An eight-week yoga program reduced the severity of rheumatoid arthritis symptoms and helped to achieve immune homeostasis.
About 1.3 American adults have rheumatoid arthritis (RA), an autoimmune disease that causes joint inflammation and pain. The condition occurs when the immune system doesn't work properly and attacks the lining of the joints.
The new study published in the journal Scientific Reports suggests that yoga can be beneficial as an adjunct therapy in RA patients.
A total of 64 participants with active rheumatoid arthritis were randomized into a yoga group or non-yoga group. Before and eight weeks into the trial, their disease severity was assessed using Disease Activity Score (DAS28-ESR), calculated based on four factors: number of tender joints, number of swollen joints, visual analog scale score of the patient's global health, and erythrocyte sedimentation rate (ESR), which is an inflammation marker.
In the yoga group, there was a significant improvement in DAS28-ESR scores at the end of eight-weeks of the yoga program.
Moreover, the yoga group saw a significant decline in Th17 cells. When these cells secrete more inflammatory cytokines, the immune response gets dysregulated.
At the same time, the Treg cell population significantly increased in the yoga group. These cells are important in controlling immune responses and their frequency drops in rheumatoid arthritis patients.
As a result, the eight-week yoga program enabled the maintenance of immune homeostasis, a balance of appropriate immune activation and suppression in tissues and organs. Disruption in homeostasis may trigger autoimmune diseases.
Moreover, significant improvements were observed in epigenetic and inflammatory markers in the yoga group.
However, the study has limitations. First, the non-yoga group had no active control group and only received medication therapy. Additionally, it may be challenging to adhere to the program long-term because each session of yoga in the trial lasted for 120 min every day while being supervised by a certified yoga instructor.
Due to the lack of long-term follow-up, it is difficult to predict how quickly participants returned to their baseline levels.
What are symptoms of rheumatoid arthritis?
While rheumatoid arthritis primarily affects joints, it may also cause problems in other body parts, including the eyes, heart, circulatory system, and lungs.
Early rheumatoid arthritis symptoms may include joint pain, tenderness, swelling, or stiffness lasting six weeks or longer and morning stiffness lasting 30 minutes or longer.
In rheumatoid arthritis, more than one joint is affected, and small joints, such as wrists and certain joints in the hands and feet, are typically affected first. Moreover, RA usually targets the same joints on both sides of the body.
Although yoga and reduces rheumatoid arthritis symptoms and normalized biomarkers associated with inflammation, more longitudinal research is necessary.
- Scientific Reports. Yoga maintains Th17/Treg cell homeostasis and reduces the rate of T cell aging in rheumatoid arthritis: a randomized controlled trial.
- Journal of Rheumatic Disease. Comparison of Disease Activity Score-28 Based on Erythrocyte Sedimentation Rate and C-reactive Protein Level in Rheumatoid Arthritis.
- Annals of Rheumatic Diseases. Regulatory T cell frequencies in patients with rheumatoid arthritis are increased by conventional and biological DMARDs but not by JAK inhibitors.
- National Library of Medicine. Pathogenic Role of Immune Cells in Rheumatoid Arthritis: Implications in Clinical Treatment and Biomarker Development.
- Arthritis Foundation. Rheumatoid Arthritis: Causes, Symptoms, Treatments and More.