Ancient Art Rivals Vaccines for Immunity Against Shingles

LOS ANGELES, April 9 -- The Chinese art of tai chi appears to protect against shingles as efficiently as a vaccine against varicella zoster and even augment the immunity conferred by the vaccine.

In a controlled study of adults vaccinated against varicella zoster virus, those who had earlier been assigned to perform a westernized version of tai chi exercises had significantly higher levels of vaccine-stimulated cell-mediated immunity than did controls, found Michael R. Irwin, M.D., of the University of California at Los Angeles, and colleagues at UC San Diego.

And even before they were vaccinated, tai chi alone helped those who practiced it to mount an immune response to varicella zoster virus comparable to that of patients half their age, the investigators reported in the April issue of the Journal of the American Geriatrics Society.

"Tai chi alone induced an increase in varicella zoster virus -cell-media that was comparable in magnitude with that induced by varicella vaccine, and the two were additive," they wrote. But they pointed out that they could not determine whether tai chi could reduce the occurrence of herpes zoster.

The research "demonstrated that a centuries-old behavioral intervention, tai chi, resulted in a level of immune response similar to that of a modern biological intervention, the varicella vaccine, and that tai chi boosted the positive effects of the vaccine," said Andrew Monjan, Ph.D., chief of the National Institute on Aging's Neurobiology of Aging Branch, which co-funded the study.

The study of 112 patients was the first convincing demonstration that a behavioral intervention can help protect adults against herpes zoster and postherpetic neuralgia, added the NIH.

Although earlier studies have suggested that tai chi could have a positive protective effect against varicella zoster virus, those studies were small, non-randomized, and enlisted younger participants at lower risk for compromised immunity than the current study, Dr. Irwin and colleagues noted.

They designed a study that would apply the most rigorous science possible to an intervention whose clinical benefits are hard to quantify through conventional means.

The risk of herpes zoster is thought to be strongly linked to cell-mediated immunity, and tai chi combines aerobic activity, relaxation, and meditation, all of which are thought to boost cell-mediated immune responses.

In addition, the gentle, methodical movements of tai chi are low impact and can be performed by older persons with limited mobility, the authors noted.

In the prospective controlled trial, 112 healthy older adults 59 to 86 years old were randomized to receive training and participation in tai chi chih, a westernized, standardized form of the art, or to a health-education program, both for 25 weeks.

After the 16th week of the respective intervention, all participants received one dose of Varivax, a live, attenuated varicella zoster virus licensed by the FDA to prevent of varicella viral infections.

The primary outcome was a quantitative measure of varicella zoster virus cell-mediated immunity, determined by measuring the frequency of peripheral blood mononuclear cells. A secondary outcome was the score on the scores on the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36).

Cell-mediated immunity was assessed at baseline and at weeks eight, 12, 16 and 25.

The authors found that the tai chi practitioners had higher levels of varicella zoster virus-cell-mediated immunity than the health-education group (P