Cited by 599Mindfulness and Compassion InterventionsBiofield Effects and BiophysicsStress Responses and Cortisol

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Mindfulness meditation and the immune system: a systematic review of randomized controlled trials

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Black, David S., Slavich, George M.·2016·Annals of the New York Academy of Sciences

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Abstract

Mindfulness meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Recently, there has been a surge of interest in how mindfulness meditation improves human health and well‐being. Although studies have shown that mindfulness meditation can improve self‐reported measures of disease symptomatology, the effect that mindfulness meditation has on biological mechanisms underlying human aging and disease is less clear. To address this issue, we conducted the first comprehensive review of randomized controlled trials examining the effects of mindfulness meditation on immune system parameters, with a specific focus on five outcomes: (1) circulating and stimulated inflammatory proteins, (2) cellular transcription factors and gene expression, (3) immune cell count, (4) immune cell aging, and (5) antibody response. This analysis revealed substantial heterogeneity across studies with respect to patient population, study design, and assay procedures. The findings suggest possible effects of mindfulness meditation on specific markers of inflammation, cell‐mediated immunity, and biological aging, but these results are tentative and require further replication. On the basis of this analysis, we describe the limitations of existing work and suggest possible avenues for future research. Mindfulness meditation may be salutogenic for immune system dynamics, but additional work is needed to examine these effects.

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Ferretti, F., Pozza, A., Bossini, L., Matto, L. D., Desantis, S., Olivola, M., Gualtieri, G., Coluccia, A., & Fagiolini, A. (2019) · Journal of Neuroscience Research · doi:10.1002/jnr.24373 · Cited by 9
“…such as Mindfulness–Based Stress Reduction or Eye Movement Desensitization Reprocessing (EMDR), which were found to pro‐ duce significant benefits for a variety of physiological functions, including the cardiovascular and immune system (Black & Slavich, 2016; Loucks et al., 2015; Shapiro, 2014).”
Background
Holistic Approach during a Pandemic for Healthy Well-Being
Rawat, D., Gulati, A., Singh, N., Vikram, N. K., Kumar, A., & Sharma, A. (2020) · The Indian Journal of Nutrition and Dietetics · doi:10.21048/ijnd.2020.57.3.25459 · Cited by 9
Maternal mindfulness during pregnancy predicts newborn neurobehavior
Ostlund, B. D., Olavson, K., Brown, M. A., Shakiba, N., Saenz, C., Crowell, S. E., & Conradt, E. D. (2021) · Developmental Psychobiology · doi:10.1002/dev.22131 · Cited by 9
“In fact, emerging evidence has shown that mindfulness may protect vulnerable individuals from immune dysregulation (Black & Slavich, 2016).”
Background
Impairment of T cells' antiviral and anti-inflammation immunities may be critical to death from COVID-19
Zhang, L., Li, R., Song, G., Scholes, G. D., & She, Z.-S. (2021) · Royal Society Open Science · doi:10.1098/rsos.211606 · Cited by 8
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Titanji, B. K., Tejani, M., Farber, E. W., Mehta, C. C., Pace, T. W., Meagley, K., Gavegnano, C., Harrison, T., Kokubun, C. W., Negi, S. D., et al. (2021) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002874 · Cited by 9
Cross-Fertilizing Qualitative Perspectives on Effects of a Mindfulness-Based Intervention: An Empirical Comparison of Four Methodical Approaches
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Trait mindfulness and sleep: Interactions between observing and nonreactivity in the association with sleep health
Xie, E. B., Sedov, I. D., Sanguino, H., Freeman, M., Kumari, J., & Tomfohr-Madsen, L. (2023) · Health Psychology Open · doi:10.1177/20551029221149282 · Cited by 8
“For instance, mindfulness-based interventions (MBIs) have been shown to reduce psychological distress and improve a variety of physiological measures including aspects of immune system activity and longer telomere lengths (Black and Slavich, 2016; Goldberg et al., 2018; Hofmann et al., 2010; Schutte et al., 2020).”
Background
Eight‐month intensive meditation‐based intervention improves refractory hallucinations and delusions and quality of life in male inpatients with schizophrenia: a randomized controlled trial
Xue, T., Sheng, J., Gao, H., Gu, Y., Dai, J., Yang, X., Peng, H., Gao, H., Lu, R., Shen, Y., et al. (2024) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13641 · Cited by 11
“88 In summary, the regulation of hallucinations and delusions in SZ through meditation may involve a complex process, and further studies should con ﬁ rm these possible mechanisms.”
Background
Effectiveness of meditation for fatigue management: Insight from a comprehensive systematic review and meta-analysis
Park, B., Choi, Y., Lee, J., Ahn, Y., Lee, E. J., & Son, C. (2024) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2024.08.001 · Cited by 8
Dynamic human gut microbiome and immune shifts during an immersive psychosocial intervention program
Zhou, X., Ganz, A. B., Rayner, A., Cheng, T. Y., Oba, H., Rolnik, B. M., Lancaster, S. M., Lu, X., Li, Y., Johnson, J. S., et al. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.12.027 · Cited by 11
“Importantly, psychosocial interventions have emerged as effective in bolstering immune function, presenting a viable alternative to traditional antide-pressants in managing depression-associated inflammation (Black and Slavich, 2016; Chandran et al., 2021; Shields et al., 2020).”
Self-citation
The impact of mindfulness meditation on pro-inflammatory biomarkers in patients with end-stage renal disease: A randomized trial
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Harmonizing the inner orchestra: the impact of urbanization and evolution of stress, inflammation, diet, and lifestyles in depression
Su, K. (2024) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000986 · Cited by 9
“Papers of particular interest, published within the annual period of review, have been highlighted as:”
Evaluating the Meditation Practices and Barriers to Adopting Mindful Medicine Among Physicians
Champagne‐Langabeer, T., Ratcliff, C. G., Bakos‐Block, C., Vega, F. R., Cárdenas-Turanzas, M., Malik, A., & Korupolu, R. (2025) · American Journal of Lifestyle Medicine · doi:10.1177/15598276251323850 · Cited by 9
“6 7-9 The Agency for Healthcare Research and Quality (AHRQ) conducted a comparative effectiveness review in 2014, ﬁ nding moderate strength of the evidence supporting the ef ﬁ cacy and safety of MM among patients with stress-related outcomes such as anxiety and depression compared with active…”
Analysis of the relationship between thermal comfort and salivary IgE in healthy adults under abrupt temperature
Li, T., Sun, J., Hu, S., Zhang, X., Li, S., & He, M. (2021) · Building and Environment · doi:10.1016/j.buildenv.2021.108454 · Cited by 8
Stress, mindfulness, and systemic lupus erythematosus: An overview and directions for future research
Molina, E., Gould, N. F., Lee, K., Krimins, R. A., Hardenbergh, D., & Timlin, H. (2022) · Lupus · doi:10.1177/09612033221122980 · Cited by 8
“A recently published systematic review comparing over 1600 individuals in 20 randomized control trials concluded that MBIs may modulate inflammation, cell-mediated immunity, antibody production, and gene expression.(29) Mindfulness-based stress reduction (MBSR) and mindfulnessbased cognitive therapy (MBCT) are two of…”
Background
Algorithm-Based Modular Psychotherapy Alleviates Brain Inflammation in Generalized Anxiety Disorder
Kéri, S., Kancsev, A., & Kelemen, O. (2024) · Life · doi:10.3390/life14070887 · Cited by 8
“For example, mindfulness-based interventions reduce the levels of pro-inflammatory cytokines and improve immune function [50].”
Background
Influence of Spirituality on Depression-Induced Inflammation and Executive Functioning in a Community Sample of African Americans
Herren, O. M., Burris, S. E., Levy, S.-A. T., Kirk, K., Banks, K. S., Jones, V. L., Beard, B., Mwendwa, D. T., Callender, C. O., & Campbell, A. L. (2019) · Ethnicity & Disease · doi:10.18865/ed.29.2.267 · Cited by 9
Trait Mindfulness Moderates Reactivity to Social Stress in an All-Male Sample
Lin, J., Massar, S. A. A., & Lim, J. (2020) · Mindfulness · doi:10.1007/s12671-020-01422-6 · Cited by 9
Investigating the impact of distinct contemplative mental trainings on daily life stress, thoughts and affect—Evidence from a nine-month longitudinal ecological momentary assessment study
Linz, R., Puhlmann, L. M. C., Engert, V., & Singer, T. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105800 · Cited by 8
The Impact of Mindfulness on Functional Brain Connectivity and Peripheral Inflammation in Breast Cancer Survivors with Cognitive Complaints
Melis, M., Schroyen, G., Blommaert, J., Leenaerts, N., Smeets, A., der Gucht, K. V., Sunaert, S. G., & Deprez, S. (2023) · Cancers · doi:10.3390/cancers15143632 · Cited by 9
“However, the evidence for alterations in peripheral cytokine levels after MBIs remains mixed [39,40].”
Background
The stress-immune system axis: Exploring the interplay between stress and immunity
Raza, M. L. (2025) · Progress in brain research · doi:10.1016/bs.pbr.2025.01.003 · Cited by 8
Tai Chi and Its Impact on Immune Mechanisms: A Comprehensive Review
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Pain and the immune system
Hodges, P. W., Fiore, N. T., Watkins, L. R., Klyne, D. M., Coppieters, M. W., & Grace, P. M. (2026) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2025.103484 · Cited by 9
Vital role for primary healthcare providers: urgent need to educate the community about daily nutritional self-care to support immune function and maintain health
Calder, P. C., Bach-Faig, A., Bevacqua, T., López, C. G. C., Chen, Z., Connolly, D., Koay, W. L., Meydani, S. N., Pinar, A.-S., Filho, D. R., et al. (2023) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2023-000755 · Cited by 7
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“Mindfulness meditation may also regulate immune responses and reduce pro-inflammatory cytokine production [58,59].”
Systematic review of the efficacy of yoga and mindfulness in the management of pediatric obesity
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“29 The practice of yoga in adults has been associated with mainly non-seriousmusculoskeletaladverseevents.”
Music Therapy Decreases Sadness and Increases Happiness in Alzheimer Patients: A Pilot Study
Ortí, J. E. D. L. R., García-Pardo, M. P., Benllochi, M., Drehmer, E., Platero, J. L., Salazar, A., Sancho, D., & Rodriguez, M. M. L. (2019) · Neuropsychiatry · doi:10.4172/neuropsychiatry.1000546 · Cited by 8
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Mindfulness Practice for Glycemic Control: Could it be a New Strategy for an Old Problem? A Systematic Review and Meta-Analysis
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Viral Respiratory Infections: An Ounce of Prevention Is Worth a Pound of Cure
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“Although the results were tentative, this area of focus might be worthy of further investigation.(34)”
The ratio of morning cortisol to CRP prospectively predicts first-onset depression in at-risk adolescents
Landau, E. R., Raniti, M. B., Blake, M. J., Waloszek, J. M., Blake, L. M., Simmons, J. G., Schwartz, O., Murray, G., Trinder, J. C., Allen, N. B., et al. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114098 · Cited by 9
Personalized Mind–Body Medicine in Integrative Oncology: Meeting the Moment with Each Patient
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Mindfulness-Based Group Medical Visits in Primary Care for Stress and Anxiety: An Observational Study
Juarez-Reyes, M., Purington, N., & Kling, S. M. R. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2021.0329 · Cited by 7
“11,16 MBIs were introduced into medical settings in the form of Mindfulness Based Stress Reduction (MBSR) for medical patients with chronic pain.”
Utilization of Mind–Body Intervention for Integrative Health Care of COVID-19 Patients and Survivors
Yang, H., Setou, N., & Koh, E. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116618 · Cited by 7
“MBI has also been studied for its effects on immune function; inflammation, and cell-mediated immunity [17,45].”
Background
Self-care and lifestyle interventions of complementary and integrative medicine during the COVID-19 pandemic—A cross-sectional study
Jeitler, M., Erehman, A., Koppold, D. A., Ortiz, M., Jerzynski, L., Stöckigt, B., Rotter, G., Blakeslee, S., Brinkhaus, B., Michalsen, A., et al. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2022.1033181 · Cited by 7
Quadrato motor training (QMT) influences IL-1β expression and creativity: Implications for inflammatory state reduction and cognitive enhancement
Verdone, L., Marson, F., Caserta, M., Zampieri, M., Reale, A., Bacalini, M. G., Vetriani, V., Ben‐Soussan, T. D., & Venditti, S. (2023) · Progress in brain research · doi:10.1016/bs.pbr.2022.12.008 · Cited by 7
A Pragmatic Introduction of Mindfulness in a Continuing Education Setting: Exploring Personal Experience, Bridging to Professional Practice
Klatt, M. D., Weinhold, K. R., Taylor, C. A., Zuber, K., & Sieck, C. J. (2017) · EXPLORE · doi:10.1016/j.explore.2017.06.003 · Cited by 7
Dynamic Effects of CAM Techniques on Inflammation and Emotional States: An Integrative Single-Case Study on a Breast Cancer Survivor
Schubert, C., Ott, M., Hannemann, J., Singer, M., Bliem, H., Fritzsche, K., Burbaum, C., Chamson, E., & Fuchs, D. (2021) · Integrative Cancer Therapies · doi:10.1177/1534735420977697 · Cited by 7
“16, 34, 52, 54, 55), physiotherapy 3 times (9, 22, 50), Tai Chi twice (12-hour units 9 and 37) and energy healing 6 times (17, 18, 19, 20, 21, 40) (Figure 1).”
Method
Mindfulness as practice: A network analysis of FMI data
Smith, J. H., Kempton, H. M., Williams, M. N., & van Ommen, C. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12400 · Cited by 7
Psychoneuroimmunological approach to gastrointestinal related pain
Toljan, K., & Vrooman, B. (2017) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2017.10.010 · Cited by 7
Mindfulness-Based Cognitive Therapy Experiences in Youth With Inflammatory Bowel Disease and Depression: Protocol for a Mixed Methods Qualitative Study
Ewais, T., Begun, J., Kenny, M., Headey, A., & Kisely, S. (2019) · JMIR Research Protocols · doi:10.2196/14432 · Cited by 5
“Mindfulness-based interventions have been increasingly trialed in IBD patients because of their potential to treat both depression and IBD [10,11], as well as attenuating immune system abnormalities, thereby improving the course of IBD [12,13].”
Background

Authors: Black, D. S., & Slavich, G. M.
Affiliations: University of Southern California (US)
University of California, Los Angeles (US)
Corresponding author: Black, David S.
ORCID: Black, David S.
Slavich, George M.
Venue: Annals of the New York Academy of Sciences
Publisher: Wiley
Published: 2016-01-21
Volume: 1373
Issue: 1
Pages: 13-24
ISSN: 0077-8923 (ISSN-L)
1749-6632
DOI: 10.1111/nyas.12998
PMC: PMC4940234
OpenAlex: W2293546053
Cited by: 599
References: 75
Citations by year: 2026: 61 · 2025: 84 · 2024: 69 · 2023: 66 · 2022: 58 · 2021: 72 · 2020: 74 · 2019: 50 · 2018: 24 · 2017: 25 · 2016: 15
FWCI: 5.63
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Annals of the New York Academy of Sciences (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Biodemography and Population Health (P30 AG017265)
National Institute of Mental Health (K08 MH103443)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Complementary and alternative medicine › Biofield Effects and Biophysics
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords: mindfulness meditation, immune system, inflammation, inflammatory proteins, cell-mediated immunity, antibody response, gene expression, transcription factors, biological aging, salutogenesis
MeSH terms: Awareness, Humans, Immune System, Immunity, Cellular, Stress, Psychological, Randomized Controlled Trials as Topic, Meditation, Mindfulness

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Mindfulness meditation and the immune system: a systematic review of randomized controlled trials

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