Music and the Immune System

By Abhijeet Kulkarni.

In today’s world, listening to music has become a daily activity. Some of us listen while we work, commute, workout or when we’re on a break. More often than not, we have music playing on our headphones helping us focus on our work or bring some fun into a chore. It is quite likely you are also listening to music as you read this post. Depending on the activity, our preferences in genre or style may vary. I find it particularly amazing how music can not only help me get through a morning run, but also help me relax and improve my mood in the evening while I am drinking some tea, making the activity a ritual I partake in almost every evening. Music can aid communication, facilitate relationships and, if nothing else, help us take a break and tune out from the world. To come to the point, listening to music or playing an instrument are activities we relish and often engage in.

Although we do so frequently, we seldom think of how it might be affecting us biologically. Music has been reported to influence our psychological, neurological, physiological, and endocrine systems [1]. It may also affect our lipid metabolism during workouts and aid post-workout recovery [2]. Considering its effects on these systems and the interconnected nature of human biology, it is not farfetched to postulate an influence, direct or indirect, of music on our immune system. Multiple researchers have tried to study the potential association between music and the immune system and have reported very interesting, sometimes contradictory, findings highlighting the need for further research. The utility of music as a therapeutic, known as Music therapy, is also the focus of numerous studies. For example, music therapy, on its own or along with standard care, was evaluated and proven to be effective as a therapeutic for mental health conditions [3]. Studies report that music therapy can improve mood and positively affect symptoms of anxiety and depression in children and adults [3].

The immune system not only protects us from harmful self and non-self challenges but also facilitates homeostasis [4]. Fancourt et al. have conducted a thorough review of several studies evaluating different effects of music or music therapy on various systems of the human body [1]. They observed that studies reported changes in frequencies of innate and adaptive immune cells, cytokine levels and IgA levels upon listening to music or playing an instrument [1]. Unfortunately, there was no clear trend in terms of frequencies with variables such as age, type of activity (listening to music or playing an instrument) and type of music adding to the complexity [1]. One study reported that the frequency of CD4⁺CD25⁺Foxp3⁺ T regulatory cells was significantly elevated in CBA mice spleens which had undergone allogeneic heart transplantation when exposed to classical music implicating potential benefits following transplantation procedures [4]. Interestingly, 4 studies reported a decrease in plasma interleukin-6 (IL-6) upon listening to relaxing recorded music or music therapy, but these results also varied depending on the age of the subject [1]. Altered expression levels of other cytokines, namely, IL-1, IL-2, IL-4, IL-12, IL-13, and IFNγ, obtained from different studies, has also been summarized [1]. In terms of humoral immunity, increased expression of IgA was reported in 8 studies in individuals following musical intervention with only 1 study reporting the opposite [1]. Based on data from multiple studies, music, either relaxing or stimulating, irrespective of being actively played or only listened to, significantly increases IgA levels [1, 3].

As stated previously, music can influence the neurological and endocrine systems of the body. Psychological stress has also been documented to impair the immune system against pathogens and enhance systemic inflammation [3]. Although this stress cannot be avoided, music as a stress management strategy has proven to be incredibly effective in limiting its debilitating effects indirectly protecting the immune system [3]. Similarly, elevated stress can spike blood cortisol levels [5] which if consistently high can be toxic to the nervous system [3]. Alternatively, neuroinflammation can cause depression and anxiety [1]. It is fascinating how music is being considered and tested as therapy for these conditions to protect multiple systems simultaneously [1]. Relaxing, tranquilizing music has been shown to be effective at reducing cortisol levels [3, 6]. However, it must be noted that vitalizing, stimulating music most likely increases cortisol levels [6] potentially suggesting the body responds differently based on type of music. Further research is required to better understand these nuances such that they can be employed as part of therapy.

Since the immune system bears such enormous responsibility, it is crucial for its functioning to be regulated to ensure targeted clearance with limited collateral damage to prevent auto-immune diseases. Interestingly, noise, the louder unpleasant counterpart of music, has been implicated to play a role in the development of auto-immune diseases [4]. Although numerous studies have detailed these observations, knowledge gaps, such as underlying mechanisms responsible for these observations, exist. Coupled with contradictory observations, it is currently difficult to conclusively state the biological importance of music and additional research is required to better understand these effects.

In short, listening to music or playing an instrument can affect and potentially improve your physical and mental health. Music can serve as one of the remedies for those suffering from mental health conditions. Along with psychological, neurological, and physiological effects, music can also influence our immune system, either directly or indirectly, but the mechanisms behind these effects remain poorly understood. Trends implicate music to possess an anti-inflammatory role preventing overactivation of the immune system but additional research elaborating on the finer details could not only improve our understanding of the effects of music but also of human biology.
Although we are aware nobody requires a reason to enjoy their music, we thought we should provide you an immunological one to cherish it even more! 😛 Happy listening!

References:

1. Fancourt D, Ockelford A, Belai A. The psychoneuroimmunological effects of music: a systematic review and a new model. Brain Behav Immun. 2014 Feb;36:15-26. doi: 10.1016/j.bbi.2013.10.014. Epub 2013 Oct 21. PMID: 24157429.
2. Yamasaki A, Booker A, Kapur V, Tilt A, Niess H, Lillemoe KD, Warshaw AL, Conrad C. The impact of music on metabolism. Nutrition. 2012 Nov-Dec;28(11-12):1075-80. doi: 10.1016/j.nut.2012.01.020. Epub 2012 Aug 2. PMID: 22858194.
3. Rebecchini L. Music, mental health, and immunity. Brain Behav Immun Health. 2021 Oct 21;18:100374. doi: 10.1016/j.bbih.2021.100374. PMID: 34761245; PMCID: PMC8566759.
4. Zhang A, Zou T, Guo D, Wang Q, Shen Y, Hu H, Ye B, Xiang M. The Immune System Can Hear Noise. Front Immunol. 2021 Feb 18;11:619189. doi: 10.3389/fimmu.2020.619189. PMID: 33679706; PMCID: PMC7930229.
5. Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014 Dec;94(12):1816-25. doi: 10.2522/ptj.20130597. Epub 2014 Jul 17. PMID: 25035267; PMCID: PMC4263906.
6. Koelsch S, Boehlig A, Hohenadel M, Nitsche I, Bauer K, Sack U. The impact of acute stress on hormones and cytokines, and how their recovery is affected by music-evoked positive mood. Sci Rep. 2016 Mar 29;6:23008. doi: 10.1038/srep23008. PMID: 27020850; PMCID: PMC4810374.