Inflammatory biomarker findings from a randomized controlled trial of heated yoga for depression

Maren B. Nyer , Simmie L. Foster , Samuel R. Petrie , Naoise Mac Giollabhui , Dylan A. Gould , M.C. Flux , Richard J. Norton , Megha Nagaswami , Alice Viotti , Grace A. Ding , Grace E. Cross , Defne Yucebas , Chloe Sorensen , Isabelle Abdallah , Juliana Peacock , Anika Dalvie , Aava Jahan , Lyanna R. Kessler , Lauren M. Sandal , Brandon M. Marquart , David Mischoulon
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Abstract

Background

Both heated and non-heated yoga have demonstrated antidepressant effects in randomized controlled trials (RCTs), with a greater number of studies evaluating non-heated yoga. Both heated and non-heated yoga may exert antidepressant effects in part by reducing inflammation. We report the first RCT evaluating the impact of heated yoga on inflammatory biomarkers in participants with moderate-to-severe depression.

Methods

Adults (N = 80) were randomized to either a heated yoga or a waitlist group. The heated yoga group attended at least two community heated yoga classes per week for 8 weeks. The waitlist group completed an initial 8-week waitlist period, followed by the same heated yoga intervention. Blood samples were collected at baseline, at 8 weeks, and after the waitlist group completed the heated yoga intervention. Serum levels of inflammatory biomarkers (IFNγ, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, and TNF-α) were measured. Linear mixed models were used to explore three aims: 1) changes in inflammatory biomarker levels between treatment groups at the primary 8-week endpoint; 2) changes in inflammatory biomarkers from baseline to study endpoint for those in the waitlist phase of the waitlist group and those in the yoga phase of the waitlist group; and 3) the interaction between baseline inflammatory biomarkers and change in depression severity after 8-weeks of heated yoga vs. waitlist control.

Results

Forty-five participants (n = 17 for the heated yoga group and n = 28 for the waitlist group) had inflammatory biomarker data available for analyses. Significant differences in inflammatory biomarker levels were not found between groups at the 8-week endpoint (Aim 1). Similarly, changes in inflammatory biomarkers from baseline to study endpoint did not differ for those in the waitlist phase of the waitlist group and those in the yoga phase of the waitlist group (Aim 2). Lastly, the interaction between baseline inflammatory biomarkers and change in depression severity after 8-weeks of heated yoga vs. waitlist control was not significant (Aim 3).

Conclusion

Heated yoga showed no significant reduction in inflammatory biomarker levels. Possible reasons include a small sample size, insufficient heated yoga dosage, timing of sampling, not targeting individuals with higher baseline inflammatory biomarker levels, or peripheral inflammatory biomarkers not influencing heated yoga’s antidepressant effects. Further research is needed to clarify the antidepressant mechanisms of heated yoga.
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加热瑜伽治疗抑郁症随机对照试验的炎症生物标志物研究结果
背景在随机对照试验(RCT)中,加热瑜伽和非加热瑜伽都显示出了抗抑郁效果,其中对非加热瑜伽进行评估的研究较多。加热瑜伽和非加热瑜伽都可能通过减少炎症来发挥抗抑郁作用。我们报告了第一项评估加热瑜伽对中重度抑郁症患者炎症生物标志物影响的 RCT 研究。加热瑜伽组每周至少参加两次社区加热瑜伽课程,为期 8 周。候补组先进行为期 8 周的候补,然后进行同样的加热瑜伽干预。分别在基线期、8 周时和候补名单组完成加热瑜伽干预后采集血液样本。测量血清中炎症生物标志物(IFNγ、IL-1α、IL-1β、IL-2、IL-4、IL-6、IL-8、IL-10、IL-12p70 和 TNF-α)的水平。线性混合模型用于探讨三个目标:1)在 8 周的主要终点时,治疗组之间炎症生物标志物水平的变化;2)从基线到研究终点,候补治疗组中候补治疗阶段的炎症生物标志物和瑜伽治疗组中瑜伽治疗阶段的炎症生物标志物的变化;3)8 周加热瑜伽与候补治疗对照后,基线炎症生物标志物与抑郁严重程度变化之间的交互作用。结果45 名参与者(加热瑜伽组 17 人,候补组 28 人)的炎症生物标志物数据可供分析。在为期 8 周的终点(目标 1),各组之间的炎症生物标志物水平未发现明显差异。同样,从基线到研究终点的炎症生物标志物变化在候选组的候选者和瑜伽组的候选者中也没有差异(目标 2)。最后,基线炎症生物标志物与加热瑜伽 8 周后抑郁严重程度的变化之间的交互作用与等待对照组之间的交互作用不显著(目标 3)。可能的原因包括样本量小、加热瑜伽剂量不足、取样时间、未针对基线炎症生物标志物水平较高的个体,或外周炎症生物标志物未影响加热瑜伽的抗抑郁效果。还需要进一步的研究来阐明加热瑜伽的抗抑郁机制。
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