Saccharomyces boulardii is a yeast widely used in humans for the prevention and treatment of infectious enteritis and Clostridium difficile-associated enterocolopathies. After oral administration to human volunteers or growing rats, S. boulardii enhances markedly the expression of intestinal enzymes as well as the production of the polymeric immunoglobulin receptor by mechanisms that remain unknown. We have analyzed the role of the yeast polyamines as potential mediators in the intestinal trophic response. In weanling rats (d 20 to d 30), a daily dose of 100 mg of lyophilized S. boulardii produced significant (p < 0.025) increases in sucrase (157%) and maltase (47%) activities. This dose corresponded to a total oral load of 678 nmol of polyamines per day (spermidine: 376 + 32, spermine: 293 + 26, putrescine: 9.5 + 1.4 nmo11100 mg). Spermine, given orally to growing rats at doses nearly equivaSaccharomyces boulardii is a thermophilic, nontoxic yeast used in many countries for the treatment of acute infectious enteritis (I), antibiotic-induced gastrointestinal disorders (2, 3), and Clostridium dificile-associatedenterocolopathies (4, 5). The physiologic impact of the yeast on the gastrointestinal tract of mammals remains largely unknown. In a previous study (6), we have shown that the oral treatment of human volunteers and weaned rats with a lyophilized preparation of S. boulardii resulted in marked increases in the specific and total activities of brush-border membrane enzymes without morphologic alteration of the intestinal mucosa.Subsequently, w e found increased secretion of IgA and of the polymeric immunoglobulin receptor in intestinal fluid and mucosa of rats treated with S. boulardii (7). Although these changes may contribute to the explana- lent (500 nmol) to the load of polyamines provided by the yeast (678 nmol), reproduced similar enzymatic changes, including a 2.5-fold induction of sucrase, and enhanced maltase activity (+24%). Spermidine and spermine concentrations measured in the jejunal mucosa of treated rats were increased over matched controls by 21.4% (p < 0.005) and 21.9%, respectively (p < 0.002). After being centrifuged and filtered to discard residual yeast cells, 2-mL samples of jejunal and ileal fluid collected from S. boulardii-treated rats by intestinal flushing contained higher levels of spermidine (48 and 60%) and spermine (150 and 316%) than did control rats. Our data indicate that lyophilized S. boulardii exerts trophic effects on the small intestine that are likely mediated by the endoluminal release of spermine and spermidine. (Pediufr Res 36: 522-527, 1994) tion of the beneficial effects of the yeast therapy in certain intestinal disorders, the exact mechanism by which S. boulardii exerts trophic effects on the small intestinal mucosa is not elucidated. Preliminary findings (6, 7) indicate that the enhanced expression of surface membrane glycoproteins including disaccharidases and secretory component seems unrelated to an increase in cell turnover (7) or to changes in the incorp...

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