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PLoS One. 2015 Apr 30;10(4):e0123861. doi: 10.1371/journal.pone.0123861. eCollection 2015.

Genomic and clinical effects associated with a relaxation response mind-body intervention in patients with irritable bowel syndrome and inflammatory bowel disease.

Author information

1
Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
2
Division of Interdisciplinary Medicine & Biotechnology, and Genomics, Proteomics, Bioinformatics and Systems Biology Center, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America; Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
3
Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
4
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
5
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America; Center for Healthcare Organization and Implementation Research (CHOIR), Bedford VA Medical Center, Bedford, Massachusetts, United States of America.
6
MGH Biostatistics Center, Massachusetts General Hospital, Boston, MA, and Harvard Medical School, Boston, Massachusetts, United States of America.
7
Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America; Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
8
Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
9
Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, United States of America; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.

Abstract

INTRODUCTION:

Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs) on IBS and IBD patients has not previously been examined.

METHODS:

Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI), focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and inflammatory markers were assessed pre- and post-intervention, and at short-term follow-up. Peripheral blood transcriptome analysis was performed to identify genomic correlates of the RR-MBI.

RESULTS:

Pain Catastrophizing Scale scores improved significantly post-intervention for IBD and at short-term follow-up for IBS and IBD. Trait Anxiety scores, IBS Quality of Life, IBS Symptom Severity Index, and IBD Questionnaire scores improved significantly post-intervention and at short-term follow-up for IBS and IBD, respectively. RR-MBI altered expression of more genes in IBD (1059 genes) than in IBS (119 genes). In IBD, reduced expression of RR-MBI response genes was most significantly linked to inflammatory response, cell growth, proliferation, and oxidative stress-related pathways. In IBS, cell cycle regulation and DNA damage related gene sets were significantly upregulated after RR-MBI. Interactive network analysis of RR-affected pathways identified TNF, AKT and NF-κB as top focus molecules in IBS, while in IBD kinases (e.g. MAPK, P38 MAPK), inflammation (e.g. VEGF-C, NF-κB) and cell cycle and proliferation (e.g. UBC, APP) related genes emerged as top focus molecules.

CONCLUSIONS:

In this uncontrolled pilot study, participation in an RR-MBI was associated with improvements in disease-specific measures, trait anxiety, and pain catastrophizing in IBS and IBD patients. Moreover, observed gene expression changes suggest that NF-κB is a target focus molecule in both IBS and IBD-and that its regulation may contribute to counteracting the harmful effects of stress in both diseases. Larger, controlled studies are needed to confirm this preliminary finding.

TRIAL REGISTRATION:

ClinicalTrials.Gov NCT02136745.

PMID:
25927528
PMCID:
PMC4415769
DOI:
10.1371/journal.pone.0123861
[Indexed for MEDLINE]
Free PMC Article

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