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Drug Res (Stuttg)
DOI: 10.1055/a-2564-2569
Original Article

A Randomized, Controlled Study Evaluating Effects of Saccharomyces boulardii in Adult Patients with Asthma

Kavosh Ansari Dezfouli
1   Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
2   Department of Internal Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
,
Mahboubeh Darban
3   Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
,
Maral Hemmati
4   Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
,
Mazyar Zahir
5   Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Mojtaba Soltani Kermanshahi
6   Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
,
Anna Abdolshahi 
7   Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
,
Hani Sadr
3   Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
,
Bahador Bagheri
4   Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
8   Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
› Author AffiliationsSupported by: Semnan University of Medical Sciences grant no.1785
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Abstract

Objective

To determine the potential benefit of adding Saccharomyces boulardii (S. boulardii) probiotic supplementation to conventional treatments in asthmatic patients.

Materials and methods

In this randomized, double-blinded, and placebo-controlled trial 50 asthmatic patients were enrolled. The eligible subjects received either S. boulardii (N=25) or placebo (N=25) added to conventional treatments for three months. Spirometry parameters (FEV1, FVC, FEV1/FVC, and FEF 25–75%) and blood test parameters (CBC, eosinophil percentage, IgE, IL-5, ESR and CRP) were measured and compared at baseline and after treatment completion.

Results

The mean age was 39.22±12.55 years. As compared to baseline values, a significant improvement was noted in FEV1 in patients who received S. boulardii (p=0.026). Although the changes in FEV1, FVC, FEV1/FVC, and FEF 25–75% were comparable between the study groups, the differences were not statistically significant (p ˃ 0.05). In addition, patients who received probiotic showed lower levels of IL-5 and IgE in comparison with patients who received placebo.

Conclusion

Our findings showed that the addition of S. boulardii to conventional treatments partially improved the pulmonary function and was associated with reductions in IgE and IL-5 levels.

Keywords

asthma - probiotics - saccharomyces boulardii - spirometry


Publication History

Received: 02 July 2024

Accepted: 15 March 2025

Article published online:
14 April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019. EClinicalMedicine 2023; 59: 101936
    PubMedSearch in Google Scholar
  • 2 Carr TF, Zeki AA, Kraft M. Eosinophilic and Noneosinophilic Asthma. Am J Respir Crit Care Med 2018; 197: 22-37
    CrossrefPubMedSearch in Google Scholar
  • 3 Ray A, Kolls JK. Neutrophilic Inflammation in Asthma and Association with Disease Severity. Trends Immunol 2017; 38: 942-54
    PubMedSearch in Google Scholar
  • 4 Fijan S, Frauwallner A, Varga L. et al. Health professionals’ knowledge of probiotics: an international survey. International journal of environmental research and public health 2019; 16: 3128
    PubMedSearch in Google Scholar
  • 5 Misra S, Pandey P, Mishra HN. Novel approaches for co-encapsulation of probiotic bacteria with bioactive compounds, their health benefits and functional food product development: A review. Trends in Food Science & Technology 2021; 109: 340-351
    PubMedSearch in Google Scholar
  • 6 Sadrifar S, Abbasi-Dokht T, Forouzandeh S. et al. Immunomodulatory effects of probiotic supplementation in patients with asthma: a randomized, double-blind, placebo-controlled trial. Allergy, Asthma & Clinical Immunology 2023; 19: 1-10
    PubMedSearch in Google Scholar
  • 7 van den Akker CH, Van Goudoever JB, Shamir R. et al. Probiotics and preterm infants: a position paper by the European Society for paediatric gastroenterology hepatology and nutrition Committee on nutrition and the European Society for paediatric gastroenterology hepatology and nutrition Working group for probiotics and prebiotics. Journal of pediatric gastroenterology and nutrition 2020; 70: 664-80
    PubMedSearch in Google Scholar
  • 8 Sen M. Role of probiotics in health and disease–A review. International Journal of Advancement in Life Sciences Research 2019; 1-11
    PubMedSearch in Google Scholar
  • 9 Diez-Gutiérrez L, San Vicente L, Barrón LJR. et al. Gamma-aminobutyric acid and probiotics: Multiple health benefits and their future in the global functional food and nutraceuticals market. Journal of Functional Foods 2020; 64: 103669
    PubMedSearch in Google Scholar
  • 10 Bisyuk Y, Litus O, Boyko N. et al. Combinations of Probiotic Bacteria (Lactobacillus helveticus, Bifidobacterium longum, Lactobacillus rhamnosus, Sacchammyces boulardii) Restores the Skin Microbiome in Atopic Dermatitis. Journal of Allergy and Clinical Immunology 2023; 151: AB148
    PubMedSearch in Google Scholar
  • 11 Kaźmierczak-Siedlecka K, Ruszkowski J, Fic M. et al. Saccharomyces boulardii CNCM I-745: A non-bacterial microorganism used as probiotic agent in supporting treatment of selected diseases. Current microbiology 2020; 77: 1987-96
    PubMedSearch in Google Scholar
  • 12 Zhang P, Chen X, Chen B. et al. Study on asthmatic children serum cytokine levels and saccharomyces boulardii intervention. Chinese Journal of Clinical Pharmacology and Therapeutics 2017; 22: 332
    PubMedSearch in Google Scholar
  • 13 Gao X, Wang Y, Shi L. et al. Effect and safety of Saccharomyces boulardii for neonatal necrotizing enterocolitis in pre-term infants: a systematic review and meta-analysis. Journal of Tropical Pediatrics 2021; 67: fmaa022
    PubMedSearch in Google Scholar
  • 14 Szajewska H, Kołodziej M, Zalewski BM. Systematic review with meta-analysis: Saccharomyces boulardii for treating acute gastroenteritis in children—a 2020 update. Alimentary pharmacology & therapeutics 2020; 51: 678-88
    PubMedSearch in Google Scholar
  • 15 Zhou BG, Chen LX, Li B. et al. Saccharomyces boulardii as an adjuvant therapy for Helicobacter pylori eradication: A systematic review and meta-analysis with trial sequential analysis. Helicobacter 2019; 24: e12651
    PubMedSearch in Google Scholar
  • 16 Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2019
    PubMedSearch in Google Scholar
  • 17 World Health Organization. World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action. 2005. World Health Organization;
    Search in Google Scholar
  • 18 Du X, Wang L, Wu S. et al. Efficacy of probiotic supplementary therapy for asthma, allergic rhinitis, and wheeze: a meta-analysis of randomized controlled trials. Allergy Asthma Proc 2019; 40: 250-60
    PubMedSearch in Google Scholar
  • 19 Wei X, Jiang P, Liu J. et al. Association between probiotic supplementation and asthma incidence in infants: a meta-analysis of randomized controlled trials. J Asthma 2020; 57: 167-78
    PubMedSearch in Google Scholar
  • 20 Lin J, Zhang Y, He C. et al. Probiotics supplementation in children with asthma: A systematic review and meta-analysis. J Paediatr Child Health 2018; 54: 953-61
    PubMedSearch in Google Scholar
  • 21 Karen M, Yuksel O, Akyürek N. et al. Probiotic agent Saccharomyces boulardii reduces the incidence of lung injury in acute necrotizing pancreatitis induced rats. Journal of Surgical Research 2010; 160: 139-144
    PubMedSearch in Google Scholar
  • 22 Li J, Gao PF, Xu YX. et al. Probiotic Saccharomyces boulardii attenuates cardiopulmonary bypass-induced acute lung injury by inhibiting ferroptosis. American Journal of Translational Research 2022; 14: 5003
    PubMedSearch in Google Scholar
  • 23 Sudo N, Yu XN, Aiba Y. et al. An oral introduction of intestinal bacteria prevents the development of a long-term Th2-skewed immunological memory induced by neonatal antibiotic treatment in mice. Clinical & Experimental Allergy 2002; 32: 1112-1116
    PubMedSearch in Google Scholar
  • 24 Chen YS, Lin YL, Jan RL. et al. Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. Pediatric pulmonology 2010; 45: 1111-1120
    PubMedSearch in Google Scholar
  • 25 Pochard P, Gosset P, Grangette C. et al. Lactic acid bacteria inhibit TH2 cytokine production by mononuclear cells from allergic patients. Journal of Allergy and Clinical Immunology 2002; 110: 617-623
    PubMedSearch in Google Scholar
  • 26 Prescott SL, Dunstan JA, Hale J. et al. Clinical effects of probiotics are associated with increased interferon-γ responses in very young children with atopic dermatitis. Clinical & Experimental Allergy 2005; 35: 1557-1564
    PubMedSearch in Google Scholar
  • 27 Giovannini M, Agostoni C, Riva E. et al. A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatric research 2007; 62: 215-220
    PubMedSearch in Google Scholar
  • 28 Rose MA, Stieglitz F, Köksal A. et al. Efficacy of probiotic Lactobacillus GG on allergic sensitization and asthma in infants at risk. Clinical & Experimental Allergy 2010; 40: 1398-1405
    PubMedSearch in Google Scholar
  • 29 Wheeler JG, Shema SJ, Bogle ML. et al. Immune and clinical impact of Lactobacillus acidophilus on asthma. Annals of Allergy, Asthma & Immunology 1997; 79: 229-233
    PubMedSearch in Google Scholar