Neuroimmune regulation of anxiety and stress: perspectives for balneotherapy

Abstract

Neuroimmune interactions play a fundamental role in the regulation of anxiety and stress responses, particularly in conditions associated with chronic stress exposure and neuropsychiatric dysregulation. Growing evidence indicates that inflammatory signalling pathways, including cytokine activation, oxidative stress, and neuroendocrine imbalance, contribute to altered emotional regulation, autonomic dysfunction, and sleep disturbances. Dysregulation of the hypothalamic–pituitary–adrenal axis and persistent low-grade inflammation may increase vulnerability to anxiety symptoms and impair adaptive stress responses. From a balneological perspective, spa-based therapeutic strategies may support the modulation of neuroimmune mechanisms through combined thermal, hydrostatic, and environmental stimuli. Balneotherapy, hydrotherapy, climatotherapy, and structured spa rehabilitation programmes may influence autonomic balance, promote parasympathetic activation, and reduce inflammatory burden, thereby contributing to improved psychological resilience and stress adaptation. Exposure to natural environments and relaxation-oriented interventions may additionally support neurobiological recovery and emotional stabilisation. Integrating contemporary neuroimmunology with balneological medicine provides a multidisciplinary framework for non-pharmacological rehabilitation targeting both physiological and psychosocial aspects of anxiety and stress-related disorders. This review highlights the potential of balneotherapy as a complementary strategy within environmental neurorehabilitation and emphasises the need for further clinical studies evaluating neuroimmune biomarkers as outcomes of spa-based interventions.