Saccharomyces cerevisiaeCNCM I-3856 in irritable bowel syndrome: An individual subject meta-analysis

Abstract

AIMTo confirm previous conclusions on Saccharomyces cerevisiae (S. cerevisiae) CNCM I-3856 for irritable bowel syndrome (IBS) management.METHODSAn individual patient data meta-analysis was performed on two randomized clinical trials studying the effect of S. cerevisiae CNCM I-3856 supplementation on gastrointestinal (GI) symptoms in IBS subjects. A total of 579 IBS subjects were included. Outcomes were the daily Likert scale scores of abdominal pain/discomfort and bloating [area under the curve (AUC) and weekly means], responder status, and bowel movements (stool frequency and consistency). Statistical analyses were conducted in Intent to Treat (ITT) population, IBS-C subjects and IBS-C subjects with an abdominal pain/discomfort score higher than or equal to 2 at baseline (“IBS-C ≥ 2 subpopulation”).RESULTSS. cerevisiae CNCM I-3856 significantly improved abdominal pain/discomfort and bloating during the second month of supplementation [AUC (W5-W8)] with improvement up to the minimal clinically relevant threshold of 10%: a 12.3% reduction of abdominal pain/discomfort in the ITT population compared to the Placebo group (P = 0.0134) has been observed. In the IBS-C ≥ 2 subpopulation, there were a 13.1% reduction of abdominal pain/discomfort and a 14.9% reduction of bloating compared to the Placebo group (P = 0.0194 and P = 0.0145, respectively). GI symptoms significantly decreased during supplementation but no statistical differences were reported between groups at the end of the supplementation period. Responder status was defined as a subject who experienced a decrease of 1 arbitrary unit (a.u.) or 50% of the abdominal discomfort score from baseline for at least 2 wk out of the last 4 wk of the study. A significant difference between groups was reported in the ITT population, when considering the first definition: subjects in the Active group had 1.510 higher odds to be a responder (reduction of 1 a.u. of abdominal pain/discomfort) compared with subjects in the Placebo group (P = 0.0240). At the end of supplementation period, stool consistency in the Active group of the ITT population was significantly improved and classified as “normal” compared to Placebo (respectively 3.13 ± 1.197 a.u. vs 2.58 ± 1.020 a.u., P = 0.0003). Similar results were seen in the IBS-C ≥ 2 subpopulation (Active group: 3.14 ± 1.219 a.u. vs Placebo group: 2.59 ± 1.017 a.u., P = 0.0009).CONCLUSIONThis meta-analysis supports previous data linking S. cerevisiae I-3856 and improvement of GI symptoms, in IBS overall population and in the IBS-C and IBS-C ≥ 2 subpopulations.

Systematic review: probiotics in the management of lower gastrointestinal symptoms – an updated evidence‐based international consensus

“…A meta‐analysis of the effect of Saccharomyces cerevisiae CNCM I‐3856 on GI symptoms in patients with IBS used data from 2 trials (both of which are included in our review). The authors reported that patients consuming the probiotic had a significantly higher chance of reduction in abdominal pain/discomfort ( P = 0.0134) and improvement in stool consistency ( P = 0.0003) than those consuming placebo . Another recent meta‐analysis examined the effects of the probiotic Bifidobacterium longum subsp.…”

“…Results from the analyses showed that consumption of the specific probiotic was associated with a significant improvement in overall GI discomfort reported that patients consuming the probiotic had a significantly higher chance of reduction in abdominal pain/discomfort (P = 0.0134) and improvement in stool consistency (P = 0.0003) than those consuming placebo. 104 Another recent meta-analysis examined the effects of the probiotic Bifidobacterium longum subsp. infantis 35624 in patients with IBS.…”

Saccharomyces cerevisiae-Based Probiotics as Novel Antimicrobial Agents to Prevent and Treat Vaginal Infections

“…Many studies have, also, highlighted the beneficial effects of several S. cerevisiae strains on entheropatogenic bacteria (Martins et al, 2005;Perez-Sotelo et al, 2005;Martins et al, 2007;Etienne-Mesmin et al, 2011;Tiago et al, 2012;Sivignon et al, 2015;Roussel et al, 2018), on inflammatory bowel diseases (Pineton de Chambrun et al, 2015;Tiago et al, 2015;Spiller et al, 2016;Cayzeele-Decherf et al, 2017b;Gayathri et al, 2020), and on pathogenic fungi (C. albicans and non-albicans Candida species, Aspergillus flavus; Premanathan et al, 2011;Abdel-Kareem et al, 2019;Kunyeit et al, 2019;Roselletti et al, 2019b). The potential mechanisms described include: inhibition of pathogen growth (Etienne-Mesmin et al, 2011;Roussel et al, 2018;Abdel-Kareem et al, 2019;Roselletti et al, 2019b), inhibition of pathogen adherence to epithelial cells (Perez-Sotelo et al, 2005;Tiago et al, 2012;Sivignon et al, 2015;Roussel et al, 2018;Kunyeit et al, 2019), immunomodulatory activity (Martins et al, 2005;Martins et al, 2007;Sivignon et al, 2015;Tiago et al, 2015;Roussel et al, 2018;Roselletti et al, 2019b), inhibition of filamentation and biofilm development (Kunyeit et al, 2019), and reduction of toxin production (Roussel et al, 2018;Abdel-Kareem et al, 2019).…”

Targeting the gut microbiota for the treatment of irritable bowel syndrome

“…44 In these two studies, the IBS-C patients with abdominal pain/discomfort showed a clinically relevant reduction (>10% compared to placebo) of 13.1% in abdominal pain/discomfort and 14.9% reduction in bloating during the second month of supplementation. 45 S boulardii has been shown to improve stool frequency and consistency after 4 weeks of treatment in IBS-D patients, 46,47 an effect that may be enhanced with the anti-inflammatory drug mesalazine. 46 (See Table 2).…”