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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Consilium Medicum</journal-id><journal-title-group><journal-title xml:lang="en">Consilium Medicum</journal-title><trans-title-group xml:lang="ru"><trans-title>Consilium Medicum</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>Consilium Medicum</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2075-1753</issn><issn publication-format="electronic">2542-2170</issn><publisher><publisher-name xml:lang="en">Consilium Medicum</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">706655</article-id><article-id pub-id-type="doi">10.26442/20751753.2026.5.203688</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Multimodal effects of <italic>Saccharomyces boulardii</italic> CNCM I-745: a review</article-title><trans-title-group xml:lang="ru"><trans-title>Мультимодальные эффекты <italic>Saccharomyces boulardii</italic> CNCM I-745</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8666-6118</contrib-id><name-alternatives><name xml:lang="en"><surname>Zakharenko</surname><given-names>Sergey M.</given-names></name><name xml:lang="ru"><surname>Захаренко</surname><given-names>Сергей Михайлович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.), Assoc. Prof.</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доц., нач. информационно-аналитического управления</p></bio><email>zsm1@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Federal Scientific and Clinical Center of Infectious Diseases</institution></aff><aff><institution xml:lang="ru">ФГБУ «Федеральный научно-клинический центр инфекционных болезней» ФМБА России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2026-06-09" publication-format="electronic"><day>09</day><month>06</month><year>2026</year></pub-date><volume>28</volume><issue>5</issue><issue-title xml:lang="en">Gastroenterology</issue-title><issue-title xml:lang="ru">Гастроэнтерология</issue-title><fpage>342</fpage><lpage>352</lpage><history><date date-type="received" iso-8601-date="2026-04-23"><day>23</day><month>04</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-04-29"><day>29</day><month>04</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://consilium.orscience.ru/2075-1753/article/view/706655">https://consilium.orscience.ru/2075-1753/article/view/706655</self-uri><abstract xml:lang="en"><p>The gut microbiome is a key regulator of health that is exposed to exposome (antibiotics, medications, and ecotoxicants, etc.). The gastrointestinal tract is the largest cellular consortium that ensures the well-being of the human body. Dysbiosis is an early marker of many diseases and is involved in their pathogenesis. The market for probiotics is growing, and by 2035, their share will reach 40% ($11.31 billion) in the structure of microbiota-oriented technologies. Understanding the molecular mechanisms of action of probiotics is crucial not only for ensuring the safety of therapy, but also for choosing the optimal strategy for their use in various clinical situations. Thus, the analysis and synthesis of current data on the molecular mechanisms of action of the probiotic strain <italic>Saccharomyces boulardii</italic> CNCM I-745 (<italic>Sb</italic> CNCM I-745) demonstrates multimodality – the result of complex and multilevel interaction with the human body, which are realized at several levels: luminal, trophic, and immune. Mechanisms include direct antimicrobial activity, barrier restoration, immune modulation, and systemic effects on the gut-liver axis (reduction of endotoxemia, protection of hepatocytes, etc.), the gut-brain axis (influence on serotonin metabolism, reduction of IBS symptoms, etc.), and metabolic control (change in the <italic>Firmicutes/Bacteroidetes</italic> ratio, increase in butyrate production, etc.). Modern medicine is based on the active implementation of various biotechnological developments in the prevention and treatment of infectious and non-infectious human diseases. The choice of probiotics should be based on proven molecular mechanisms, and <italic>Sb </italic>CNCM I-745 (the drug Enterol®) meets this criterion, offering a comprehensive, safe, and effective therapeutic tool. A broad evidence base, more than 30 meta-analyses based on over 130 studies conducted worldwide, served as the basis for the inclusion of <italic>Sb</italic> CNCM I-745 in a large number of guidelines and clinical recommendations in many countries, including the recommendations of the Ministry of Health of the Russian Federation.</p></abstract><trans-abstract xml:lang="ru"><p>Микробиом кишечника – это ключевой регулятор здоровья, подверженный воздействию экспосома (антибиотиков, лекарств, экотоксикантов и др.). Крупнейшим клеточным консорциумом, обеспечивающим благополучие организма человека, является желудочно-кишечный тракт. Дисбиоз, с одной стороны, является ранним маркером многих заболеваний, а с другой – участвует в их патогенезе. Рынок пробиотиков растет, доля которых к 2035 г. достигнет 40% (11,31 млрд дол. США) в структуре микробиоценоз-ориентированных технологий. Понимание молекулярных механизмов действия пробиотиков принципиально важно не только для обеспечения безопасности терапии, но и для выбора оптимальной стратегии их применения в самых разных клинических ситуациях. В связи с этим анализ и обобщение современных данных о молекулярных механизмах действия пробиотического штамма <italic>Saccharomyces boulardii</italic> CNCM I-745 (<italic>Sb</italic> CNCM I-745) демонстрируют мультимодальность – результат сложного и многоуровневого взаимодействия с организмом человека, реализующуюся на нескольких уровнях: просветном, трофическом и иммунном. Механизмы включают прямую антимикробную активность, восстановление кишечного барьера, модуляцию иммунитета и системные эффекты по осям «кишечник – печень» (снижение эндотоксинемии, защиту гепатоцитов и др.), «кишечник – мозг» (влияние на метаболизм серотонина, уменьшение симптомов синдрома раздраженного кишечника и др.), метаболический контроль (изменение соотношения <italic>Firmicutes/Bacteroidetes</italic>, увеличение продукции бутирата и др.). Современная медицина базируется на активном внедрении различных биотехнологических разработок в профилактику и терапию инфекционных и неинфекционных болезней человека. Выбор пробиотиков должен основываться на доказанных молекулярных механизмах, а <italic>Sb</italic> CNCM I-745 (лекарственный препарат Энтерол®) соответствует этому критерию, предлагая комплексный, безопасный и эффективный терапевтический инструмент. Широкая доказательная база, более 30 метаанализов, основанных на проведенных по всему миру свыше 130 исследованиях, послужили основанием для включения <italic>Sb</italic> CNCM I-745 в большое число руководств и клинических рекомендаций во многих странах, в том числе и в рекомендации Минздрава России.</p></trans-abstract><kwd-group xml:lang="en"><kwd>probiotic Enterol®</kwd><kwd>Saccharomyces boulardii CNCM I-745</kwd><kwd>mechanism of action</kwd><kwd>multimodality</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>пробиотик Энтерол®</kwd><kwd>Saccharomyces boulardii СNCM I-745</kwd><kwd>механизм действия</kwd><kwd>мультимодальность</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution xml:lang="ru">ООО «Биокодекс»</institution></institution-wrap><institution-wrap><institution xml:lang="en">Biocodex LLC</institution></institution-wrap></funding-source></award-group><funding-statement xml:lang="en">The paper was prepared with the financial support of Biocodex LLC. The sponsor was not involved in the data collection and analysis and the interpretation of results. In preparing the manuscript, the author maintained the independence of opinion.</funding-statement><funding-statement xml:lang="ru">Материал подготовлен при финансовой поддержке ООО «Биокодекс». Спонсор не участвовал в сборе, анализе данных, интерпретации результатов. При подготовке рукописи автор сохранил независимость мнений.</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Скворцова В.И. IV Форум будущих технологий «Биоэкономика для человека». Сессия «Инновационные биотехнологии: от разработки до реализации». М. 2026 [Skvortsova VI. IV Forum budushchikh tekhnologii «Bioekonomika dlia cheloveka». Sessiia «Innovatsionnye biotekhnologii: ot razrabotki do realizatsii». Moscow. 2026 (in Russian)].</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Velmurugan G. 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