Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial.
BACKGROUND
Yoga is a popular mind-body therapy that has demonstrated beneficial effects on psychological, behavioral, and functional outcomes. However, few studies have investigated effects on inflammatory processes. This study tested the hypothesis that an Iyengar yoga intervention specifically designed for fatigued breast cancer survivors would lead to decreases in inflammation-related gene expression and circulating markers of proinflammatory cytokine activity.


METHODS
Breast cancer survivors with persistent cancer-related fatigue were randomized to a 12-week Iyengar yoga intervention (n=16) or a 12-week health education control condition (n=15). Blood samples were collected at baseline, post-intervention, and at a 3-month follow-up for genome-wide transcriptional profiling and bioinformatic analyses. Plasma inflammatory markers and salivary cortisol were also assessed.


RESULTS
In promoter-based bioinformatics analyses, the yoga group showed reduced activity of the pro-inflammatory transcription factor nuclear factor kappa B (NF-κB), increased activity of the anti-inflammatory glucocorticoid receptor, and reduced activity of cAMP response element-binding protein (CREB) family transcription factors relative to controls (all ps<.05). There was also a significant intervention effect on the soluble tumor necrosis factor receptor type II (sTNF-RII), a marker of TNF activity; plasma levels of sTNF-RII remained stable in the yoga group, whereas levels of this marker increased in the health education group (p=.028). A similar, non-significant trend was observed for the interleukin 1 receptor antagonist (p=.16). No significant changes in C reactive protein (CRP), interleukin 6 (IL-6), or diurnal cortisol measures were observed.


CONCLUSIONS
A 12-week restorative Iyengar yoga intervention reduced inflammation-related gene expression in breast cancer survivors with persistent fatigue. These findings suggest that a targeted yoga program may have beneficial effects on inflammatory activity in this patient population, with potential relevance for behavioral and physical health.
UCLA Department of Psychology, Los Angeles, CA, United States; UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, United States; Cousins Center for Psychoneuroimmunology, Semel Institute at UCLA, Los Angeles, CA, United States; Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, CA, United States. Electronic address: jbower@ucla.edu.
Julienne E
JE
Bower
UCLA Department of Geriatrics, Los Angeles, CA, United States.
Gail
G
Greendale
UCLA Department of Psychology, Los Angeles, CA, United States.
Alexandra D
AD
Crosswell
Cousins Center for Psychoneuroimmunology, Semel Institute at UCLA, Los Angeles, CA, United States.
Deborah
D
Garet
Pediatric Pain Program, Mattel Children's Hospital at UCLA, Los Angeles, CA, United States.
Beth
B
Sternlieb
Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, CA, United States; UCLA Schools of Medicine and Public Health, Los Angeles, CA, United States.
Patricia A
PA
Ganz
UCLA Department of Psychology, Los Angeles, CA, United States; UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, United States; Cousins Center for Psychoneuroimmunology, Semel Institute at UCLA, Los Angeles, CA, United States; Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, CA, United States.
Michael R
MR
Irwin
UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, United States; Cousins Center for Psychoneuroimmunology, Semel Institute at UCLA, Los Angeles, CA, United States.
Richard
R
Olmstead
UCLA Department of Medicine, Los Angeles, CA, United States.
Jesusa
J
Arevalo
Cousins Center for Psychoneuroimmunology, Semel Institute at UCLA, Los Angeles, CA, United States; UCLA Department of Medicine, Los Angeles, CA, United States.
Steve W
SW
Cole
D001943:Breast Neoplasms / Q000150:complications / Q000503:physiopathology*; D019295:Computational Biology; D016207:Cytokines / Q000097:blood; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007249:Inflammation / Q000503:physiopathology*; D008875:Middle Aged; D015398:Signal Transduction; D017741:Survivors; D015013:Yoga
D016207:Cytokines; D006854:Hydrocortisone
Cancer; Cortisol; Fatigue; Gene expression; Inflammation; Yoga