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Mindfulness meditation and the immune system: a systematic review of randomized controlled trials
Open accessAbstract
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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“In non-pregnant adults, MT has been shown to alter the functioning of autonomic nervous and immune system pathways associated with hypertension.31,32”
From Prenatal Mindfulness Training and Interoceptive Awareness in Pregnant People at Risk for Hypertensive Disorders. (2024) · cites this paper as [32]
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“Additional evidence has also shown that MBIs may enhance personal well-being, perceptual sensitivity, processing speed, empathy, concentration, reaction time, motor skills, immune function, and performance outcomes. 40-45”
From Randomized Controlled Trials of Mindfulness and Acceptance-Based Interventions Over the Past Two Decades: A Bibliometric Analysis. (2021) · cites this paper as [45]
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“the effects of mindfulness practice on health appear similar in magnitude to the changes demonstrated by other conventional approaches for treating stress, pain, and illness, including the administration of psychoactive medications, psychotherapy, health education, and behaviour modification2,64.”
From Mindfulness-based online intervention increases well-being and decreases stress after Covid-19 lockdown (2022) · cites this paper as [2]
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“Concordantly, several randomized controlled trials targeting stress management have largely lead to improvement in the morbidity of inflammatory diseases (Black and Slavich, 2016; Pbert et al., 2012; Simpson et al., 2014).”
From Origin and function of stress-induced IL-6 in murine models (2020) · cites this paper as Black and Slavich, 2016
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“For the 2015–2016 CPE residents, the articles selected had a thematic focus on prayer (Balboni et al., 2011; Galek et al., 2009; Silton, Flannelly, Galek, & Fleenor, 2012) and mindfulness (Black & Slavich, 2016; Raab, 2014) in the context of health care chaplaincy.”
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“The strongest evidence concerns cardiovascular health (Scott-Sheldon et al., 2020), chronic pain (Hilton et al., 2017), and inflammatory and immunological markers (Black and Slavich, 2016; Heckenberg et al., 2018; Pascoe et al., 2017; Rosenkranz et al., 2013; Higgins et al., 2022).”
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“For example, mindfulness studies have used as placebo comparisons such disparate “controls” as education courses on stress management, dementia, and sleep hygiene; exercise; mind-body medicine courses; waiting lists; and usual care (Black and Slavich 2016).”
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“133 JOURNAL OF TRANSLATIONAL INTERNAL MEDICINE / JUL-SEP 2020 / VOL 8 |ISSUE 3 A metanalysis of 20 randomized controlled trials reported that mindfulness meditation is associated with reduced inflammation as shown by reduced CRP, improved CD4+ T-cell count, and increased telomerase activity.[21] Increased telomerase a…”
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Self-citationThe neurobiology of love and addiction: Central nervous system signaling and energy metabolism
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“Downregulation of these responses results in lower cortisol levels and decreased sympathetic nervous system activity, which further protects mitochondrial function and improves systemic metabolic efficiency (Black & Slavich, 2016).”
Cechnicki, A., Chrobak, A. A., Plencler, I., Stankiewicz, P., Kalisz, A., Błądziński, P., Kruk, D., Radoń, S., Szewczyk, B., Faron‐Górecka, A., et al. (2025) · Annals of General Psychiatry · doi:10.1186/s12991-025-00587-5 · Cited by 3
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Aliberti, S. M., Capunzo, M., & Funk, R. H. W. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26167887 · Cited by 5
“…trial involving 96 participants undergoing 12 weeks of mindfulness-based stress reduction (MBSR) reported a 17% increase in telomerase activity, maintenance of telomere length, a 25% rise in Lactobacillus abundance, and significant improvements in both physical and psychological well-being [86,87].”
Gonçalves, S. D. (2025) · Exploration of Medicine · doi:10.37349/emed.2025.1001355 · Cited by 4
Almeida, V., Ferreira, A. D. D., Veloso, A., Rocha, R., Leite, Â. M. T., & Teixeira, A. (2025) · Healthcare · doi:10.3390/healthcare13222947 · Cited by 3
Galluzzi, S., Solorzano, C. S., Marizzoni, M., Gatti, E., Gualco, C., Lanfredi, M., Rossi, R., Cattaneo, A., Frisoni, G. B., Crescentini, C., et al. (2025) · Mindfulness · doi:10.1007/s12671-025-02718-1 · Cited by 3
“…et al., 2021; Sezer et al., 2022; Young et al., 2018), the autonomic system (Geiger et al., 2023), endocrine secretion (Rogerson et al., 2024; Sanada et al., 2016), the immune system (Black & Slavich, 2016; Dunn & Dimolareva, 2022; Sanada et al., 2020), and gene expression (Buric et al., 2017).”
Gaignard, M., Stanić, J., Bodmer, A., Zaman, K., Sarivalasis, A., Labidi‐Galy, S. I., Jermann, F., Marco, M. D., Ljuslin, M., Ryser, S., et al. (2023) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000096 · Cited by 3
Bodhiprasiddhinand, P. (2024) · Religions · doi:10.3390/rel15040511 · Cited by 8
Kaliman, P., Álvarez‐López, M. J., Lehodey, A., Fernández, D., Chocat, A., Schlosser, M., Sayette, V. D. L., Vivien, D., Marchant, N. L., Chételat, G., et al. (2024) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2024.100398 · Cited by 6
“…interventions for the prevention or treatment of age-related diseases, including cognitive impairment and dementia, a growing body of scienti fi c research suggests that meditation-based interventions can have bene fi cial effects on psychological, neuroendocrine, and immune variables (18,19).”
Østergaard, H. D., Pallesen, K. J., Nielsen, M. N., Fjorback, L. O., Juul, L., & Winterdahl, M. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.12.011 · Cited by 3
MyndFood: a conversational agent for enhancing the cooking and eating experience
Parra, M. O., Favela, J., & Castro, L. A. (2025) · Frontiers in Computer Science · doi:10.3389/fcomp.2025.1566940 · Cited by 3
Herbert, M. S., & Afari, N. (2022) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197550076.013.10 · Cited by 3
Online mindfulness training in percutaneous coronary intervention: a randomized clinical trial
Liu, N., & Xie, W. (2022) · STEMedicine · doi:10.37175/stemedicine.v3i4.143 · Cited by 3
“143 7 pain, and improve patients’ immunity (25).”
Kundalini Yoga for Post-Treatment Lyme Disease: A Preliminary Randomized Study
Murray, L. A., Alexander, C., Bennett, C., Kuvaldina, M., Khalsa, G. S., & Fallon, B. A. (2022) · Healthcare · doi:10.3390/healthcare10071314 · Cited by 4
Karrasch, S., Hitzler, M., Gumpp, A. M., Karabatsiakis, A., & Kolassa, I. (2020) · Verhaltenstherapie · doi:10.1159/000505380 · Cited by 4
Mindfulness and Cardiometabolic Health During Pregnancy: An Integrative Review
Lindsay, K. L., Guo, Y., & Gyllenhammer, L. E. (2024) · Mindfulness · doi:10.1007/s12671-024-02337-2 · Cited by 2
“…on changes to the immune system, and all concluded there were reductions in proinflammatory processes, with evidence for cell-mediated immunity (Black & Slavich, 2016; Djalilova et al., 2019; Falkenberg et al., 2018; Moraes et al., 2018) and dose–response improvements (Black & Slavich, 2016;…”
InfluentialAlhawatmeh, H. N., Najadat, I. A., & Hweidi, I. M. (2024) · International Journal of Nursing Practice · doi:10.1111/ijn.13282 · Cited by 2
Understanding the Bidirectional Relationship between Alzheimer's and Depression
Pannu, A. S., & Goyal, R. K. (2024) · Current Psychiatry Research and Reviews · doi:10.2174/0126660822303361240903075653 · Cited by 4
Barrera, J. A., Straube, L. D., Huml, Z., Yielder, R., Zion, S. R., Evans, K. M., Louis, K., Moriarity, D. P., Gasteiger, C., Slavich, G. M., et al. (2025) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2025.07.011 · Cited by 2
“First, inflammation has been implicated in the pathophysiology of a wide variety of diseases, making the present findings both clinically relevant and consistent with prior work linking psychosocial interventions and inflammatory activity (e.g., Black and Slavich, 2016; Shields et al., 2020).”
Self-citationHabits of Mind: Mindful Awareness from a Habits Framework
Lipsett, M., Berkman, E. T., & Creswell, J. D. (2025) · Springer eBooks · doi:10.1007/978-3-031-91451-5_5 · Cited by 2
Ziyanok, S. (2025) · Doğu Karadeniz Sağlık Bilimleri Dergisi · doi:10.59312/ebshealth.1765591 · Cited by 2
Duller, S., Clarke, G. A., Herculano‐Houzel, S., von Känel, R., Kirsch, P., Landolt, H., Naschold, B., Reber, S. O., Schreiber, R., Walter, M., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1577689 · Cited by 7
Self-citationLin, H., Wang, H., Hou, R., Hao, Y., Yan, R., Sun, J., Meng, H., Gong, K., & Hu, S. (2025) · Results in Engineering · doi:10.1016/j.rineng.2025.107976 · Cited by 2
Garfin, D. R., Lee, C., Jovanović, B., Torres, A., & Nyamathi, A. (2025) · Mindfulness · doi:10.1007/s12671-025-02661-1 · Cited by 3
“…promise for reducing symptoms of PTSD (Khusid & Vythilingam, 2016; Polusny et al., 2015) and associated biological markers of the stress response (Black & Slavich, 2017; Bower et al., 2017) by lowering physiological arousal and improving attention and acceptance of the past and present (Lang et…”
Sundquist, K., Palmér, K., Memon, A. A., Sundquist, J., & Wang, X. (2020) · Mindfulness · doi:10.1007/s12671-020-01352-3 · Cited by 2
Bhardwaj, P., Pathania, N., Pathania, M., & Rathaur, V. K. (2021) · Journal of Primary Care Specialties · doi:10.4103/jopcs.jopcs_4_21 · Cited by 2
Владимировна, М. Е. (2021) · Vestnik of Minin University · doi:10.26795/2307-1281-2021-9-4-7 · Cited by 2
Integration of Motivational Interviewing with Mindfulness and Other Integrative Health Modalities
Stephens, J. J., & Gold, M. A. (2023) · doi:10.1093/med/9780197583876.003.0019 · Cited by 2
Mindfulness-Based Mobile Application for African American Caregivers
Carswell, S. B., Alexander, K., Gryczynski, J., Knowlton, A. R., Abatemarco, D. J., Horodyski, A. M., & Mitchell, M. M. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00366-7 · Cited by 2
“…from randomized controlled trials (RCTs) indicates that MBSR interventions can reduce stress and depressive symptoms and improve positive affect, physical health, and overall well-being (Black & Slavich, 2016; De Vibe et al., 2012; Duncan et al., 2012; Lengacher et al., 2009; Walsh et al., 2019).”
The Role and Mechanism of Meditation on Physical Health and Well-Being – a literature review
Rutkowska, M., Bieńko, M., Król, T., Toborek, M., Marchaj, M., Korta, K., Putra, A., Niedziela, N., & Margas, M. (2024) · Journal of Education Health and Sport · doi:10.12775/jehs.2024.73.51696 · Cited by 2
Epigenetic Regulation in Psychosomatics and Psychotherapy
Kroflin, K., & Zannas, A. S. (2024) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20230061 · Cited by 3
Keune, P. M., Meister, R., Keune, J., Springer, R., Oschmann, P., Hansen, S., Holmerová, I., & Auer, S. (2024) · Clinical Gerontologist · doi:10.1080/07317115.2024.2427268 · Cited by 2
“MBIs may foster adaptive regulation of glucocorticoids and inflammation (Gardi et al., 2022; Lindsay et al., 2021) as well as of serotonin (Stoffel et al., 2019), which may in turn counteract such detrimental effects (Black & Slavich, 2016; Young, 2011).”
Bavani, M., von Lieres, J. S., Sowndaram, C. S., & Prasad, R. (2024) · IEEE Global Humanitarian Technology Conference (GHTC) · doi:10.1109/ghtc62424.2024.10771539 · Cited by 2
“Various research studies have shown the effects of mindfulness meditation on the body, e.g., strengthening the immune system and reducing illness symptoms [25].”
How Meditation Promotes Well‐Being: Applying a Dual‐System Theory
Lehman, B. J., Fogel, C. A., & Wiederaenders, E. (2025) · Social and Personality Psychology Compass · doi:10.1111/spc3.70037 · Cited by 5
Secular Mindfulness-Based Interventions: Efficacy and Neurobiology
Schmidtman, E. A., Hurley, R. A., & Taber, K. H. (2017) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.17020034 · Cited by 2
Blasi, Z. D., & Rice, A. (2019) · Springer eBooks · doi:10.1007/978-3-030-20311-5_8 · Cited by 3
Mindfulness-Based Interventions in the Treatment of Physical Conditions
Goyal, M., & Rusch, H. L. (2020) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780198808640.013.34 · Cited by 2
Mindfulness and Health: The Nursing Science Bridge
Saban, K. L., & Janusek, L. W. (2020) · Western Journal of Nursing Research · doi:10.1177/0193945920973748 · Cited by 2
“Emerging work suggests mindfulness may buffer stress-related immune dysregulation, and promote a more healthy (i.e., resilient) immune profile (Black & Slavich, 2016).”
BackgroundBases biológicas del mindfulness y su aplicación en la práctica clínica
Gómez, S. M., Peñaloza, M., Rodríguez, N. B., & Alba, L. H. (2022) · Universitas Médica · doi:10.11144/javeriana.umed63-2.mind · Cited by 4
“Existe evidencia de que las terapias basadas en mindfulness inducen cambios biológicos positivos en los sistemas nervioso, cardiovascular, inmunológico y hormonal, lo cual explica el auge de este tipo de aproximaciones como terapias complementarias en el manejo de patologías relacionadas con los sistemas mencionados (…”
Background
Metadata
- Authors
- Black, D. S., & Slavich, G. M.
- Affiliations
- University of Southern California (US)
- University of California, Los Angeles (US)
- Corresponding author
- Black, David S.
- 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
- 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
- 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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