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Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial
Open accessAbstract
Background Yoga is a popular mind-body therapy that has demonstrated beneficial effects on psychological, behavioral, and functional outcomes. However, few studies have investigated effects on inflammatory processes. This study tested the hypothesis that an Iyengar yoga intervention specifically designed for fatigued breast cancer survivors would lead to decreases in inflammation-related gene expression and circulating markers of proinflammatory cytokine activity.Methods Breast cancer survivors with persistent cancer-related fatigue were randomized to a 12-week Iyengar yoga intervention (n=16) or a 12-week health education control condition (n=15). Blood samples were collected at baseline, post-intervention, and at a 3-month follow-up for genome-wide transcriptional profiling and bioinformatic analyses. Plasma inflammatory markers and salivary cortisol were also assessed.Results In promoter-based bioinformatics analyses, the yoga group showed reduced activity of the pro-inflammatory transcription factor nuclear factor kappa B (NF-κB), increased activity of the anti-inflammatory glucocorticoid receptor, and reduced activity of cAMP response element-binding protein (CREB) family transcription factors relative to controls (all ps<.05). There was also a significant intervention effect on the soluble tumor necrosis factor receptor type II (sTNF-RII), a marker of TNF activity; plasma levels of sTNF-RII remained stable in the yoga group, whereas levels of this marker increased in the health education group (p=.028). A similar, non-significant trend was observed for the interleukin 1 receptor antagonist (p=.16). No significant changes in C reactive protein (CRP), interleukin 6 (IL-6), or diurnal cortisol measures were observed.Conclusions A 12-week restorative Iyengar yoga intervention reduced inflammation-related gene expression in breast cancer survivors with persistent fatigue. These findings suggest that a targeted yoga program may have beneficial effects on inflammatory activity in this patient population, with potential relevance for behavioral and physical health.
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“have been shown to be effective for improving sleep,27 peripheral muscular strength,28 and QOL,29 and for reducing fatigue,30 pain,31 nausea,32 and inflammatory signaling33 in cancer survivors”
From Individualized, Single Session Yoga Therapy to Reduce Physical and Emotional Symptoms in Hospitalized Hematological Cancer Patients. (2019) · cites this paper as [33]
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“The results provide support in favor of the positive effect of MBI on spirituality. 44,47,49,51,62”
From How do mindfulness-based interventions promote coping and self-efficacy in patients with cancer: A systematic review of qualitative and quantitative data (2024) · cites this paper as [44]
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“while behavioral interventions that reduce somatic symptoms like fatigue also appear to work by reducing inflammatory signaling (Bower et al., 2014)”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Bower et al., 2014
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InfluentialSelf-citationAggarwal, B. B., Vijayalekshmi, R. V., & Sung, B. (2009) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-08-0149 · Cited by 812
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Cited by
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Cancer-related fatigue—mechanisms, risk factors, and treatments
Bower, J. E. (2014) · Nature Reviews Clinical Oncology · doi:10.1038/nrclinonc.2014.127 · Cited by 1,666
Self-citationStress and Health: A Review of Psychobiological Processes
O'Connor, D. B., Thayer, J. F., & Vedhara, K. (2021) · Annual Review of Psychology · doi:10.1146/annurev-psych-062520-122331 · Cited by 948
Inflammation: Depression Fans the Flames and Feasts on the Heat
Kiecolt-Glaser, J. K., Derry, H. M., & Fagundes, C. P. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15020152 · Cited by 844
Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis.
Pascoe, M. C., Thompson, D. R., & Ski, C. F. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.08.008 · Cited by 570
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Metadata
- Authors
- Bower, J. E., Greendale, G., Crosswell, A. D., Garet, D., Sternlieb, B., Ganz, P. A., Irwin, M. R., Olmstead, R., Arevalo, J., & Cole, S. W.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Bower, Julienne E.
- ORCID
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 43
- Pages
- 20-29
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC4060606
- OpenAlex
- W2133441071
- Cited by
- 283
- References
- 51
- Citations by year
- 2026: 20 · 2025: 25 · 2024: 23 · 2023: 20 · 2022: 37 · 2021: 19 · 2020: 15 · 2019: 33 · 2018: 28 · 2017: 20 · 2016: 22 · 2015: 12 · 2014: 9
- FWCI
- 10.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5t32gm084903-03)
- National Institute on Aging (P30AG028748)
- National Cancer Institute (P30CA016042)
- National Institute of General Medical Sciences (T32-GM084903)
- National Center for Complementary and Alternative Medicine
- National Center for Complementary and Integrative Health (U01AT003682)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- Iyengar yoga, breast cancer survivors, cancer-related fatigue, inflammation, NF-κB, glucocorticoid receptor, interleukin-1 receptor antagonist, gene expression, inflammatory cytokines, salivary cortisol, mind-body interventions
- MeSH terms
- Breast Neoplasms, Fatigue, Female, Humans, Hydrocortisone, Inflammation, Middle Aged, Yoga, Signal Transduction, Cytokines, Survivors, Computational Biology, Gene Expression Profiling
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