Non-pharmacological Mitigation of Psoriasis
Condition: Psoriasis; Stress; Inflammation; Depression; Pruritus; Sleep Disorder; Quality of Life
MeSH terms: Sleep Wake Disorders; Psoriasis; Pruritus; Inflammation
Study type: Interventional

Summary: 
      In the past few years, research has provided evidence for a possibility of dampening immune
      system by one's will after undergoing a specific training program. Aim of this study was to
      verity the efficacy in affecting both mind and body by assessing psoriasis activity and
      psychological functioning. Among the members of both of the groups intensity of skin lesions
      and pruritus were assessed, consultation regarding treatment took place and multiple
      questionnaires regarding sleep quality, mindfulness and depressive symptoms were distributed.
      Blood samples were collected to asses intensity of inflammation, including interleukins.
    

Detailed description: 
      Psoriasis is a skin disease of an unknown origin. Current understanding of its
      pathophysiology focuses on an undefined imbalance between the immune system and the nervous
      system. In this study the researchers assessed the effects of a training program which was
      proven to affect both. A group of psoriatic patients volunteered, and were randomized to
      either the intervention (n = 19), or control group (n = 19). Subjects in the intervention
      group were trained for 10 weeks in breathing techniques, exposure to cold and meditation. The
      control group was not trained.

      After two weeks of the intervention, a full lockdown due to the COVID-19 pandemics was
      introduced. Modified protocol included exercises possible to conduct at home only.

      Two study visits (before and after the intervention) took place.

      Total count of variables analysed equaled 60. Primary endpoints regarded intensity of
      psoriasis. This group included laboratory markers (hsCRP, WBC, LEU, MONO, IL-6, IL-8, IL-10,
      IL-17, TNFalpha) measured in serum and saliva, visual skin assessment performed by a health
      professional using Psoriasis Area Severity Index, consultations regarding treatment, and
      results of the questionnaires (Dermatological Life Quality Index, pruritus). Secondary
      endpoints pertained comorbidities of psoriasis. These were also assessed using
      questionnaires, and included Pittsburgh Sleep Quality Index, Patient Health Questionnaire - 9
      (depressive symptoms), Five Facet Mindfulness Questionnaire, Perceived Stress Scale - 10.

      The intervention is a specific combination of breathing exercises, meditation and cold
      exposure. It has been previously proven to have an effect among healthy young males who were
      able to drop febrile temperatures induced with an intravenously distributed LPS. That
      phenomena was achieved using previously trained breathing techniques.

      For 10 weeks members of the intervention group were trained via popular social media
      platform. Exercises included exposure to cold using regular, cold showers, performing
      breathing exercises finished with a short meditation session. Length and general difficulty
      were gradually built up.

      Initially, total number of the subjects equaled 54. 31 for the intervention group and 23 for
      the control group. Due to drop-out or meeting the exclusion criteria, final count for both of
      the groups was 19 participants.
    

Intervention name(s): breathing exercises, cold exposure and meditation
Intervention type(s): Other
Intervention description(s): It is a combination of exercises that include breathing exercises, cold exposure and meditation
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups, intervention and control, 10 weeks of intervention. Study visits, blood, saliva collection twice: "before" and "after".
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: meditation; exposure to cold; inflammation; breathing