Meditation practice may positively influence allergy, immunology symptoms

Key takeaways:

• Meditation has positive effects on immunity markers and cellular aging.
• The practice improved asthma and eczema symptoms.
• Meditation may also come with adverse effects.

BOSTON — Practicing meditation has significant clinical impacts on allergy and immunology, according to a presentation at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

Gary Soffer, MD, assistant professor in the department of pediatric pulmonology, allergy, immunology and sleep medicine and the department of integrative medicine, Smilow Cancer Center, Yale School of Medicine, explained that meditation is “really quite simple. It’s just consciously directing your attention to something specific.”

He said that for some people, that attention is focused on breath, and for others it can be focused on a mantra such as “Om,” or even a visual. It is all about bringing the wandering mind back to that point of attention and practicing, according to Soffer.

Soffer recounted a brief history of meditation, sharing that the earliest references come from Hindu scriptures in the fifth and sixth centuries.

“It was initially developed by Hindus to become closer to God, almost more of a prayer-like state than anything else,” he said. “Then Hinduism and Buddhism split, and Hinduism remained to be closer to God, while Buddhism really focused on interrelatedness. This is where our modern mindfulness, our modern meditation world, emerged from.”

Meditation and science

“There’s a scientific history here that I think is really important to go over because integrative medicine is all about lineage,” Soffer said.

He explained that the scientific history of meditation began in Boston with Herbert Benson, MD, at Harvard Medical School. Benson developed the religious relaxation response, which stemmed from Tibetan Buddhism meditation and mindfulness techniques.

From that, Jon Kabat-Zinn, PhD, of the University of Massachusetts Medical School, developed the Mindfulness Based Stress Reduction (MBSR) program. MBSR is a standardized 8-week program that is reproducible and has been used in meditation studies.

Soffer also highlighted the work of Francisco Varela, PhD, a neuroscientist who collaborated with the Dalai Lama and “created a whole scientific world through the Mind and Life Institute.”

Lastly, Soffer mentioned Richard J. Davidson, PhD, of the University of Wisconsin-Madison, who “studied the role of meditation on brain cognitive outcomes and the differences between what we call expert meditators like Buddhist monks, and their impact on their health and well-being.”

The role of stress on immunity

“We believe that stress and immunity are interrelated,” Soffer said. “We have these thoughts and we develop these stress hormones like cortisol and norepinephrine, and these in turn develop an immune response that can really impact our overall physiology.”

He further explained that when experiencing stress, we see increased pro-inflammatory cytokines. There is a decreased T-cell proliferation and function. B cells show altered immunoglobulin production and total numbers.

“Specific to innate immunity, stress reduces [natural killer (NK)] cell activity and macrophage function,” Soffer said. “In our allergy world, you see chronic stress leading to increased cytokines like IL-4, IL-5 and IL-13.”

Stress impacting allergy

“We see that increased chronic stress does lead to increased cortisol response and then leads to increased blood and sputum eosinophils,” Soffer said.

Soffer cited a study by that looked at stress and skin test responses and showed that stress increased histamine responses.

“I think about this a lot because I only see pediatrics for allergies,” he said. “I think about this when I’m deciding between 1 mm to 2 mm of whether I’m going to challenge a patient or not. Because how much are they crying, how much are they screaming and how much did that impact the test that I just did?”

Asthma hospitalizations are also associated with negative support in day-to-day life, mood disorders, negative rumination, family conflict and negative life events, Soffer noted.

“Even a recall of anxious and stressful experiences will decrease expiratory flow rates in children with chronic asthma with no preexisting psychopathology,” he said.

How does meditation impact immunity?

Soffer admitted that not a whole lot is known about meditation and immunity, but some studies show its effects.

The role of meditation can be seen on mediators and markers of immunity. Studies showed that meditation was associated with a decrease in tumor necrosis factor alpha and an increase in IL-8. Other studies showed a decrease in nuclear factor kappa B and IL-6, with the IL-6 result coming from a meta-analysis.

In terms of innate immunity, the role of meditation on inflammatory markers showed a decrease in CRP and NK cells enhanced in numbers, activity and function. Macrophages showed a balanced response.

T-cell activity is also shown to be affected by meditation. In a 2019 study by Bower et al, T-cell activity increased in patients who underwent cancer treatment while practicing meditation. Another study showed a reduction in pro-inflammatory T helper 17 cells in patients with chronic inflammatory conditions.

“This included patients with rheumatologic diseases and other things,” Soffer said. “Overall, you see enhanced T-cell activation.”

Another study included patients with HIV who practiced a mindfulness-based cognitive therapy over 8 weeks, which led to significantly improved and sustained T-cell responses.

“These interventions are small, they’re noninvasive, but they can have a really meaningful impact,” Soffer said.

Soffer also presented a study that looked at patients with ulcerative colitis who took the MBSR course and saw an increase in IL-10 cytokines and immune regulation. When looking at B cells and antibody changes, Soffer noted that one study showed no change in total B cell count but another showed an increase in globulin immediately after MBSR intervention.

Meditation also had an impact on cellular aging. Studies showed an increase in telomere length and activity.

“Meditation actually has a positive response on our immune aging,” Soffer said.

He referenced another study that looked at young breast cancer survivors who did a 6-week mindfulness awareness practice. Results showed a significant decrease in the expression of 19 pro-inflammatory genes associated with chronic stress and dose-dependent decreases in IL-6.

Interestingly, when looking at people who have meditated for over 10,000 hours in their life vs. non-meditators, there was a decreased expression of pro-inflammatory genes and changes in histone deacetylase leading to RIPK2 and COX2 expression, Soffer noted.

The clinical impacts of meditation

“I think we like very specific markers, but I think we all see patients who are suffering and if we can make them feel better in any meaningful way, we should,” Soffer said.

Meditation reduced patient stress, which, in turn, seemed to reduce the use of rescue medication for patients with asthma, according to a systematic review and meta-analysis by Paudyal et al. Another study showed a reduced level of exhaled nitric oxide.

Looking at meditation’s impact on eczema, Soffer highlighted a Cochrane review that said mindfulness, meditation and relaxation techniques appeared to show promise for reducing itch.

Mindfulness-based cognitive therapy also reduced caregiver burden and relieved anxiety and depression in caregivers of children with allergic rhinitis, Soffer noted.

Lastly, Soffer spoke about the impact of breath as a part of meditation. He mentioned how pranayama yoga breathing improved FEV₁, FEV₁ over FVC, asthma symptoms and quality of life.

“This is probably one of my favorite studies because it really embodies what integrative medicine is,” he said. “We’re integrating conventional care with traditional therapeutics.”

This study looked at a group of patients who used fluticasone and patients who used fluticasone and practiced alternate nostril breathing.

“All they did was switch breathing in through one nostril, breathe out through the other nostril,” Soffer said. “Not surprisingly, both patient groups did well. Fluticasone works, but fluticasone plus the alternate nostril breathing shows statistically significant improvement over fluticasone alone.”

Potential adverse effects of meditation

While concluding his presentation, Soffer noted, “I just want to point out that meditation is not a pedestal.”

“These things do have adverse effects and we want to be mindful of them,” he continued. “Patients can experience anxiety, depression, cognitive anomalies, even GI problems and sometimes even suicidal behaviors. So even though we’re recommending these interventions and they are generally very safe, we should be mindful that they are not without some degree of adverse impact.”

References:

• Paudyal P, et al. J Asthma. 2017;doi:10.1080/02770903.2017.1365887.
• Bower JE, et al. Cancer. 2015;doi:10.1002/cncr.29194.