed to evaluate the disease activity index. The expression of zona occludens-1 (ZO-1) and occludin in intestinal tissue were measured by immunohistochemistry. The level of tumor necrosis factor-α (TNF-α) and interleukin (IL)-8 in plasma was measured by enzyme linked immunosorbent assay. Inter-cellular tight junctions were observed by transmission electron microscopy. The feces and intestinal contents were collected sterilely, and intestinal flora was analyzed by 16S rRNA sequencing.@*Results@#Compared with group B, Sb reduced the disease activity index and histological score of group C (disease activity index: group B 2.708 ± 0.628, group C 1.542 ± 0.616, PBC = 0.005; histological score: group B 9.875 ± 3.271, group C 4.750 ± 1.832, PBC = 0.005) in DSS-induced colitis in mice. Sb exerted a protect effect on the expression of ZO-1 (group B 2.075 ± 1.176, group C 4.225 ± 1.316, PBC = 0.019) and occludin (group B 2.200 ± 0.968, group C 3.525 ± 1.047, PBC = 0.023). Compared with group B, Sb decreased the level of TNF-α and IL-8 of group C (TNF-α: group B 716.323 ± 44.691 ng/L, group C 521.740 ± 90.121 ng/L, PBC = 0.001; IL-8: group B 128.992 ± 11.475 pg/mL, group C 106.283 ± 15.906 pg/mL, PBC = 0.012). Treatment with Sb preserved the tight junctions and ameliorated microvilli and inter-cellular space. Treatment with Sb also showed its own characteristics: a higher percentage of Bacteroidetes and a lower percentage of Firmicutes, with significant differences or a significant trend. The proportion of the S24-7 family was increased significantly in the Sb treatment group.@*Conclusions@#Sb shows an anti-inflammatory effect and has a protective effect on the intestinal mucosal mechanical barrier. Sb may up-regulate the abundance of family S24-7 specifically, and maybe a mechanism underlying its function.

Clinical Efficacy of Xiaoer Anorexia Granule Combined with Saccharomyces Brassicus in Treatment of Pediatric Anorexia and Its Effect on Serum Cytokines / 中国实验方剂学杂志

Objective: To investigate the clinical efficacy of Xiaoer anorexia granule combined with Saccharomyces brassicus in the treatment of infantile anorexia and its effect on serum cytokines. Method: Totally 240 cases of infantile anorexia treated in Jinhua People's Hospital from October 2015 to October 2017 were randomly divided into three groups. Group A (combination group) orally took Xiaoer anorexia granule, 1 pack/time for 1-3 years old, 2 packs/time for 4-6 years old, 3 times a day, and combined with saccharomyces brasiliensis, 0.5 g/time, 2 times a day, 15-30 min before meal. Group B took saccharomyces brasiliensis by the same method as the combination group. Group C took Xiaoer anorexia granules by the same method as above,with 80 cases in each group. 8 weeks is a course of treatment. Serum inflammatory cytokines leptin, SP and Ghrelin were also detected. The clinical efficacy, body weight, height improvement and serum cytokine levels were observed in 3 groups. Result: The total improvement rate of group A was 91.25%, which was significantly higher than 71.25%of group B and 73.75%of group C, with statistically significant differences (PPPPPPPConclusion: Treatment of infantile anorexia with Xiaoer anorexia granules combined with Saccharomyces cerevisiae can improve the total clinical effective rate, adjust serum cytokine levels and increase height and body mass.

The effect of Saccharomycesboulardii on interleukin-17,interleukin-10 and transforming growth factor-β1 of inflammatory bowel disease rat / 中国小儿急救医学

Objective To observe the effect of Saccharomyces boulardii(SB) on interleukin-17, interleukin-10 and transforming growth factor-β1 of inflammatory bowel disease ( IBD ) rats which were induced by trinitro-benzene-sulfonic acid( TNBS) . Methods Balb/c female rats were randomly divided into three groups,normal group,TNBS group and TNBS+SB group. TNBS method was used to set up IBD rat models. TNBS group:the mice were injected by 5％ TNBS 0. 1 ml+50％ ethanol 0. 1 ml per mouse from rectum for 5 days,and then were filled in stomach by normal saline 0. 1 ml on the 2nd day for 2 weeks;TNBS+SB group:the mice were injected by 5％ TNBS 0. 10 ml+50％ ethanol 0. 10 ml per mouse from rectum for 5 days,and then were filled in stomach by SB (SB no less than 109 CFU/ml) 0. 1 ml on the 2nd day for 2 weeks;the normal group:the mice were injected by 50％ ethanol 0. 2 ml per mouse from rectum for 5 days, and then were filled in stomach by normal saline 0. 1 ml on the 2nd day for 2 weeks. At the 15th day,the general situation of mice were observed,serum and colon tissue was collected. Alterations of colon inflamma-tion were observed by means of haematoxylin-eosin ( HE);the level of IL-17,IL-10 and TGF-β1 in serum were evaluated by enzyme linked immunosorbent assay (ELISA). The level of IL-17,IL-10 and TGF-β1 in colon tissue was evaluated by immunohistochemistry. Results The IL-17 level of serum and colon tissue in-creased(P<0. 05),but IL-10(P<0. 05) and TGF-β1(P<0. 05)decreased in TNBS group compared with those in the normal group. The level of IL-17 in TNBS+SB group was lower than that in TNBS group( P<0. 05),but the levels of IL-10(P<0. 05) and TGF-β1(P<0. 05)were higher than those in TNBS group. Compared with the normal group,the level of IL-17 in TNBS+SB group increased ( P<0. 05 ) , but IL-10 (P<0.05) and TGF-β1(P <0.05)decreased. Conclusion The expression of cytokine IL-17 increase, IL-10 and TGF-β1 decrease in peripheral blood and colon tissue of IBD. SB may ameliorate the intestinal inflammatory response of IBD by balancing the expression of IL-17,IL-10 and TGF-β1.

Study of Shenling-Baizhu granule combined with saccharomyces boulardii treatment for pediatric antibiotic associated diarrhea / 国际中医中药杂志

Objective To observe Shenling-Baizhu granule combined with saccharomyces boulardii treatment for pediatric antibiotic associated diarrhea (AAD). Methods A total of 146 children with AAD were randomly divided into the control group (n=73) and the observation group (n=73). The control group received the saccharomyces boulardii, and the observation group received saccharomyces boulardii and Shenling-Baizhu granule, with a course of 5 days. The CD4 and CD8 T lymphocytes were detected by flow cytometry. The stool frequency, stool frequency recovery time, and clinic effects were compared. Results The stool frequency (3.0 ± 0.4 times/d vs. 3.6 ± 0.4 times/d, t=2.624), stool frequency recovery time (3.2 ± 0.6 d vs. 4.5 ± 0.8 d, t=2.641), and recovery time (4.1 ± 0.8 d vs. 5.3 ± 1.1 d, t=2.522) in observation group were significantly lower than those in control group ( P＜0.05). After the treatment, the CD4+(38.65% ± 5.74% vs. 33.72% ± 5.23%, t=2.452), CD4+/CD8+(1.92 ± 0.38 vs. 1.45 ± 0.26, t=2.483) of the observation group was significantly higher than those of the control group, and the CD8+(20.15% ± 3.16% vs. 23.21% ± 3.44%, t=2.483) of the observation group was significantly lower than this of the control group (P＜0.05). The rate of clinic effects was 93.2% (68/73) in observation group, which was higher than 80.8% (59/73) in control group (χ2=2.446, P＜0.05). Conclusions The Shenling-Baizhu granule combined with saccharomyces boulardii could enhance the immune function in children with AAD with significant clinical efficacy.

A multicenter randomized controlled study of Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea in infants and young children / 中华儿科杂志

Objective@#To evaluate the efficacy and safety of Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea (AAD) in infants and young children.@*Method@#From November 2012 to September 2013, ten research units of large teaching hospitals or children′s hospitals participated in this multicenter randomized controlled clinical trial. Hospitalized young children aged between 1 month and 3 years (nongastrointestinal infection and antibiotic therapy required)were involved in our study. The children were randomly divided into control group and prevention group by means of block random allocation method. The control group received antibiotic therapy and other conventional treatment. The prevention group was given additional Saccharomyces boulardii (250 mg/d) orally. Diarrhea rates of two groups were compared both during the usage of antibiotics and within 14 days after the antibiotics withdrawal. The adverse reactions of Saccharomyces boulardii were observed all through this study. The results were analyzed by χ2 test or Kruskal-Wallis test or t test.@*Result@#Totally 408 cases (213 cases in prevention group and 195 cases in control group) were enrolled. The age ranged from 1 month to 3 years, with an average age of 1.14 years. The basic diseases were parenteral infections: 368 cases with different kinds of respiratory tract infections or pneumonia, 10 cases of bacterial meningitis, 9 cases with septicemia or sepsis, 6 cases with pertussis or pertussis like syndrome, 5 cases with urinary infection, 5 cases with skin or subcutaneous tissue infections, 3 cases of Kawasaki disease, one with scarlet fever and one with congenital syphilis. During the administration of antibiotics, the incidence of AAD in prevention group was 10.3% (22 cases), which was significantly lower than that of control group (57 cases, 29.2%, χ2=23.296, P<0.05). Within 14 days after the discontinuation of antibiotics, the percent of new diarrhea cases in prevention group (2.4%, 5/213) was also significantly lower than that in control group (16.4%, 32/195, χ2=23.4, P<0.05). Further analysis revealed that the rate of AAD in children less than or equal to 1 year old (25.1%, 52/207) was significantly higher than that of over 1 year old (13.4%, 27/201, χ2=8.922, P<0.05). The incidence of AAD in children treated with antibiotics for more than 5 days was 22.2%(60/270), which was significantly higher than that of less than or equal to 5 days (13.8%, 19/138, χ2=4.180, P<0.05). Although no significant difference was observed, the AAD rate of patients with combined use of two antibiotics was higher than that of using one. During the antibiotic therapy, compared with the control group, the risk of AAD in children under 1 year old was reduced by 52% (χ2=9.217, P<0.05), and 91% (χ2=20.35, P<0.05) in the children over 1 year old in prevention group. The risk of AAD of prevention group decreased by 66% (χ2=13.67, P<0.05) in patients treated with one antibiotics, and 65% in children with combined use of antibiotics (χ2=10.57, P<0.05). In patients treated with antibiotics for less than or equal to 5 days, the risk of AAD decreased by 74% in prevention group (χ2=7.38, P<0.05); and 63% if the course lasted for over 5 days (χ2=16.87, P<0.05). Within 14 days after the withdrawal of antibiotics, compared with the control group, the risk of diarrhea in the prevention group decreased by 82% (χ2=13.35, P<0.05) in infants (≤1 year old) and 93% (χ2=12.00, P<0.05) in children (>1 year old); the risk of diarrhea was reduced by 86% (χ2=9.57, P<0.05) and 87% (χ2=17.71, P<0.05) respectively in prevention group with single and combined use of antibiotics. In patients treated with antibiotics for more than 5 days, the risk of diarrhea in prevention group was reduced by 63% (χ2=22.79, P<0.05), while there was no significant difference if the antibiotics course was less than or equal to 5 days (χ2=2.97, P>0.05). No adverse effects related with Saccharomyces boulardii were observed in our study.@*Conclusion@#Saccharomyces boulardii is effective and safe to prevent AAD of infants and young children both during the usage of antibiotics and up to 14 days after drug discontinuance. It can be one of the drugs of for choice prevention of AAD in infants and young children. Trial registration Chinese Clinical Trial Tegister, ChiECRCT-2012-25.

A prospective control study of Saccharomyces boulardii in prevention of antibiotic-associated diarrhea in the older inpatients / 中华内科杂志

Objective To study the value of Saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in older inpatients.Methods A total of 163 older patients who were treated with wide-spectrum antibiotics at least three days during January 2014 to December 2015 were randomly divided into control and study group.In study group, 81 patients were administrated with oral Saccharomyces boulardii 500 mg twice a day for 21 days.The control group was of no intervention.Morbidity rate of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea, frequency and duration of diarrhea were recorded.Results The incidence of antibiotic-associated diarrhea in study group was significantly lower than that in control group [14.8%(12/81) vs 28.0%(23/82), P0.05] in two groups.The frequency and duration of diarrhea in the study group were significantly lower and shorter than those in control group[(4.3±1.7) times/day vs (6.9±2.0) times/day;(3.0±1.1) days vs (5.7±1.8) days, both P<0.01].Conclusion Saccharomyces boulardii may reduce the incidence of antibiotic-associated diarrhea therefore improving the symptom of diarrhea in older inpatients.

Treatment of Quadruple Therapy Combined with Saccharomyces boulardii Sachets on Helicobacter pylori Infection: A Report of 125 Cases / 医药导报

Objective To discuss whether Saccharomyces boulardii sachets can improve the eradication rate and reduce some untoward effects of gastrointestinal tract when adding in the Helicobacter pylori (Hp) standard quadruple therapy.Methods 249 cases infected with Hp were randomly divided into control group(124 cases) and treatment group (125 cases).The control group was treated with standard quadruple therapy:colloidal bismuth pectin capsules,100 mg,tid,po;furazolidone tablets,0.1 g,bid,po;amoxil capsule,1 g,bid,po;rabeprazole sodium enteric-coated capsules,20 mg,qd,po.The treatment group was treated with Saccharomyces boulardii sachets(0.25 g,bid,po)besides.Both groups were treated for 4 weeks.Evaluate the effect of Hp eradication rate by using the method of intent of treatment (ITT) analysis and consistent scenario set (PP)analysis.Results According to the ITT analysis,the eradication rate of control group was 89.52%,and that of treatment group was 96.00%.According to the PP analysis,the eradication rate of control group was 90.00%,and the rate of treatment group was 97.39%.Both analysis results showed the eradication rate of Hp in treatment group was significantly higher than control group(P<0.05).As for reducing the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra,control group was obviously lower than treatment group (P<0.05).Conclusion Compared with standard quadruple therapy only,adding Saccharomyces boulardii sachets can significantly improve the eradication rate of Hp and obviously reduce the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra.It is worth to be generalized and applied in clinical practice.

Clinical Observation of Saccharomyces boulardii Adjuvant with Aluminium Phosphate in the Treatment of Pediatric Acute Diarrhea / 中国药房

OBJECTIVE:To investigate the effect of Saccharomyces boulardii adjuvant with aluminium phosphate on symp-toms and signs disappearance time,immune function and inflammatory factors in children with acute diarrhea. METHODS:Totally 110 children with acute diarrhea were chosen from our hospital during Mar. 2013-Mar. 2016,and then randomly divided into con-trol group and observation group according to random number table,with 55 cases in each group. Control group was given Alumini-um phosphate gel 2.5 g,po,qd,on the basis of conventional treatment. Observation group was additionally given S. boulardii cap-sules 0.25 g,po,bid,on the basis of control group. Both groups were treated for 3 d. Clinical efficacies,symptoms and signs(di-arrhea,abdominal pain,vomiting,abnormal stool routine)disappearance time as well as stool frequency,stool character scores, immune function indexes(CD3+,CD4+,CD8+,CD4+/CD8+),inflammatory factors(IL-6,IL-10,TNF-α)before and after treat-ment,the occurrence of ADR were compared between 2 groups. RESULTS:The total response rate of observation group (90.91%)was significantly higher than that of control group(70.91%);the symptoms and signs disappearance time was signifi-cantly shorter than control group,with statistical significance(P0.05). After treatment,stool frequency,stool character scores and inflammatory factor levels of 2 groups were significantly lower than before, and the observation group was significantly lower than the control group;the levels of CD3+,CD4+,CD4+/CD8+ were significantly higher than before treatment and control group,and the level of CD8 + was significantly lower than before treatment and control group,with statistical significance(P0.05). Total incidence of dry mouth and constipation was 5.45% in control group and 9.09% in obser-vation group,without statistical significance(P>0.05). CONCLUSIONS:S. boulardii adjuvant with aluminium phosphate in the treatment of pediatric acute diarrhea can efficiently improve symptoms and signs,shorten disease duration,improve immune func-tion and reduce inflammatory reaction with good safety.

Comparison of the Effects of Saccharomyces boulardii Sachets and Bismuth Agent both Combined with Triple Therapy on Helicobacter pylori Eradication / 医药导报

Objective To compare the efficacy and safety of Saccharomyces boulardii sachets and bismuth in the treatment of chronic gastritis and duodenal ulcer patients with Helicobacter pylori (Hp)infection.Methods A total of 176 patients with chronic gastritis or duodenal ulcer with Hp infection were enrolled.Patients with chronic gastritis (n=116) were randomly divided into the treatment group (58 cases) and the control group (58 cases): treatment group received triple therapy(rabeprazole+amoxicillin +levofloxacin) and Saccharomyces boulardii sachets for 14 days;control group received triple therapy and colloidal bismuth pectin for 14 days.Patients with duodenal ulcer (n=60) were ulcer group,given with bismuth-containing quadruple therapy for 14 days,then rabeprazole for 14 days.All patients were tested for 13 C urea breath test four weeks after stopping treatment.Results One hundred and seventy cases completed the trial.Hp eradication rate was 84.5%in treatment group,87.9% in control group,and 90.0% in ulcer group (analysis by intent of treatment,ITT analysis).The difference between the three groups was not statistically significant(P>0.05).The incidence of adverse events was significantly lower in treatment group (10.3%)than in control group (20.7%)and ulcer group (21.7%)(P<0.05).Conclusion Quadruple therapy with Saccharomyces boulardii sachets can effectively eradicate Hp.It can reduce the occurrence of adverse reactions.

Effect of Saccharomyces boulardii on Rescue Therapy of Helicobacter pylori Infection / 胃肠病学

In recent years, the eradication rate of standard triple therapy for Helicobacter pylori (Hp) infection has been reduced to less than 80% because of many factors, such as strain variation, drug resistance and cross infection of different strains.As more and more cases with failure of initial eradication therapy, the focus of clinical practice is to explore new alternative rescue therapies.Aims: To assess the efficacy and safety of Saccharomyces boulardii combined with moxifloxacin-based triple regimen for rescue therapy of Hp infection.Methods: A total of 400 patients with chronic gastritis who had failed initial bismuth quadruple therapy were enrolled and randomly assigned into two groups: 200 cases of control group and 200 cases of test group.Patients in control group received a rescue triple therapy (esomeprazole, amoxicillin and moxifloxacin) for 14 days and those in test group with the further addition of Saccharomyces boulardii sachets.Hp eradication was assessed by 13C/14C-urea breath test four weeks after treatment, and the adverse events during treatment course were observed.Results: The Hp eradication rates in control group and test group were 80.1% (121/151) and 90.4% (142/157) by per-protocol (PP) analysis, respectively, and 60.5% (121/200) and 71.0% (142/200) by intention-to-treat (ITT) analysis, respectively.The eradication rate in test group was significantly higher than that in control group by both PP and ITT analyses (P<0.05).The incidence rate of adverse events was significantly lower in test group than in control group (9.6% vs.17.9%, P<0.05).Conclusions: Saccharomyces boulardii added to moxifloxacin-based rescue triple therapy could increase the eradication rate of Hp infection with less adverse events.

Saccharomyces boulardii Interfere nas vias de sinalização celular NF-KB, MAPK e TLR/MYD88 alteradas pelo 5-fluorouracil

Introdução: A mucosite induzida por antineoplásicos é um fator limitante na terapiaanticâncer. O trato gastrintestinal é vulnerável por causa da alta proliferação e frequência de renovação celular. Saccharomyces boulardii(SB) é uma levedura probiótica que é utilizadapara proteger a microflora gastrintestinal dodesequilíbrio e de distúrbios gastrintestinais associados. Objetivos: Avaliar o efeito do tratamento com SBna resposta inflamatória e nas vias de sinalização celular (NFkB e MAPK) e nos receptores Toll-like 2 e 4 associados a proteína adaptadora (MyD88)no curso da mucosite intestinal experimental induzida por 5-FU. Métodos: Camundongos machos Swiss (25-30g) foram tratados com 5-FU(450mg/Kg,i.p.)ou com solução salina(controle). OgrupoSB recebeudurante 3 diasconsecutivossomente o SB (1.109UFC/Kg, gavagem)até o dia do sacrifício. Ogrupo 5-FU+SB recebeu SBpor3diasconsecutivosapós a administração do 5-FU. No 4º dia após o 5-FU ou 5-FU+SB, os animais foram sacrificados, amostras de jejuno e íleo foram retiradas e os parâmetros gerais da mucosite foram avaliados (leucograma, perca de peso, diarreia, histologiaeMPO). Utilizou-se também as células Caco2 incubadascom 5-FU (1mM) e SB por 24h. Avaliou-se tambéma inflamação e as vias de sinalização celular, para isso avaliamos aexpressão de NFkB, IkB, MAPK (p-ERK1/2,p-p38, p-JNK), iNOS, citocinaspró-inflamatórias(TNF-α, IL-1β, CXCL1, IL-8, IL-4, IL-6, IL-12, IFN-ɣ), receptores toll-like 2 e 4 e,MyD88. Utilizou-seos métodos de ELISA e Imunohistoquímica para as análises em tecidos animais e, utilizamos as técnicas de qPCR e de WB para as análises celulares...

Introduction: Intestinal mucositis is a frequent side-effect associated to 5-fluorouracil (5-FU) clinical use and results in inflammatory events. It is characterized by epithelial ulcerations in the mucosa and clinical manifestations of abdominal pain, nauseas and diarrhea.Saccharomyces boulardiiis a probiotic yeast which has been shown to protect the gastrointestinal microflora from disequilibrium and from associated gastrointestinal disorders. Aim: To evaluate the effect of treatment with SB in the inflammatory response and in cellular signaling pathways (MAPK and NFkB) and Toll-like receptors 2 and 4, and associated adapter protein (MyD88) in the course of experimental intestinal mucositis induced by 5-FU. Methods: Male Swiss mice (25-30g) were treated with 5-FU (450 mg / kg, i.p.) or saline (control). The SB group received for 3 consecutive days only the SB (1,109CFU / kg, gavage) until the day of sacrifice. 5-FU group received 5-FU+SB for 3 consecutive days after administration of 5-FU. On the 4th day after 5-FU or 5-FU + SB, the animals were sacrificed, samples of jejunum and ileum were removed and the general parameters of mucositis were evaluated (WBC, loss of weight, diarrhea, histology and MPO). It also used the Caco2 cells treated with 5-FU (1mM) and SB for 24h. We also evaluated the inflammation and cellular signaling pathways, for that evaluate the expression of NFkB, IkB, MAPK (p-ERK1 / 2, p38-p, p-JNK), iNOS, inflammatory proinflammatory cytokines (TNF-α, IL-1β, CXCL1, IL-8, IL-4, IL-6, IL-12, IFN-ɣ), toll-like receptors 2 and 4 and MyD88. Immunohistochemistry and ELISA methods were used for the analysis in animal tissues and used qPCR techniques and WB for cell analysis...

The effect of saccharomyces boulardii combined with chiropractics in asphyxial newborn with ;feeding intolerance / 中国医师进修杂志

Objective To observe the effect of saccharomyces boulardii combined with chiropractics in asphyxial newborn with feeding intolerance. Methods One hundred and twenty asphyxial newborn with feeding intolerance were allocated into observation group (68 patients) and control group (52 patients) by random digits table. The newborn in control group accepted trace feeding and parenteral nutrition treatment, and the newborn in observation group accepted additional oral saccharomyces boulardii and chiropractic therapy on the base of control group. The time of reaching to full enteral feeding, the time of restoring to birth weight, the incidence of hyperbilirubinemia and the total efficiency of treatment were observed. Results The time of reaching to full enteral feeding, the time of restoring to birth weight in either mild asphyxial newborn or severe asphxial newborn in observation group were significantly lower than those in control group (P<0.01 or<0.05). The incidence of hyperbilirubinemia in mild asphyxial newborn or severe asphxial newborn in observation group was 16.7%(8/48) and 5/20, in control group was 36.8%(14/38) and 9/14, and there were significant differences (P<0.05). The total efficiency of treatment in observation group was significantly higher than that in control group:91.2%(62/68) vs. 69.2%(36/52), P<0.05. Conclusions Saccharomyces boulardii combined with chiropractics in asphyxial newborn with feeding intolerance can reduce the time of reaching to full enteral feeding and the time of restoring to birth weight. It can decrease the incidence of hyperbilirubinemia, and the treatment effect is obvious.