Cognitive behavioral and mindfulness with daily exercise intervention is associated with changes in intestinal microbial taxa and systemic inflammation in patients with Crohn’s disease

ABSTRACT

Crohn’s disease (CD) is a chronic inflammatory bowel disease associated with psychological distress and intestinal microbial changes. Here, we examined whether a 3-month period of Cognitive Behavioral and Mindfulness with Daily Exercise (COBMINDEX) intervention, which improves the wellbeing and inflammatory state of CD patients, may also affect their gut microbiome. Gut microbiota, circulating inflammatory markers and hormones were analyzed in 24 CD patients before (T1) and after 3 months of COBMINDEX (T2), and in 25 age- and sex-matched wait-list control patients at the corresponding time-points. Microbiota analysis examined relative taxonomical abundance, alpha and beta diversity, and microbiome correlations with inflammatory and psychological parameters. At T1, CD patients exhibited a characteristic microbial profile mainly constituted of Proteobacteria (17.71%), Firmicutes (65.56%), Actinobacteria (8.46%) and Bacteroidetes (6.24%). Baseline bacterial abundances showed significant correlations with psychological markers of distress and with IFN$\mathit{\gamma }$. Following COBMINDEX, no significant changes in alpha and beta diversity were observed between both study groups, though a trend change in beta diversity was noted. Significant changes occurred in the abundance of phyla, families and genera only among the COBMINDEX group. Furthermore, abundance of phyla, families and genera that were altered following COBMNIDEX, significantly correlated with levels of cytokines and psychological parameters. Our results demonstrated that a short-term intervention of COBMINDEX was associated with changes in microbial indices, some of which are linked to psychological manifestations and systemic inflammation in CD patients. Psychological interventions to reduce chronic stress, such as COBMINDEX, appear to be beneficial in mitigating the pathobiology of CD patients, and may thus provide a useful adjunct to pharmacological therapy.

KEYWORDS:

• IBD
• Crohn’s disease
• cytokines
• microbiome
• psychological intervention
• distress

Acknowledgments

The study was supported by The Leona M. and Harry B. Helmsley Charitable Trust and the Ministry of Science and Technology of Israel (MOST, 3-14356; to A.M.). We acknowledge Ekaterina Vinogradov who participated in serum samples preparation and Rotem Bartov who helped with analysis and graphic illustrations. We acknowledge the non-IIRN gastroenterologists: Eyal Hirsch, MD, Timna Naftali, MD, Anat Nevo, MD, Naim Abu-Freha, MD, Arik Segal, MD, David Yardeni, MD for their assistance in patient recruitment.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data supporting this study’s findings of this study are available on request from the corresponding author [A.M]. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Ethical Considerations

The institutional review boards of Soroka Medical Center (Beer Sheva, Israel) and Rabin Medical Center (Petah Tikva, Israel) approved the trial. Participants were given a detailed written and oral description of the research project and provided informed consent.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19490976.2024.2337269

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The work was supported by the Leona M. and Harry B. Helmsley Charitable Trust [2018PG-CD005] and the Ministry of Science and Technology of Israel (MOST, 3-14356; to A.M.).