Trial reportProceedings of the National Academy of Sciences of the United States of America2014
Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans.
Trial report in Proceedings of the National Academy of Sciences of the United States of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 128 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Increasing Plasma Adrenaline Levels Through Breathing Techniques - an Explorative Study
Evidence-Based Mindset & Physical Therapy for Add-on Treatment of Active Axial Spondyloarthritis: Safety and Efficacy
Effects Of Meditation On The Gut Microbiome And Human Health and Disease
Who cites it
128 citing papers in PubMed, 3 syntheses or guidelines pooled it, 269 citations in OpenAlex.
- Cold-water exposure and psychological outcomes in adults: a systematic review and meta-analysis.Frontiers in physiology · 2026Pooled it
- Pooled it
- Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials.Scientific reports · 2023Pooled it
- The effect of breathing exercises and mindset with or without cold exposure on mental and physical health in persons with a spinal cord injury-Results of a randomized controlled trial.Clinical rehabilitation · 2026Trial
- Oral microbiome modulation mitigates hyperglycemia exacerbation in gestational diabetes mellitus.Nature communications · 2026Trial
- A semi-randomised control trial assessing psychophysiological effects of breathwork and cold immersion.Scientific reports · 2025Trial
- Effects of brief remote high ventilation breathwork with retention on mental health and wellbeing: a randomised placebo-controlled trial.Scientific reports · 2024Trial
- The effectiveness of the Wim Hof method on cardiac autonomic function, blood pressure, arterial compliance, and different psychological parameters.Scientific reports · 2023Trial
- Brief structured respiration practices enhance mood and reduce physiological arousal.Cell reports. Medicine · 2023Trial
- Remote ischaemic preconditioning does not modulate the systemic inflammatory response or renal tubular stress biomarkers after endotoxaemia in healthy human volunteers: a single-centre, mechanistic, randomised controlled trial.British journal of anaesthesia · 2019Trial
- Trial
- Trial
- The role of outcome expectancies for a training program consisting of meditation, breathing exercises, and cold exposure on the response to endotoxin administration: a proof-of-principle study.Clinical rheumatology · 2016Trial
- Trial
- Gamma-irradiated bacille Calmette-Guérin vaccination does not modulate the innate immune response during experimental human endotoxemia in adult males.Journal of immunology research · 2015Trial
- Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans.PloS one · 2015Trial
- Voluntary attention regulates acute immune responses in humans.Nature human behaviour · 2026Article
- Perspective on Lessons Not Learned: From Coley's Toxins to Microbial Drug Delivery, Guidance for Institutional Review Boards (IRBs).International journal of molecular sciences · 2026Review
- Endotoxin-induced inflammation promotes, via the adrenomedullary system, a hyperglycemic and anti-inflammatory reflex.Brain, behavior, & immunity - health · 2026Article
- Targeting low-grade inflammation in multiple sclerosis through the Wim Hof method or lifestyle intervention: a pilot comparative study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
68 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.