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1 Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Charlestown, Massachusetts, United States; Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts, United States
2 Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Charlestown, Massachusetts, United States; Gastroenterology, Beth Isreal Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
3 Gastroenterology, Beth Isreal Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
* To whom correspondence should be addressed. E-mail: mccormic{at}mgh.helix.harvard.edu.
Saccharomyces boulardii is gaining in popularity as a treatment for a variety of diarrheal diseases, as well as inflammatory bowel disease. This study was designed to examine the effect of this yeast on infection by Shigella flexneri, a highly infectious and human host adapted enteric pathogen. We investigated key interactions between the bacteria and host cells in the presence of the yeast, in addition to a number of host responses including pro-inflammatory events and markers. While presence of the yeast during infection did not alter the number of bacteria that were able to attach or invade T-84 cells, it did positively impact the tight junction protein, Z0-2, and significantly increase barrier integrity of model epithelia. The yeast also decreased ERK, JNK and NF-?B activation in response to S. flexneri, events likely responsible for the observed reductions in IL-8 secretion and the transepithelial migration of polymorphonuclear leukocytes (PMNs) across T-84 monolayers. These results, suggesting the yeast allowed for a dampened inflammatory response were confirmed in vivo utilizing a highly relevant model of human fetal colonic tissue transplanted into scid mice. Furthermore, a cell-free S. boulardii culture supernatant was also capable of reducing IL-8 secretion by infected T-84 cells. These data suggest that while the use of S. boulardii during infection with S. flexneri may alleviate symptoms associated with the host's inflammatory response, it would not prevent infection.
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