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Review
. 2024 Apr 3;16(4):e57541.
doi: 10.7759/cureus.57541. eCollection 2024 Apr.

Effectiveness of Yoga in Modulating Markers of Immunity and Inflammation: A Systematic Review and Meta-Analysis

Affiliations
Review

Effectiveness of Yoga in Modulating Markers of Immunity and Inflammation: A Systematic Review and Meta-Analysis

Biswamohan Mishra et al. Cureus. .

Abstract

Chronic inflammation is central to the pathogenesis of many chronic inflammatory conditions. This review aims to analyze whether the practice of yoga, or yogic meditation and breathing, has any effect on the levels of inflammatory cytokines and other inflammatory markers in patients with various chronic inflammatory diseases such as rheumatoid arthritis, neoplastic disorders, and asthma, as well as in healthy subjects, compared to usual care or sham interventions. A comprehensive search of databases (PubMed, CENTRAL, Embase, and CINAHL) was performed. Randomized controlled trials (RCTs) that evaluated the effects of yoga as an intervention on inflammatory markers were analyzed. A total of 26 studies were included. Only two studies had a low risk of bias (RoB); 24 other studies had a high RoB. Most studies (n=24) reported a favorable outcome with yoga, irrespective of the type of yoga used, the condition studied, and the duration of the intervention. The commonly reported inflammatory markers included IL-6 (n=17), tumor necrosis factor-alpha (TNF-a) (n=13), and C-reactive protein (CRP) (n=10). Most studies showed a significant reduction in inflammatory markers in the yoga group (YG) compared to the control group (CG). Few studies also showed significant improvement in markers of cellular immunity (interferon gamma (IFN-g), IL-10, and transforming growth factor-beta (TGF-b); n=2 each) and improved mucosal defense (IgA, IL-6, and IL-2; n=2 each). A meta-analysis of IL-6, TNF-a, and CRP showed yoga had a favorable effect on the levels of these markers, but it was not statistically significant. Current evidence suggests that yoga can be a complementary intervention for various chronic inflammatory conditions. However, the quality of the evidence is poor, along with considerable heterogeneity. In the future, investigators should describe the intervention better, with a uniform assortment of outcome measures and treatment conditions, to generate high-quality evidence.

Keywords: il-6; inflammatory cytokines; systemic inflammatory markers; tnf-alpha; yoga therapy; yogic breathing.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart depicting the identification, screening, and inclusion of studies for this systematic review
PRISMA: Preferred Reporting for Systematic Reviews and Meta-analyses
Figure 2
Figure 2. The types of outcomes reported in various studies
Figure 3
Figure 3. The types of population reported in various studies
Figure 4
Figure 4. The types of yoga specified as an intervention in the included studies
Figure 5
Figure 5. The types of interventions stated as controls in the included studies
Figure 6
Figure 6. Forest plot showing the effect of yoga on inflammatory markers IL-6 versus control interventions, standard medical therapy, or the usual daily routine
Figure 7
Figure 7. Forest plot showing the effect of yoga on inflammatory marker TNF-alpha versus control interventions, standard medical therapy, or usual daily routine.
Figure 8
Figure 8. Funnel plot and Egger’s regression test for publication bias
(a): Studies reporting IL-6; (b): Studies reporting TNF-a; (c): Studies reporting CRP TNF: Tumour necrosis factor, CRP: C-reactive protein
Figure 9
Figure 9. Forest plot showing the effect of yoga on inflammatory marker CRP versus control interventions, standard medical therapy, or usual daily routine
Figure 10
Figure 10. Traffic light plot made using the Cochrane RoB2 tool for RCTs included in this review
RoB: Risk of bias, RCTs: Randomized controlled trials
Figure 11
Figure 11. Summary plot of the Cochrane RoB2 tool assessment for RCTs included in this review
RoB: Risk of bias, RCTs: Randomized controlled trials

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Grants and funding

This study is supported by the Department of Science and Technology (DST), Science and Technology for Yoga and Meditation (SATYAM) (DST/SATYAM/COVID-19/2020/13).

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