The Effects of Cold Exposure Training and a Breathing Exercise on the Inflammatory Response in Humans: A Pilot Study
Zwaag J, Naaktgeboren R, van Herwaarden AE, Pickkers P, Kox M
Psychosomatic medicine · 27 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Mechanisms only
Who paid for it
- Funding
- Independent funding
- University or hospital
- Radboud Universiteit
- University or hospital
- Radboud Universitair Medisch Centrum
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2022-02-23 · Psychosom Med · vol. 84 · issue 4 · pp. 457–467
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 35 citations · more than 91% of similar papers · 2.8× the field average
- Impact
- Top 10% most cited in its field
- References
- 24 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Exercise and Physiological Responses · Thermoregulation and physiological responses · Heart Rate Variability and Autonomic Control
- Keywords
- Inflammatory response, Breathing, Breathing exercises, Inflammation, In vivo, Fight-or-flight response
- MeSH
- humans, epinephrine, lipopolysaccharides, cytokines, breathing exercises, pilot projects, male
5 authors
From NL
- Jelle ZwaagRadboud University Nijmegen; Radboud University Medical Center
- Rick NaaktgeborenRadboud University Nijmegen; Radboud University Medical Center
- Antonius E. van HerwaardenRadboud University Nijmegen; Radboud University Medical Center
- Peter PickkersRadboud University Nijmegen; Radboud University Medical Center
- Matthijs Kox · correspondingRadboud University Nijmegen; Radboud University Medical Center
Abstract
Objective
We previously showed that a training intervention comprising a combination of meditation, exposure to cold, and breathing exercises enables voluntary activation of the sympathetic nervous system, reflected by profoundly increased plasma epinephrine levels, and subsequent attenuation of the lipopolysaccharide (LPS)-induced inflammatory response. Several elements of the intervention may contribute to these effects, namely, two different breathing exercises (either with or without prolonged breath retention) and exposure to cold. We determined the contribution of these different elements to the observed effects.
Methods
Forty healthy male volunteers were randomized to either a short or an extensive training in both breathing exercises by either the creator of the training intervention or an independent trainer. The primary outcome was plasma epinephrine levels. In a subsequent study, 48 healthy male volunteers were randomized to cold exposure training, training in the established optimal breathing exercise, a combination of both, or no training. These 48 participants were subsequently intravenously challenged with 2 ng/kg LPS. The primary outcome was plasma cytokine levels.
Results
Both breathing exercises were associated with an increase in plasma epinephrine levels, which did not vary as a function of length of training or the trainer (F(4,152) = 0.53, p = .71, and F(4,152) = 0.92, p = .46, respectively). In the second study, the breathing exercise also resulted in increased plasma epinephrine levels. Cold exposure training alone did not relevantly modulate the LPS-induced inflammatory response (F(8,37) = 0.60, p = .77), whereas the breathing exercise led to significantly enhanced anti-inflammatory and attenuated proinflammatory cytokine levels (F(8,37) = 3.80, p = .002). Cold exposure training significantly enhanced the immunomodulatory effects of the breathing exercise (F(8,37) = 2.57, p = .02).
Conclusions
The combination of cold exposure training and a breathing exercise most potently attenuates the in vivo inflammatory response in healthy young males. Our study demonstrates that the immunomodulatory effects of the intervention can be reproduced in a standardized manner, thereby paving the way for clinical trials.Trial Registration:ClinicalTrials.gov identifiers: NCT02417155 and NCT03240497.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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