Multimodal psychological intervention improves psychological well-being and inflammatory profiles in patients with diabetic nephropathy.

Résumé

Patients with diabetic nephropathy (DN) often experience negative emotions and a decline in quality of life, conditions in which the neuro-endocrine-immune axis plays a crucial role. In this study, we explored the effects of an eight-week multimodal psychological intervention, incorporating cognitive behavioral therapy, mindfulness meditation, and relaxation training, on DN patients. Ninety participants were randomly assigned to an intervention group, a sham intervention group, or a control group. The sham intervention group received nonspecific contact of equivalent duration, while the control group received routine care only. Psychological outcomes were evaluated using HADS and SF-36 scales, and serum levels of cortisol, CRH, ACTH, IL-6, IL-1β, and TNF-α were measured by enzyme-linked immunosorbent assay. Bioinformatic analyses, including Gene Ontology/Kyoto Encyclopedia of Genes and Genomes functional enrichment analysis and protein-protein interaction network mapping, were employed to identify key molecular mechanisms. Results demonstrated that the intervention group exhibited significant improvements in emotional well-being and quality of life, accompanied by reductions in neuroendocrine hormones and inflammatory cytokines. Bioinformatic data further revealed the central role of IL-6 within the inflammatory regulatory network in DN. These findings suggest that multimodal psychological intervention can effectively improve psychological outcomes and inflammatory profiles in DN patients by targeting the neuro-endocrine-immune axis, with IL-6 acting as a pivotal mediator. This work provides novel evidence supporting the integration of psychological interventions into the management of DN and highlights IL-6 as a potential therapeutic target.