Evaluating the Cytokine-Modulating Anti-inflammatory Effects of Ayurvedic Treatments on Non-communicable Diseases: An Observational Prospective Pilot Study
Prathiban Rengarajan, Ramkumar Kunka Mohanram, Satish Kumar Rajappan Chandra, Bala PesalaBackground
Chronic inflammation is a key driver of non-communicable diseases (NCDs) such as diabetes, gastroesophageal reflux disease (GERD), hypertension, and osteoarthritis. Ayurveda, an ancient medical system, emphasizes herbal treatments to restore balance and modulate immune responses, but its association with cytokine profiles remains underexplored.
Objective
This study aimed to evaluate the association between Ayurvedic interventions and pro-inflammatory and anti-inflammatory cytokine levels in patients with various NCDs.
Methods
This prospective observational pilot study included 60 patients undergoing Ayurvedic treatment for different NCDs, without a control group. Cytokine levels, including pro-inflammatory markers (IFN-γ, IL-6, IL-17, TNF-α), anti-inflammatory markers (IL-4, IL-10), and IL-1, were measured before and after treatment using multiplex bead-based assays. Statistical analyses, performed in Python, included paired-samples t-tests, Wilcoxon signed-rank tests, effect sizes (Cohen’s dz and rank-biserial correlation), mean and Hodges–Lehmann differences with 95% confidence intervals, and paired (sign-flip) permutation tests, applied to cytokine levels and their ratios.
Results
After Ayurvedic treatment, all four pro-inflammatory cytokines (IFN-γ, IL-6, IL-17, TNF-α) were significantly lower across the cohort and consistently across disease subgroups, with large effect sizes. The anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in the overall cohort and in GERD, with smaller effect sizes, while IL-1 was unchanged. The ratios of pro-inflammatory to anti-inflammatory cytokines decreased significantly after treatment, consistent with a shift toward an anti-inflammatory balance. A paired permutation sensitivity analysis was concordant with these findings.
Conclusion
In this uncontrolled observational study, personalized Ayurvedic treatment was associated with lower pro-inflammatory cytokines and, in specific subgroups, higher anti-inflammatory cytokines, consistent with a shift toward an anti-inflammatory state in patients with NCDs. These findings provide preliminary, hypothesis-generating evidence and should be interpreted as associations rather than treatment effects. Larger, controlled trials are needed to confirm these associations and elucidate the underlying mechanisms.