{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:36:55Z","timestamp":1793489815747,"version":"4.5.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aims to evaluate the effects of Tai Chi Chuan on the expression of pro-inflammatory genes IL-6, IL-1\u03b2, and TNF-\u03b1\u2014downstream of the NF-\u03baB pathway\u2014in adults with chronic diseases. It further explores potential anti-inflammatory mechanisms and identifies research gaps in the literature regarding these mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study searched seven electronic databases for relevant literature, with language restrictions limited to English and Chinese. The risk of bias in all included trials was assessed using the Cochrane Risk of Bias Assessment Tool (version 2.0) and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to evaluate pooled effect sizes. P values &amp;lt; 0.05 were considered statistically significant. Subgroup analyses were conducted according to disease systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We retrieved a total of 1,110 relevant studies, with 20 studies ultimately included in the analysis. These covered diseases across multiple systems, including oncology, endocrinology, respiratory, and neurological disorders. To more directly reflect intervention effects, we extracted the mean \u00b1 standard deviation of change values post-intervention compared to baseline as the analysis data. After assessing publication bias and minimizing heterogeneity effects, we found that Tai Chi Chuan significantly reduced the expression of downstream target genes (SMD = -0.48, 95% CI: -0.76 to -0.19, p &amp;lt; 0.01), significantly down-regulated IL-6 (SMD = -0.66, 95% CI: -1.27 to -0.06, p = 0.03), and IL-1\u03b2 (SMD = -0.59, 95% CI: -0.95 to -0.23, p &amp;lt; 0.01). while TNF-\u03b1 showed a downward trend but without statistical significance (SMD = -0.28, 95% CI: -0.59 to 0.02, p = 0.07). Subgroup analysis revealed that patients with endocrine and respiratory system diseases derived the most significant benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tai Chi can alleviate systemic inflammation in patients with chronic diseases by suppressing NF-\u03baB-driven pro-inflammatory gene expression, demonstrating both safety and feasibility. Furthermore, we identified gaps in existing research on Tai Chi and NF-\u03baB, particularly the lack of randomized controlled trials (RCTs). Future studies should conduct RCTs with NF-\u03baB core proteins and factors as direct outcome measures to directly elucidate Tai Chi\u2019s regulatory effects on the NF-\u03baB pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420251112908.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1702830","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:17:09Z","timestamp":1777954629000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Performance of Tai Chi Chuan and NF-\u03baB-driven proinflammatory gene expression (IL-6, IL-1\u03b2, TNF-\u03b1) in adult chronic disease patients: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"17","author":[{"given":"Si-Qi","family":"Zhu","sequence":"first","affiliation":[{"name":"Graduate School of Wuhan Institute of Physical Education","place":["Wuhan, China"]},{"name":"School of Graduate, Wuhan Sports University","place":["Wuhan, China"]},{"name":"School of Wushu, Wuhan Sports University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Graduate, Wuhan Sports University","place":["Wuhan, China"]},{"name":"School of Wushu, Wuhan Sports University","place":["Wuhan, China"]},{"name":"Wuhan Institute of Physical Education and Wushu","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0675-0","article-title":"Chronic inflammation in the etiology of disease across the life span","volume":"25","author":"Furman","year":"2019","journal-title":"Nat Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1043","article-title":"Inflammation, immunity, and infection in atherothrombosis: JACC review topic of the week","volume":"72","author":"Libby","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1038\/s41392-024-01757-9","article-title":"NF-\u03baB in biology and targeted therapy: new insights and translational implications","volume":"9","author":"Guo","year":"2024","journal-title":"Signal Transd Targ Ther"},{"key":"B4","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1038\/nature14228","article-title":"A gp130-Src-YAP module links inflammation to epithelial regeneration","volume":"519","author":"Taniguchi","year":"2015","journal-title":"Nature"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1128\/mcb.10.5.2327-2334.1990","article-title":"Activation of interleukin-6 gene expression through the NF-kappa B transcription factor","volume":"10","author":"Libermann","year":"1990","journal-title":"Mol Cell Biol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1159\/000313586","article-title":"Prolonged physical training decreases mRNA levels of glucocorticoid receptor and inflammatory genes","volume":"74","author":"Sousa e Silva","year":"2010","journal-title":"Horm Res Paediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1007\/s12170-015-0463-4","article-title":"Effects of exercise on gene expression of inflammatory markers in human peripheral blood cells: a systematic review","volume":"9","author":"Gjevestad","year":"2015","journal-title":"Curr Cardiovasc Risk Rep"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/s2005-2901(09)60052-2","article-title":"The effect of Tai Chi on psychosocial well-being: a systematic review of randomized controlled trials","volume":"2","author":"Wang","year":"2009","journal-title":"J Acupunct Merid Stud"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5549006","article-title":"The effect of Tai Chi Chuan on emotional health: potential mechanisms and prefrontal cortex hypothesis","volume":"2021","author":"Yao","year":"2021","journal-title":"Evid Based Compl Altern Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2015.02.010","article-title":"Improved sleep quality in older adults with insomnia reduces biomarkers of disease risk: pilot results from a randomized controlled comparative efficacy trial","volume":"55","author":"Carroll","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2015.01.010","article-title":"Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial","volume":"78","author":"Irwin","year":"2015","journal-title":"Biol Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1093\/jncimonographs\/lgu028","article-title":"Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial","volume":"2014","author":"Irwin","year":"2014","journal-title":"J Natl Cancer Inst Monogr"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/srep25325","article-title":"Tai Chi for chronic pain conditions: a systematic review and meta-analysis of randomized controlled trials","volume":"6","author":"Kong","year":"2016","journal-title":"Sci Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2147\/cia.S111927","article-title":"Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: a pilot randomized controlled trial","volume":"11","author":"Chan","year":"2016","journal-title":"Clin Interv Aging"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.766649","article-title":"Combining transcranial direct current stimulation with Tai Chi to improve dual-task gait performance in older adults with mild cognitive impairment: a randomized controlled trial","volume":"13","author":"Liao","year":"2021","journal-title":"Front Aging Neurosci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14594","article-title":"Effects of Tai Chi on cognition and fall risk in older adults with mild cognitive impairment: a randomized controlled trial","volume":"65","author":"Sungkarat","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1295342","article-title":"The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis","volume":"11","author":"Kuang","year":"2023","journal-title":"Front Public Health"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/medicines7070039","article-title":"The effects of Tai Chi and Qigong on immune responses: a systematic review and meta-analysis","volume":"7","author":"Oh","year":"2020","journal-title":"Medicines (Basel)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3736\/jcim20090918","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"3","author":"Moher","year":"2009","journal-title":"Open Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/978-1-61779-527-5_2","article-title":"Detection and quantification of cytokines and other biomarkers","volume":"844","author":"Chiswick","year":"2012","journal-title":"Methods Mol Biol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"Bmj"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"Bmj"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1515\/ijb-2022-0070","article-title":"Heterogeneity in meta-analysis: a comprehensive overview","volume":"20","author":"Stogiannis","year":"2024","journal-title":"Int J Biostat"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2307\/2533446","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"50","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1002-0829.2014.02.009","article-title":"Log-transformation and its implications for data analysis","volume":"26","author":"Feng","year":"2014","journal-title":"Shang Arch Psychiatry"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2019-100146corr1","article-title":"Correction: Log-transformation and its implications for data analysis","volume":"32","author":"Feng","year":"2019","journal-title":"Gen Psychiatr"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-014-0395-x","article-title":"Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial","volume":"9","author":"Campo","year":"2015","journal-title":"J Cancer Surviv"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2024.05.022","article-title":"Tai Chi compared with cognitive behavioral therapy and the reversal of systemic, cellular and genomic markers of inflammation in breast cancer survivors with insomnia: a randomized clinical trial","volume":"120","author":"Irwin","year":"2024","journal-title":"Brain Behav Immun"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2011.03.013","article-title":"Effects of Tai Chi Chuan on insulin and cytokine levels in a randomized controlled pilot study on breast cancer survivors","volume":"11","author":"Janelsins","year":"2011","journal-title":"Clin Breast Cancer"},{"key":"B31","doi-asserted-by":"publisher","first-page":"101161","DOI":"10.1016\/j.eujim.2020.101161","article-title":"Does Tai Chi improve antioxidant and anti-inflammatory abilities via the KEAP1-NRF2 pathway and increase blood oxygen level in lung cancer patients: a randomized controlled trial","volume":"37","author":"Jiang","year":"2020","journal-title":"Eur J Integr Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-011-0205-7","article-title":"Health-related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan","volume":"6","author":"Sprod","year":"2012","journal-title":"J Cancer Survivors"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1026509","article-title":"The effect of tai chi intervention on NLRP3 and its related antiviral inflammatory factors in the serum of patients with pre-diabetes","volume":"13","author":"Hu","year":"2022","journal-title":"Front Immunol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299495","article-title":"Twenty-four week Taichi training improves pulmonary diffusion capacity and glycemic control in patients with Type 2 diabetes mellitus","volume":"19","author":"Liu","year":"2024","journal-title":"PloS One"},{"key":"B35","article-title":"Effect of type 24 simplified taijiquan on serum inflammatory cytokines and quality of lifein type 2 diabetes patients","volume":"32","author":"Fan","year":"2009","journal-title":"Chin J Phys Med Rehabil"},{"key":"B36","article-title":"Effects ofTaichi exercise on oxidative stress and inflammatory levels in elderly patients with type 2 diabetes mellitus","volume":"33","author":"XB","year":"2013","journal-title":"Chin J Gerontol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-024-04401-3","article-title":"Effect of long-term Tai Chi therapy on the immune-inflammatory pathway in patients with schizophrenia with antipsychotic-stabilized","volume":"62","author":"Yang","year":"2025","journal-title":"Mol Neurobiol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1186\/s40035-022-00280-7","article-title":"Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson\u2019s disease patients","volume":"11","author":"Li","year":"2022","journal-title":"Transl Neurodegener"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1177\/1545968317753682","article-title":"Tai Chi improves cognition and plasma BDNF in older adults with mild cognitive impairment: a randomized controlled trial","volume":"32","author":"Sungkarat","year":"2018","journal-title":"Neurorehabil Neural Repair"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.150","article-title":"Tai chi exercise in patients with chronic heart failure: a randomized clinical trial","volume":"171","author":"Yeh","year":"2011","journal-title":"Arch Intern Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1369675","article-title":"Effects of a Tai Chi rehabilitation program implemented using a hybrid online and offline mode on oxidative stress and inflammatory responses in patients with coronary heart disease: a randomized controlled trial","volume":"12","author":"Cui","year":"2024","journal-title":"Front Public Health"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2019.109883","article-title":"An exploratory randomized sub-study of light-to-moderate intensity exercise on cognitive function, depression symptoms and inflammation in older adults with heart failure","volume":"128","author":"Redwine","year":"2020","journal-title":"J Psychosom Res"},{"key":"B43","article-title":"The effects of Taijiquan on serum concentration of interleukin-6, interleukin-8, tumor necrosis factor-a in patients with chronic obstructive pulmonary disease in stationary stage","volume":"36","author":"Du","year":"2014","journal-title":"Chin J Phys Med Rehabil"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.2147\/cia.S157584","article-title":"Hypoglycemic and antioxidant effect of Tai chi exercise training in older adults with metabolic syndrome","volume":"13","author":"Mendoza-N\u00fa\u00f1ez","year":"2018","journal-title":"Clin Interventions Aging"},{"key":"B45","doi-asserted-by":"publisher","first-page":"603853","DOI":"10.1155\/2014\/603853","article-title":"Tai Chi exercise increases SOD activity and total antioxidant status in saliva and is linked to an improvement of periodontal disease in the elderly","volume":"2014","author":"Mendoza-N\u00fa\u00f1ez","year":"2014","journal-title":"Oxid Med Cell Longevity"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.21037\/apm-21-640","article-title":"Impact of Tai Chi on CRP, TNF-alpha and IL-6 in inflammation: a systematic review and meta-analysis","volume":"10","author":"Shu","year":"2021","journal-title":"Ann Palliat Med"},{"key":"B47","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3233\/978-1-60750-945-5-39","article-title":"Bodily systems and the spatial-functional structure of the human body","volume":"102","author":"Smith","year":"2004","journal-title":"Stud Health Technol Inform"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2006.11.001","article-title":"Cancer metastasis: building a framework","volume":"127","author":"Gupta","year":"2006","journal-title":"Cell"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.2337\/db09-0824","article-title":"Full-length adiponectin attenuates insulin signaling and inhibits insulin-stimulated amino acid transport in human primary trophoblast cells","volume":"59","author":"Jones","year":"2010","journal-title":"Diabetes"},{"key":"B50","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1165\/ajrcmb.19.1.3132","article-title":"Air pollution particles induce IL-6 gene expression in human airway epithelial cells via NF-kappaB activation","volume":"19","author":"Quay","year":"1998","journal-title":"Am J Respir Cell Mol Biol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/s0167-5699(97)01103-1","article-title":"IL-6 and APPs: anti-inflammatory and immunosuppressive mediators","volume":"18","author":"Tilg","year":"1997","journal-title":"Immunol Today"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvq076","article-title":"The nuclear factor-kappaB-interleukin-6 signalling pathway mediating vascular inflammation","volume":"86","author":"Brasier","year":"2010","journal-title":"Cardiovasc Res"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.86.1.203","article-title":"Sympathetic and immune interactions during dynamic exercise. Mediation via a beta 2-adrenergic-dependent mechanism","volume":"86","author":"Murray","year":"1992","journal-title":"Circulation"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/61.11.1177","article-title":"Tai Chi Chih acutely decreases sympathetic nervous system activity in older adults","volume":"61","author":"Motivala","year":"2006","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"B55","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000134225","article-title":"The exercise intensity of tai chi chuan","volume":"52","author":"Lan","year":"2008","journal-title":"Med Sport Sci"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1702830\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:17:11Z","timestamp":1777954631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1702830\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":55,"alternative-id":["10.3389\/fimmu.2026.1702830"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1702830","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"article-number":"1702830"}}