Brain-immune axis regulation is responsive to cognitive behavioral therapy and mindfulness intervention: Observations from a randomized controlled trial in patients with Crohn's disease

Anna Nemirovsky, Karny Ilan, Livnat Lerner, Liel Cohen-Lavi, Doron Schwartz, Ganit Goren, Ruslan Sergienko, Dan Greenberg, Vered Slonim-Nevo, Orly Sarid, Michael Friger, Shirley Regev, Shmuel Odes, Tomer Hertz, Alon Monsonego

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background and aims: Crohn's disease (CD) is a chronic inflammatory bowel disease associated with psychological stress that is regulated primarily by the hypothalamus-pituitary-adrenal (HPA) axis. Here, we determined whether the psychological characteristics of CD patients associate with their inflammatory state, and whether a 3-month trial of cognitive-behavioral and mindfulness-based stress reduction (COBMINDEX) impacts their inflammatory process. Methods: Circulating inflammatory markers and a wide range of psychological parameters related to stress and well-being were measured in CD patients before and after COBMINDEX. Inflammatory markers in CD patients were also compared to age- and sex-matched healthy controls (HCs). Results: CD patients exhibited increased peripheral low-grade inflammation compared with HCs, demonstrated by interconnected inflammatory modules represented by IL-6, TNFα, IL-17, MCP-1 and IL-18. Notably, higher IL-18 levels correlated with higher score of stress and a lower score of wellbeing in CD patients. COBMINDEX was accompanied by changes in inflammatory markers that coincided with changes in cortisol: changes in serum levels of cortisol correlated positively with those of IL-10 and IFNα and negatively with those of MCP-1. Furthermore, inflammatory markers of CD patients at baseline predicted COBMINDEX efficacy, as higher levels of distinct cytokines and cortisol at baseline, correlated negatively with changes in disease activity (by Harvey-Bradshaw Index) and psychological distress (global severity index measure) following COBMINDEX. Conclusion: CD patients have a characteristic immunological profile that correlates with psychological stress, and disease severity. We suggest that COBMINDEX induces stress resilience in CD patients, which impacts their well-being, and their disease-associated inflammatory process.

Original languageEnglish
Article number100407
JournalBrain, Behavior, and Immunity - Health
Volume19
DOIs
StatePublished - 1 Feb 2022

Keywords

  • Crohn's disease
  • Cytokines
  • HPA axis
  • IBD
  • Mindfulness
  • Psychological intervention
  • Stress

ASJC Scopus subject areas

  • Nephrology

Fingerprint

Dive into the research topics of 'Brain-immune axis regulation is responsive to cognitive behavioral therapy and mindfulness intervention: Observations from a randomized controlled trial in patients with Crohn's disease'. Together they form a unique fingerprint.

Cite this