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      The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis

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          Abstract

          Importance

          Psychological and health-restorative benefits of mind-body therapies have been investigated, but their impact on the immune system remain less defined.

          Objective

          To conduct the first comprehensive review of available controlled trial evidence to evaluate the effects of mind-body therapies on the immune system, focusing on markers of inflammation and anti-viral related immune responses.

          Methods

          Data sources included MEDLINE, CINAHL, SPORTDiscus, and PsycINFO through September 1, 2013. Randomized controlled trials published in English evaluating at least four weeks of Tai Chi, Qi Gong, meditation, or Yoga that reported immune outcome measures were selected. Studies were synthesized separately by inflammatory (n = 18), anti-viral related immunity (n = 7), and enumerative (n = 14) outcomes measures. We performed random-effects meta-analyses using standardized mean difference when appropriate.

          Results

          Thirty-four studies published in 39 articles (total 2, 219 participants) met inclusion criteria. For inflammatory measures, after 7 to 16 weeks of mind-body intervention, there was a moderate effect on reduction of C-reactive protein (effect size [ES], 0.58; 95% confidence interval [CI], 0.04 to 1.12), a small but not statistically significant reduction of interleukin-6 (ES, 0.35; 95% CI, −0.04 to 0.75), and negligible effect on tumor necrosis factor-α (ES, 0.21; 95% CI, −0.15 to 0.58). For anti-viral related immune and enumerative measures, there were negligible effects on CD4 counts (ES, 0.15; 95% CI, −0.04 to 0.34) and natural killer cell counts (ES, 0.12, 95% CI −0.21 to 0.45). Some evidence indicated mind-body therapies increase immune responses to vaccination.

          Conclusions

          Mind-body therapies reduce markers of inflammation and influence virus-specific immune responses to vaccination despite minimal evidence suggesting effects on resting anti-viral or enumerative measures. These immunomodulatory effects, albeit incomplete, warrant further methodologically rigorous studies to determine the clinical implications of these findings for inflammatory and infectious disease outcomes.

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          Effects of mindfulness on psychological health: a review of empirical studies.

          Shian-Ling Keng, Moria Smoski, Clive Robins (2011)
          Within the past few decades, there has been a surge of interest in the investigation of mindfulness as a psychological construct and as a form of clinical intervention. This article reviews the empirical literature on the effects of mindfulness on psychological health. We begin with a discussion of the construct of mindfulness, differences between Buddhist and Western psychological conceptualizations of mindfulness, and how mindfulness has been integrated into Western medicine and psychology, before reviewing three areas of empirical research: cross-sectional, correlational research on the associations between mindfulness and various indicators of psychological health; intervention research on the effects of mindfulness-oriented interventions on psychological health; and laboratory-based, experimental research on the immediate effects of mindfulness inductions on emotional and behavioral functioning. We conclude that mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation. The review ends with a discussion on mechanisms of change of mindfulness interventions and suggested directions for future research. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis.

            Andrew Steptoe, Mark Hamer, Yoichi Chida (2007)
            Stress influences circulating inflammatory markers, and these effects may mediate the influence of psychosocial factors on cardiovascular risk and other conditions such as psoriasis and rheumatoid arthritis. Inflammatory responses can be investigated under controlled experimental conditions in humans, and evidence is beginning to emerge showing that circulating inflammatory factors respond to acute psychological stress under laboratory conditions. However, research published to date has varied greatly in the composition of study groups, the timing of samples, assay methods, and the type of challenge imposed. The purpose of this review is to synthesize existing data using meta-analytic techniques. Thirty studies met inclusion criteria. Results showed robust effects for increased levels of circulating IL-6 (r=0.19, p=0.001) and IL-1beta (r=0.58, p<0.001) following acute stress, and marginal effects for CRP (r=0.12, p=0.088). The effects of stress on stimulated cytokine production were less consistent. Significant variation in the inflammatory response was also related to the health status of participants and the timing of post-stress samples. A number of psychobiological mechanisms may underlie responses, including stress-induced reductions in plasma volume, upregulation of synthesis, or enlargement of the cell pool contributing to synthesis. The acute stress-induced inflammatory response may have implications for future health, and has become an important topic of psychoneuroimmunological research.
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              IL-6 enhances plasma IL-1ra, IL-10, and cortisol in humans.

              Adam Steensberg, Christian Fischer, Charlotte Keller … (2003)
              The purpose of the present study was to test the hypothesis that a transient increase in plasma IL-6 induces an anti-inflammatory environment in humans. Therefore, young healthy volunteers received a low dose of recombinant human (rh)IL-6 or saline for 3 h. Plasma IL-6 levels during rhIL-6 infusion were approximately 140 pg/ml, corresponding to the levels obtained during strenuous exercise. The infusion of rhIL-6 did not induce enhanced levels of the proinflammatory cytokine TNF-alpha but enhanced the plasma levels of the two anti-inflammatory cytokines IL-1 receptor agonist (IL-1ra) and IL-10 compared with saline infusion. In addition, C-reactive protein increased 3 h post-rhIL-6 infusion and was further elevated 16 h later compared with saline infusion. rhIL-6 induced increased levels of plasma cortisol and, consequently, an increase in circulating neutrophils and a decrease in the lymphocyte number without effects on plasma epinephrine, body temperature, mean arterial pressure, or heart rate. In conclusion, this study demonstrates that physiological concentrations of IL-6 induce an anti-inflammatory rather than an inflammatory response in humans and that IL-6, independently of TNF-alpha, enhances the levels not only of IL-1ra but also of IL-10. Furthermore, IL-6 induces an increase in cortisol and, consequently, in neutrocytosis and late lymphopenia to the same magnitude and with the same kinetics as during exercise, suggesting that muscle-derived IL-6 has a central role in exercise-induced leukocyte trafficking.
              Article 0 comments Cited 305 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Reury F. P. Bacurau: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2014
                Publication date (Electronic): 2 July 2014
                Volume: 9
                Issue: 7
                Electronic Location Identifier: e100903
                Affiliations
                [1 ]Center for Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States of America
                [2 ]Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, University of California Los Angeles, Los Angeles, California, United States of America
                [3 ]Nutrition/Infection Unit, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
                University of Sao Paulo, Brazil
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: NM MRI CW. Analyzed the data: NM MC. Wrote the paper: NM MRI MC CW. Collected data: NM MC. Obtained funding for the study: CW.

                Article
                Publisher ID: PONE-D-14-00315
                DOI: 10.1371/journal.pone.0100903
                PMC ID: 4079606
                PubMed ID: 24988414
                SO-VID: 4852303c-33d8-40f8-9ef6-ad8948e9c9b4
                Copyright statement: Copyright @ 2014
                License:

                This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                Date received : 3 January 2014
                Date accepted : 30 May 2014
                Page count
                Pages: 14
                Funding
                Dr. Wang is supported by the National Center for Complementary and Alternative Medicine (K24 AT007323, R01 AT006367, R01 AT005521, R01 AT006367-01A1). Dr. Irwin is supported by the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience, and by the National Institutes of Health (R01-AG034588; R01-AG026364; R01 CA160245-01; R01-CA119159; R01 HL095799; R01 DA032922-01; P30-AG028748; and UCLA CTSI UL1TR000124). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the NCCAM. The investigators are solely responsible for the content of the manuscript and the decision to submit for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Immunology
                Subject: Immune Response
                Subject: Psychology
                Subject: Medicine and Health Sciences
                Subject: Complementary and Alternative Medicine
                Subject: Research and Analysis Methods
                Subject: Research Assessment
                Subject: Systematic Reviews
                Subject: Research Design
                Subject: Clinical Research Design
                Subject: Social Sciences

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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