Mindfulness-based stress reduction may decrease stress, disease activity, and inflammatory cytokine levels in patients with autoimmune hepatitis.
Leina S Alrabadi, Anne Dutton, Anahita Rabiee, Scott J Roberts, Yanhong Deng, Laura Cusack, Marina G Silveira, Maria Ciarleglio, Richard Bucala, Rajita Sinha, James L Boyer, David N Assis
JHEP reports : innovation in hepatology May 2022 DOI: 10.1016/j.jhepr.2022.100450 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Single-arm exploratory pilot study Peer reviewed |
|---|---|
| Sample size | 17 |
| Population | Adult patients with autoimmune hepatitis |
| Intervention | Mindfulness-based stress reduction (MBSR) |
| Duration | 8-week MBSR program, with follow-up at 12 months |
| Measures | Perceived Stress Survey-10 (PSS), Brief Self-Control Scale (BSCS), serum alanine aminotransferase (ALT), cytokine levels (IL-6, IL-8, IL-10, IL-17, IL-23, sCD74/MIF ratio) |
| Topics | Meditation |
| Keywords | Aih, autoimmune hepatitis Alt, alanine aminotransferase Cytokines Psychological stress Stress reduction |
| Registration | NCT02950077 |
| Key points | MBSR was associated with improved perceived stress and self-control scores at 8 weeks and 12 months, reduced prednisone doses at 8 weeks and 12 months, and improved peripheral blood cytokine levels from baseline to 8 weeks. Median ALT fell from 71.5 to 44.5 U/L among patients with ALT above 34 U/L, a difference that did not reach statistical significance (p = 0.06). The authors propose that stress modification may affect quality of life and disease activity in autoimmune hepatitis and should be further evaluated. |
Abstract
Psychological and life stressors may impact autoimmune hepatitis (AIH) disease activity and increase relapse risk. Mindfulness-based stress reduction (MBSR) is a validated course that reduces stress reactivity, and improves stress and emotion regulation. This single-arm exploratory pilot study of adult patients with AIH aimed to define the impact of an 8-week MBSR program on quality of life, disease activity, and cytokine mediators. The perceived stress survey-10 (PSS) and the brief self-control scale (BSCS) measured subjective distress and self-control. Serum alanine aminotransferase (ALT) and cytokine levels were measured, and immunosuppressant doses recorded. Seventeen patients completed the MBSR program. Post-MBSR, 71% (n = 12) showed PSS score improvement at 8 weeks vs. baseline (median 15 vs. 21, p = 0.02). At 12 months, PSS improvement persisted vs. baseline (median 15 vs. 21, p = 0.02). Post-MBSR, 71% (n = 12) showed BSCS score improvement at 8 weeks vs. baseline (median 4.1 vs. 3.8, p = 0.03). At 12 months, the median BSCS score remained significant (3.9 vs. 3.8, p = 0.03). After the 8-week MBSR, the 35% of patients with ALT >34 U/L had a median ALT reduction (44.5 vs. 71.5 U/L, p = 0.06), whereas the 71% of patients on prednisone had significant dose reductions (5.75 vs. 10 mg, p = 0.02) which persisted at 12 months vs. baseline (3.75 vs. 10 mg, p = 0.02) without a compensatory increase in steroid-sparing dosing. Significant improvement was noted in peripheral blood cytokine levels (IL-6, IL-8, IL-10, IL-17, IL-23, and sCD74/MIF ratio) from baseline to 8 weeks. MBSR significantly improved perceived stress and self-control scores while decreasing ALT levels, steroid requirements, and inflammatory cytokine levels in this pilot study in adult AIH. Stress modification may impact quality of life and disease activity, and should be further evaluated as an intervention in AIH. This study is registered at ClinicalTrials.gov (NCT02950077). Autoimmune hepatitis can reduce quality of life and mental health, while stress may impact autoimmune hepatitis itself. We piloted mindfulness-based stress reduction as a strategy to reduce stress in adult patients with autoimmune hepatitis and found that the intervention reduced perceived stress and may have also impacted the disease by improving inflammation and medication needs. Stress reduction should be further studied to improve quality of life and possibly to impact disease activity in autoimmune hepatitis.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 3
- Combined Mindfulness-Based Stress Reduction and Exercise Intervention for Improving Psychological Well-Being in Patients With Non-Small Cell Lung Cancer. Clinical Psychology & Psychotherapy 2024
- The Role of Mindfulness in Hemodialysis Patients: A Scoping Review Mindfulness September 9, 2026
- A short-term mindfulness and auricular acupressure program for preoperative sleep fragmentation in patients with spinal metastases: a retrospective quasi-experimental study. Frontiers in Psychiatry 2026
Cites 9
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- Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis The Journal of Alternative and Complementary Medicine May 1, 2009
- A Randomized, Wait-List Controlled Clinical Trial: The Effect of a Mindfulness Meditation-Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients Psychosomatic Medicine September 1, 2000
- Brief mindfulness training reduces salivary IL-6 and TNF-α in young women with depressive symptomatology. Journal of Consulting and Clinical Psychology June 9, 2016
- Macrophage Migration Inhibitory Factor and microRNA-451a in Response to Mindfulness-based Therapy or Treatment as Usual in Patients with Depression, Anxiety, or Stress and Adjustment Disorders The International Journal of Neuropsychopharmacology January 10, 2018
and 4 more in the library