Crohn’s disease is a chronic inflammatory bowel disease in which immune cells are out of balance. Stress can exacerbate the symptoms and accelerate the course of the disease. A research team from the Faculty of Medicine at the University of Duisburg-Essen and the Bamberg Social Foundation recently showed that a multimodal programme of stress management and lifestyle changes can have a positive effect on the immune system. The extensive analyses of the immune cells for the study, which has now been published in ‘Inflammatory Bowel Diseases’, were carried out in Essen.

Essen, November, 18, 2024 It has long been known that stress has a negative impact on the immune system. Researchers from the Faculty of Medicine at the University of Duisburg-Essen and the Bamberg Social Foundation investigated a total of 37 patients over a period of nine months and published their findings at the beginning of the year, showing that the reverse is also true and that stress-reduction exercises have a positive effect on the quality of life of patients with Crohn’s disease. The improved quality of life was also accompanied by changes in the immune system. The research team has now presented exactly what these immunological changes look like in a new study. They focussed on two cell types in particular: regulatory T cells (Tregs), which slow down inflammation, and conventional CD4+ helper T cells, which tend to promote inflammation. As the migration of T cells plays an important role in the development of Crohn’s disease, two molecules were also investigated that help the immune cells to specifically enter the intestine: GPR15 and CCR9.

More activated T cells circulate in the blood of Crohn’s disease patients than in healthy people. This could be improved through lifestyle intervention. Those affected learnt various techniques for better stress management, which included movement elements, breathing exercises and relaxation techniques. This complex approach also showed success on an immunological level. ‘In particular, the number of regulatory T cells, the Tregs, was reduced to a healthy level,’ says Dr Alexandra Mekes-Adamczyk, first author of the study. Two molecules, the two ‘gut homing’ receptors GPR15 and CCR9, are greatly increased in patients with the disease. Their levels were also significantly reduced by the programme. ‘The improvement in the patients‘ quality of life correlated significantly with the changes in the immune cells and could indicate reduced inflammatory activity in the gut,’ explains Dr Mekes-Adamczyk. ‘We are confident that continuous application of such programmes could have long-term positive effects on the immune system and gut health and would therefore like to further investigate the exact mechanisms in the gut,’ the authors conclude.

‘Our results illustrate how important it is to incorporate stress management and lifestyle changes into the treatment of inflammatory bowel disease,’ says Prof Dr Jost Langhorst, who holds the Endowed Chair of Integrative Medicine and is Chief Physician at the Klinikum am Bruderwald in Bamberg with a focus on translational gastroenterology at the University of Duisburg-Essen. ‘The multimodal mind-body approaches in stress management are promising for positively influencing the immune system and improving the general well-being of Crohn’s disease patients.’

‘The elements of mind-body medicine can complement conventional therapies and personalised treatment approaches,’ say the authors. However, further research is needed to understand the exact mechanisms and optimise the use of these approaches in clinical practice.

Originalpublication:

(https://pubmed.ncbi.nlm.nih.gov/38350430/)Evaluation of a Multimodal Stress Management and Comprehensive Lifestyle Modification Program on Quality of Life and Gastrointestinal Symptoms in Patients with Crohn’s Disease: A Randomized Controlled Pilot Trial with 9-Month Follow-Up
(https://pubmed.ncbi.nlm.nih.gov/39102712/)Lifestyle Intervention Modulates the CD4+ T Cell Profile in the Blood of Crohn’s Disease Patients

Further Information:

(https://www.uni-due.de/med/meldung.php?id=1710)

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