标题：Effect of an 8-Week Yoga-Based Lifestyle Intervention on Psycho-Neuro-Immune Axis, Disease Activity, and Perceived Quality of Life in Rheumatoid Arthritis Patients: A Randomized Controlled Trial
摘要：Various external stressors and environmental challenges lead to the provocation of
the immune system in autoimmune diseases like Rheumatoid arthritis (RA). The
inappropriate immune response further triggers the cascade of inflammatory changes
resulting in precipitation of symptoms and hampers quality of life (QOL). The underlying
psycho-somatic component of the disease requires a holistic approach to its treatment
dimension rather than the use of pharmacotherapy. The applicability of mind-body
interventions has become essential in today’s fast-paced life. Yoga, a mind-body
technique, alters the mind’s capacity to facilitate systemic functioning at multiple organ
system levels. Hence, we conducted this study to evaluate the impact of 8 weeks
of a yoga-based lifestyle intervention (YBLI) on psycho-neuro-immune markers, gene
expression patterns, and QOL in RA patients on routine medical therapy. A total of 66
patients were randomized into two groups: yoga group or non-yoga group and were
assessed for a panel of inflammatory cytokines (IL-6, IL-17A, TNF-α, and TGF-β), mindbody communicative markers (BDNF, DHEAS, β-endorphin, and sirtuin) and transcript
levels of various genes (IL-6, TNF-α, NFKB1, TGF-β, and CTLA4). We assessed
disease activity and QOL using the DAS28-ESR and WHOQOL-BREF questionnaire,
respectively. Yoga group observed significant improvements in the levels of markers,
which influenced the psycho-neuro-immune axis (p < 0.001) with an estimated effect
size from small to medium range. In the yoga group, there was a significant reduction in
DAS28-ESR (p < 0.001) and improvement seen in the physical health, psychological,
social relationships domains (p < 0.001) of QOL, except environmental (p > 0.05). The
yoga group showed downregulation of IL-6, TNF-α, and CTLA4 and upregulation of
TGF-β. These results suggest that a decrease in disease activity after yoga practice
is associated with a significant reduction in inflammatory cytokines, the elevation of
mind-body communicative markers, and normalization of various transcript levels, which improved QOL. Thus the adoption of YBLI improves clinical outcome in RA, and
decreases systemic inflammation by its beneficial effects on psycho-neuro-immune axis
and normalization of dysregulated transcripts. Thus YBLI may be used for RA patients
as an adjunctive therapy.
