Yoga and immune system functioning: a systematic review of randomized controlled trials

Abbas, A. K., Lichtman, A. H., & Pillai, S. (2016). Basic immunology: Functions and disorders of the immune system (5th ed.). Missouri: Elsevier. Agnihotri, S., Kant, S., Kumar, S., Mishra, R. K., & Mishra, S. K. (2014). Impact of yoga on biochemical profile of asthmatics: A randomized controlled study. International Journal of Yoga, 7, 17–21. https://doi.org/10.4103/0973-6131.123473 Ashcroft, G. S., Jeong, M.-J., Ashworth, J. J., Hardman, M., Jin, W., Moutsopoulos, N.,. . . Wahl, S. M. (2012). Tumor necrosis factor-alpha (TNF-α) is a therapeutic target for impaired cutaneous wound healing. Wound Repair and Regeneration: Official Publication of the Wound Healing Society [and] the European Tissue Repair Society, 20(1), 38–49. https://doi.org/10.1111/j.1524-475x.2011.00748.x Barnes, P. J. (2006). How corticosteroids control inflammation: Quintiles Prize Lecture 2005. British Journal of Pharmacology, 148, 245–254. https://doi.org/10.1038/sj.bjp.0706736 Bayley-Veloso, R., & Salmon, P. G. (2016). Yoga in clinical practice. Mindfulness, 7, 308–319. https://doi.org/10.1007/s12671-015-0449-9 Black, D. S., & Slavich, G. M. (2016). Mindfulness meditation and the immune system: A systematic review of randomized controlled trials. Annals of the New York Academy of Sciences, 1373, 13–24. https://doi.org/10.1111/nyas.12998 Bower, J. E., Greendale, G., Crosswell, A. D., Garet, D., Sternlieb, B., Ganz, P. A., et al. (2014). Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial. Psychoneuroendocrinology, 43, 20–29. https://doi.org/10.1016/j.psyneuen.2014.01.019 Bower, J. E., & Irwin, M. R. (2016). Mind-body therapies and control of inflammatory biology: A descriptive review. Brain, Behavior, and Immunity, 51, 1–11. https://doi.org/10.1016/j.bbi.2015.06.012 Buric, I., Farias, M., Jong, J., Mee, C., & Brazil, I. A. (2017). What is the molecular signature of mind-body interventions? A systematic review of gene expression changes induced by meditation and related practices. Frontiers in Immunology, 8, 670. https://doi.org/10.3389/fimmu.2017.00670 Cade, W. T., Reeds, D. N., Mondy, K. E., Overton, E. T., Grassino, J., Tucker, S., et al. (2010). Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors. HIV Medicine, 11, 379–388. https://doi.org/10.1111/j.1468-1293.2009.00801.x Chen, N., Xia, X., Qin, L., Luo, L., Han, S., Wang, G., et al. (2016). Effects of 8-week Hatha yoga training on metabolic and inflammatory markers in healthy, female chinese subjects: A randomized clinical trial. BioMed Research International, 2016, 5387258. https://doi.org/10.1155/2016/5387258 Chen, P.-J., Yang, L., Chou, C.-C., Li, C.-C., Chang, Y.-C., & Liaw, J.-J. (2017). Effects of prenatal yoga on women’s stress and immune function across pregnancy: A randomized controlled trial. Complementary Therapies in Medicine, 31, 109–117. https://doi.org/10.1016/j.ctim.2017.03.003 Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. Del Vecchio, M., Bajetta, E., Canova, S., Lotze, M. T., Wesa, A., Parmiani, G., et al. (2007). Interleukin-12: Biological properties and clinical application. Clinical Cancer Research: An Official Journal of the American Association for Cancer Research, 13, 4677–4685. https://doi.org/10.1158/1078-0432.CCR-07-0776 Desikachar, K., Bragdon, L., & Bossart, C. (2005). The yoga of healing: Exploring yoga’s holistic model for health and well-being. International Journal of Yoga Therapy, 15, 17–39. Dinarello, C. A. (2011). Interleukin-1 in the pathogenesis and treatment of inflammatory diseases. Blood, 117, 3720–3732. https://doi.org/10.1182/blood-2010-07-273417 Feuerstein, G. (2011). The parth of yoga: An essential guide to its principles and practices. Boston: Shambala. Field, T. (2011). Yoga clinical research review. Complementary Therapies in Clinical Practice, 17, 1–8. https://doi.org/10.1016/j.ctcp.2010.09.007 Field, T. (2016). Yoga research review. Complementary Therapies in Clinical Practice, 24, 145–161. https://doi.org/10.1016/j.ctcp.2016.06.005 Gopal, A., Mondal, S., Gandhi, A., Arora, S., & Bhattacharjee, J. (2011). Effect of integrated yoga practices on immune responses in examination stress—A preliminary study. International Journal of Yoga, 4, 26–32. https://doi.org/10.4103/0973-6131.78178 Harkess, K. N., Ryan, J., Delfabbro, P. H., & Cohen-Woods, S. (2016). Preliminary indications of the effect of a brief yoga intervention on markers of inflammation and DNA methylation in chronically stressed women. Translational Psychiatry, 6, e965. https://doi.org/10.1038/tp.2016.234 Higgins, J. P. (2008). Cochrane handbook for systematic reviews of interventions. Cochrane book series. Chichester: Wiley. Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., et al. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical Research Edition), 343, d5928. https://doi.org/10.1136/bmj.d5928 Hunter, C. A., & Jones, S. A. (2015). IL-6 as a keystone cytokine in health and disease. Nature Immunology, 16, 448–457. https://doi.org/10.1038/ni.3153 Irwin, M. R. (2008). Human psychoneuroimmunology: 20 years of discovery. Brain, Behavior, and Immunity, 22, 129–139. https://doi.org/10.1016/j.bbi.2007.07.013 Kiecolt-Glaser, J. K., Bennett, J. M., Andridge, R., Peng, J., Shapiro, C. L., Malarkey, W. B., et al. (2014). Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: A randomized controlled trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 32, 1040–1049. https://doi.org/10.1200/jco.2013.51.8860 Kiecolt-Glaser, J. K., Christian, L., Preston, H., Houts, C. R., Malarkey, W. B., Emery, C. F., et al. (2010). Stress, inflammation, and yoga practice. Psychosomatic Medicine, 72, 113–121. https://doi.org/10.1097/PSY.0b013e3181cb9377 Krishna, B. H., Keerthi, G. S., Kumar, C. K., & Reddy, N. M. (2015). Association of leukocyte telomere length with oxidative stress in yoga practitioners. Journal of Clinical and Diagnostic Research: JCDR, 9, CC01–CC03. https://doi.org/10.7860/jcdr/2015/13076.5729 Kumar, S. B., Yadav, R., Yadav, R. K., Tolahunase, M., & Dada, R. (2015). Telomerase activity and cellular aging might be positively modified by a yoga-based lifestyle intervention. Journal of Alternative and Complementary Medicine (New York, NY), 21, 370–372. https://doi.org/10.1089/acm.2014.0298 Lawrence, T. (2009). The nuclear factor NF-kappaB pathway in inflammation. Cold Spring Harbor Perspectives in Biology, 1, a001651. https://doi.org/10.1101/cshperspect.a001651 Lim, S.-A., & Cheong, K.-J. (2015). Regular yoga practice improves antioxidant status, immune function, and stress hormone releases in young healthy people: A randomized, double-blind, controlled pilot study. Journal of Alternative and Complementary Medicine (New York, NY), 21, 530–538. https://doi.org/10.1089/acm.2014.0044 Lipsey, M. W., & Wilson, D. B. (2015). Practical meta-analysis (Vol. 49). Thousand Oaks: Sage. Long Parma, D., Hughes, D. C., Ghosh, S., Li, R., Treviño-Whitaker, R. A., Ogden, S. M., et al. (2015). Effects of six months of Yoga on inflammatory serum markers prognostic of recurrence risk in breast cancer survivors. SpringerPlus, 4, 143. https://doi.org/10.1186/s40064-015-0912-z McGough, J. J., & Faraone, S. V. (2009). Estimating the size of treatment effects: Moving beyond P values. Psychiatry (Edgmont), 6, 21–29. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791668/ Mezentsev, A., Merks, R. M. H., O’Riordan, E., Chen, J., Mendelev, N., Goligorsky, M. S., et al. (2005). Endothelial microparticles affect angiogenesis in vitro: Role of oxidative stress. American Journal of Physiology Heart and Circulatory Physiology, 289, H1106–H1114. https://doi.org/10.1152/ajpheart.00265.2005 Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6, e1000097. https://doi.org/10.1371/journal.pmed.1000097 Morgan, N., Irwin, M. R., Chung, M., & Wang, C. (2014). The effects of mind-body therapies on the immune system: Meta-analysis. PLoS ONE, 9, e100903. https://doi.org/10.1371/journal.pone.0100903 Naoroibam, R., Metri, K. G., Bhargav, H., Nagaratna, R., & Nagendra, H. R. (2016). Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study. International Journal of Yoga, 9, 57–61. https://doi.org/10.4103/0973-6131.171723 Pollard, K. M., Cauvi, D. M., Toomey, C. B., Morris, K. V., & Kono, D. H. (2013). Interferon-γ and Systemic Autoimmunity. Discovery medicine, 16(87), 123–131. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934799/ Popa, C., Netea, M. G., van Riel, P. L. C. M., van der Meer, J. W. M., & Stalenhoef, A. F. H. (2007). The role of TNF-alpha in chronic inflammatory conditions, intermediary metabolism, and cardiovascular risk. Journal of Lipid Research, 48, 751–762. https://doi.org/10.1194/jlr.R600021-JLR200 Pullen, P. R. (2009). The benefits of yoga therapy for heart failure patients. (Dissertation). Georgia State University, Georgia. Retrieved from http://scholarworks.gsu.edu/kin_health_diss/2 Pullen, P. R., Nagamia, S. H., Mehta, P. K., Thompson, W. R., Benardot, D., Hammoud, R., et al. (2008). Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure. Journal of Cardiac Failure, 14, 407–413. https://doi.org/10.1016/j.cardfail.2007.12.007 Pullen, P. R., Thompson, W. R., Benardot, D., Brandon, L. J., Mehta, P. K., Rifai, L., et al. (2010). Benefits of yoga for African American heart failure patients. Medicine and Science in Sports and Exercise, 42, 651–657. https://doi.org/10.1249/mss.0b013e3181bf24c4 Purdy, J. (2013). Chronic physical illness: A psychophysiological approach for chronic physical illness. The Yale Journal of Biology and Medicine, 86, 15–28. Qu, S., Olafsrud, S. M., Meza-Zepeda, L. A., & Saatcioglu, F. (2013). Rapid gene expression changes in peripheral blood lymphocytes upon practice of a comprehensive yoga program. PLoS ONE, 8, e61910. https://doi.org/10.1371/journal.pone.0061910 Rajbhoj, P. H., Shete, S. U., Verma, A., & Bhogal, R. S. (2015). Effect of yoga module on pro-inflammatory and anti-inflammatory cytokines in industrial workers of lonavla: A randomized controlled trial. Journal of Clinical and Diagnostic Research: JCDR, 9(2), CC01–CC05. https://doi.org/10.7860/jcdr/2015/11426.5551 Rao, R. M., Nagendra, H. R., Raghuram, N., Vinay, C., Chandrashekara, S., Gopinath, K. S., et al. (2008a). Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery. International Journal of Yoga, 1, 11–20. https://doi.org/10.4103/0973-6131.36789 Rao, R. M., Nagendra, H. R., Raghuram, N., Vinay, C., Chandrashekara, S., Gopinath, K. S., et al. (2008b). Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. International Journal of Yoga, 1, 33–41. https://doi.org/10.4103/0973-6131.36795 Riley, K. E., & Park, C. L. (2015). How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health Psychology Review, 9, 379–396. https://doi.org/10.1080/17437199.2014.981778 Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: A review of comparison studies. Journal of Alternative and Complementary Medicine, 16(1), 3–12. https://doi.org/10.1089/acm.2009.0044. Sauer-Zavala, S. E., Walsh, E. C., Eisenlohr-Moul, T. A., & Lykins, E. L. B. (2013). Comparing mindfulness-based intervention strategies: Differential effects of sitting meditation, body scan, and mindful yoga. Mindfulness, 4, 383–388. https://doi.org/10.1007/s12671-012-0139-9 Schoenborn, J. R., & Wilson, C. B. (2007). Regulation of Interferon-γ During Innate and Adaptive Immune Responses. Advances in Immunology, 96, 41–101. https://doi.org/10.1016/S0065-2776(07)96002-2 Sharma, P., Poojary, G., Dwivedi, S. N., & Deepak, K. K. (2015). Effect of yoga-based intervention in patients with inflammatory bowel disease. International Journal of Yoga Therapy, 25, 101–112. https://doi.org/10.17761/1531-2054-25.1.101 Shrivastava, A. K., Singh, H. V., Raizada, A., & Singh, S. K. (2015). C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal, 67, 89–97. https://doi.org/10.1016/j.ehj.2014.11.005 Slavich, G. M. (2015). Understanding inflammation, its regulation, and relevance for health: A top scientific and public priority. Brain, Behavior, and Immunity, 45, 13–14. https://doi.org/10.1016/j.bbi.2014.10.012 Steptoe, A., Hamer, M., & Chida, Y. (2007). The effects of acute psychological stress on circulating inflammatory factors in humans: A review and meta-analysis. Brain, Behavior, and Immunity, 21, 901–912. https://doi.org/10.1016/j.bbi.2007.03.011 Tolahunase, M., Sagar, R., & Dada, R. (2017). Impact of yoga and meditation on cellular aging in apparently healthy individuals: A prospective, open-label single-arm exploratory study. Oxidative Medicine and Cellular Longevity, 2017, 7928981. https://doi.org/10.1155/2017/7928981 Vijayaraghava, A., Doreswamy, V., Narasipur, O. S., Kunnavil, R., & Srinivasamurthy, N. (2015). Effect of yoga practice on levels of inflammatory markers after moderate and strenuous exercise. Journal of Clinical and Diagnostic Research: JCDR, 9, CC08–CC12. https://doi.org/10.7860/jcdr/2015/12851.6021 Vogler, J., O’Hara, L., Gregg, J., & Burnell, F. (2011). The impact of a short-term iyengar yoga program on the health and well-being of physically inactive older adults. International Journal of Yoga Therapy, 21, 61–72. Wan, X., Wang, W., Liu, J., & Tong, T. (2014). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology, 14, 135. https://doi.org/10.1186/1471-2288-14-135 Yadav, R. K., Magan, D., Mehta, N., Sharma, R., & Mahapatra, S. C. (2012). Efficacy of a short-term yoga-based lifestyle intervention in reducing stress and inflammation: Preliminary results. Journal of Alternative and Complementary Medicine, 18, 662–667. https://doi.org/10.1089/acm.2011.0265