Written by Joyce Smith, BS. Study suggests that yoga, by targeting mind-body connections, may positively modify the pathobiology of autoimmunity at cellular and molecular levels.
Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease that results from the interplay of genetic and environmental factors. It causes extensive systemic inflammation, cartilage damage, and synovial hyperplasia that can lead to physical disability and psychiatric comorbidity 1. The co-existence of depression and RA in individuals poses a significant healthcare burden on the patients, their caregivers, healthcare systems, and society as a whole 2. Existing medical therapies are limited in scope and fail to adequately deal with the psychological component of this disease and furthermore, have many side effects. In addition, the inability of patients to comply with and adhere to medical treatment is often compounded by depression, resulting in worse health outcomes 3 and increased disease severity 4.
The objective of this mind-body intervention (MBI) study 5 was to explore the role of yoga-based MBI as an effective intervention to complement RA management with respect to clinical symptoms, quality of life, psychosocial outcomes, and functional ability and more specifically to quantify the effect of yoga on systemic biomarkers of inflammation, cellular aging, and oxidative stress in rheumatoid arthritic patients. The randomized controlled study of 72 RA patients consisted of a yoga group that practiced 120 minutes of yoga five days per week for 8 weeks and a control (no yoga) group. Both groups of RA patients maintained their routine disease modifying anti-rheumatic drug therapy through the eight-week period.
A disease activity score, pre and post intervention blood samples to measure systemic biomarkers, erythrocyte sedimentation rate (DAS28ESR) and the health assessment questionnaire disability index (HAQ-DI) were used to help assess disease activity and functional status at pre and post intervention time points. The Beck Depression Inventory II scale (BDI-II) assessed depression severity at 2-weekly intervals over the 8-week period.
Following the intensive yoga-based MBI, researchers found significant improvements in systemic biomarkers of neuroplasticity, inflammation, immune-modulation, cellular health integrity, and aging. They also saw a positive clinical outcome of reduction in depression severity, disease activity, and disability quotient in the RA patients.
- A significant reduction in various systemic inflammatory marker levels as well as (DAS28ESR) (p-value <0.0001; effect size = 0.210) and HAQ-DI (p-value 0.001; effect size = 0.159).
- Also, the yoga group experienced a statistically significant time dependent step-wise decline in depression symptoms over the 8-week period compared to control group (p-value <0.0001; effect size = 0.5).
- Compared to the control group, the yoga group had a greater reduction in the BDI-II scores, DAS28ESR (R2 = 0.426; p < 0.0001) and HAQ-DI(R2 = 0.236; p = 0.003) based on regression analysis.
These results suggest that yoga facilitates the mind’s capacity to affect bodily function and symptoms that are mediated through a variety of downstream pathways to support a natural immunological tolerance. Thus, in severe autoimmune inflammatory arthritis with a major psychosomatic component, yoga may provide a complementary/adjunct therapy.
Source: Gautam, Surabhi, Madhuri Tolahunase, Uma Kumar, and Rima Dada. “Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active Rheumatoid arthritis patients: A randomized controlled trial.” Restorative neurology and neuroscience 37, no. 1 (2019): 41-59.
© 2019 – IOS Press and the authors.
Posted March 23, 2020.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. New England Journal of Medicine. 2011;365(23):2205-2219.
- Sambamoorthi U, Shah D, Zhao X. Healthcare burden of depression in adults with arthritis. Expert review of pharmacoeconomics & outcomes research. 2017;17(1):53-65.
- Margaretten M, Barton J, Julian L, et al. Socioeconomic determinants of disability and depression in patients with rheumatoid arthritis. Arthritis care & research. 2011;63(2):240-246.
- Margaretten M, Julian L, Katz P, Yelin E. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. International journal of clinical rheumatology. 2011;6(6):617.
- Gautam S, Tolahunase M, Kumar U, Dada R. Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active Rheumatoid arthritis patients: A randomized controlled trial. Restorative neurology and neuroscience. 2019;37(1):41-59.
