Evidence map›Paper›PMID 24799686›Full record

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.

Matthijs Kox, Lucas T van Eijk, Jelle Zwaag, Joanne van den Wildenberg, Fred C G J Sweep, Johannes G van der Hoeven, Peter Pickkers

3 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 3 pooled it
5.6field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02417155 nacompletednot on this map

Increasing Plasma Adrenaline Levels Through Breathing Techniques - an Explorative Study

TypeinterventionalSponsorRadboud University Medical CenterRan2014 to 2015Enrolled40ConditionsAutoimmune DiseasesArmsHyper/hypoventilation, Strength ventilation
NCT02744014 nacompletednot on this mapstarted 2016, after this paper: background citation

Evidence-Based Mindset & Physical Therapy for Add-on Treatment of Active Axial Spondyloarthritis: Safety and Efficacy

TypeinterventionalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2016 to 2017Enrolled24ConditionsAxial SpondyloarthritisArmsAdd-on Therapy for Axial Spondyloarthritis
NCT06583395 enrolling by invitationnot on this mapstarted 2021, after this paper: background citation

Effects Of Meditation On The Gut Microbiome And Human Health and Disease

TypeobservationalSponsorTobias Moeller-BertramRan2021 to 2025Enrolled3,000ConditionsAmyotrophic Lateral Sclerosis (ALS), Angina, Stable, Anxiety, AsthmaArmsAdvanced multi-component meditation practice
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 3 syntheses or guidelines pooled it, 269 citations in OpenAlex.

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  20. 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 · 2026
    Article

68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Matthijs KoxIntensive Care Medicine,Anesthesiology,Nijmegen Institute for Infection, Inflammation and Immunity, and matthijs.kox@radboudumc.nl.
Lucas T van EijkIntensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Jelle ZwaagIntensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Joanne van den WildenbergIntensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Fred C G J SweepLaboratory Medicine, Radboud University Medical Centre, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands.
Johannes G van der HoevenIntensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Peter PickkersIntensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Institute of Infection and Immunity · CADigestive Care (United States) · USRadboud University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

AdultCatecholaminesCold TemperatureEndotoxinsEpinephrineHealthy VolunteersHumansHydrocortisoneHypoxiaImmunity, InnateInflammationInterleukin-10Interleukin-6Interleukin-8MaleMeditationCatecholaminesendotoxin, Escherichia coliEndotoxinsEpinephrineHydrocortisoneInterleukin-10Interleukin-6Interleukin-8Tumor Necrosis Factor-alphacathecholaminescortisolLPS

Identifiers

PMID24799686
PMCPMC4034215
OpenAlexW2055487408

What OpenQuestion holds

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Read underepoch 390

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.