Alexandra Mekes-Adamczyk, Nadine Gausmann, Özlem Öznur, Katrin Pfuhlmann, Jan Dziobaka, Jan Buer, Jost Langhorst, Astrid M Westendorf
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引用次数: 0
Abstract
Background: Crohn's disease (CD) significantly affects patients' well-being and is influenced by stress and lifestyle factors, highlighting the importance of improving quality of life in CD management. An imbalance between pro- and anti-inflammatory CD4+ T cell responses is a key factor in CD, and stress has been shown to alter the function of CD4+ T cells. Therefore, this study aimed to evaluate the effect of a mind-body medicine stress management and lifestyle modification (MBM) program on the CD4+ T cell profile in CD patients.
Methods: Circulating CD4+ T cells from CD patients were analyzed by flow cytometry following the MBM program. Patients were randomly assigned to either a guided intervention group (IG) or a self-guided waitlist control group (CG) over a 9-month trial and compared with healthy blood donors.
Results: Lifestyle intervention reduced regulatory T cell (Treg) frequencies in the blood of CD patients. Notably, we observed a significant correlation between the quality of life improvement and Treg frequencies in the IG but not in the CG. Furthermore, differential activation and expression of the gut-homing molecules G protein-coupled receptor 15 and CCR9 on circulating Tregs and CD4+ effector T cells were detected in both the IG and CG.
Conclusions: The MBM program, whether guided or self-directed, has the potential to restore the CD4+ T cell profile of CD patients to levels comparable to healthy blood donors. Lifestyle interventions may benefit CD progression, symptoms, and immunological status, but further analysis is needed to substantiate these findings and to fully understand their clinical implications. (ClinicalTrials.gov: NCT05182645).
背景：克罗恩病（CD）严重影响患者的身心健康，并受到压力和生活方式因素的影响，这凸显了改善生活质量对克罗恩病治疗的重要性。促炎和抗炎 CD4+ T 细胞反应之间的不平衡是 CD 的一个关键因素，而压力已被证明会改变 CD4+ T 细胞的功能。因此，本研究旨在评估身心医学压力管理和生活方式调整（MBM）计划对 CD 患者 CD4+ T 细胞谱的影响：方法：在实施身心医学压力管理和生活方式调整（MBM）计划后，通过流式细胞术分析 CD 患者的循环 CD4+ T 细胞。在为期9个月的试验中，患者被随机分配到指导干预组（IG）或自我指导候补对照组（CG），并与健康献血者进行比较：生活方式干预降低了 CD 患者血液中调节性 T 细胞（Treg）的频率。值得注意的是，我们观察到生活质量的改善与 IG 组而非 CG 组 Treg 频率之间存在明显的相关性。此外，在 IG 和 CG 中，循环 Tregs 和 CD4+ 效应 T 细胞上的肠道归宿分子 G 蛋白偶联受体 15 和 CCR9 的活化和表达均有所不同：MBM计划，无论是指导性的还是自我指导的，都有可能将CD患者的CD4+ T细胞谱恢复到与健康献血者相当的水平。生活方式干预可能有益于 CD 的进展、症状和免疫状态，但还需要进一步的分析来证实这些发现，并充分了解其临床意义。(ClinicalTrials.gov：NCT05182645）。
期刊介绍：
Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.
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