Meditation and Exercise for Prevention of Acute Respiratory Infection

描述(申请人提供)：背景：初步证据表明，冥想和锻炼可能通过相互作用的心理和生理途径来刺激免疫系统，减少传染病。方法：在这项研究中，50岁以上的女性和男性将被随机分为：1)8周的正念冥想行为训练计划；2)8周的强度、持续时间和地点相匹配的运动训练计划；或3)健康教育会话注意对照组。样本量为N=333，每组N=111。主要结果将是在8个月的观察中根据严重程度调整的急性呼吸道感染(ARI)疾病的总天数，这是威斯康星州上呼吸道症状调查的自我报告，这是一个经过验证的问卷结果衡量标准。基于核酸的病毒识别将验证感染情况。ARI期间的鼻腔冲洗将分析炎症标记物IL-8和鼻中性粒细胞计数。副结果免疫生物标记物将包括流感免疫的抗体反应(血清免疫球蛋白、粘膜免疫球蛋白A)和细胞因子干扰素？和IL-10从体外培养的淋巴细胞。评估感受到的压力、积极和消极情感、乐观和焦虑的问卷测量将被分析为免疫调节的潜在中介。时间表/后勤：这将是一个为期4年的项目，有3个年度队列(第一年N=75；第二和第三年N=129)。每年的队列将在1月至8月进行筛选，在9月份进行短暂的遵守情况评估磨合试验，然后表示同意，并从10月份开始随机进行冥想、锻炼或对照。三价流感疫苗接种将在11月的第六周行为会议上进行。在基线、8周疗程结束时和3个月后再次抽血进行抗体滴度和体外细胞因子检测。同时将进行鼻拭子检测IgA。参与者将接受每两周一次的电话联系，每月一次的问卷调查，并在急性呼吸窘迫综合征期间进行每日自我评估。分析：基于方差分析的模型评估冥想和运动对免疫标记物和ARI疾病的影响。心理测量将被评估为冥想和锻炼对ARI疾病影响的潜在中介。广义估计方程、随机效应模式混合模型和分层线性模型将用于评估纵向效应、交互作用和协变量中介。 公共卫生回顾：该项目的首要目标是确定诸如冥想或锻炼等身心练习是否可以减轻急性呼吸道感染的公共卫生负担。一个主要的次要目标是确定正念、冥想或中等强度的锻炼是否可以增强免疫过程，例如对流感疫苗(流感疫苗)的抗体反应。最后，我们想要调查压力、乐观、焦虑和正负情绪对呼吸道感染免疫和抵抗力的影响。

DESCRIPTION (provided by applicant): Background: Preliminary evidence suggests that meditation and exercise may work through interacting psychological and physiological pathways to stimulate the immune system and reduce infectious disease. Methods: In this study, women and men aged 50 and older will be randomized to: 1) an 8 week behavioral training program in mindfulness meditation, 2) an intensity, duration and location-matched 8 week exercise training program, or 3) a health education session attention control group. Sample size will be N=333, with N=111 in each group. The primary outcome will be severity-adjusted total days of acute respiratory infection (ARI) illness during 8 months of observation, as self-reported on the Wisconsin Upper Respiratory Symptom Survey, a validated questionnaire outcome measure. Nucleic acid based viral identification will verify infection. Nasal wash during ARI illness will be analyzed for inflammatory markers IL-8 and nasal neutrophil count. Secondary outcome immune biomarkers will include antibody response to influenza immunization (serum IgG, mucosal IgA) and cytokines IFN-? and IL-10 from cultured ex vivo lymphocytes. Questionnaire measures assessing perceived stress, positive and negative affectivity, optimism and anxiety will be analyzed as potential mediators of immunomodulation. Timeframe / logistics: This will be a 4 year project, with 3 annual cohorts (1st year N=75; 2nd and 3rd years N=129 each). Yearly cohorts will be screened from January to August, undergo a short adherence-assessing run-in trial in September, then consent and be randomized to meditation, exercise or control starting in October. Tri-valent influenza vaccination will occur in November on week 6 of behavioral sessions. Blood for antibody titer and ex vivo cytokine assay will be drawn at baseline, at the end of the 8 week session, and once again 3 months later. Nasal swab for IgA will be done at the same time. Participants will be followed with telephone contact every two weeks, with monthly questionnaire instruments, and with daily self-assessments during ARI illness episodes. Analysis: ANOVA-based models assess effects of meditation and exercise on immune markers and ARI illness. Psychological measures will be assessed as potential mediators of effects of meditation and exercise on ARI illness. Generalized estimating equations, random-effects pattern-mixture models, and hierarchical linear models will be used to assess longitudinal effects, interactions, and covariate mediation. PUBLIC HEALTH REVELANCE: The overarching goal of this project is to determine whether mind-body practices such as meditation or exercise can reduce the public health burden of acute respiratory infection. A major secondary goal is to determine whether mindfulness meditation or moderately strenuous exercise can enhance immune processes such as antibody response to influenza vaccination (flu shots). Finally, we want to investigate the influence of stress, optimism, anxiety and positive and negative emotion on immunity and resistance to respiratory infection.