Serum proteomic correlates of arts and cultural engagement: implications for novel biological pathways linking arts to health

Arts and cultural engagement (ACEng) have been linked to numerous physical and mental health outcomes across the life course, but research into the underlying biological mechanisms remains embryonic. We characterized the serum proteomic signatures of ACEng using data from a general population sample of [~]6,000 adults (Mean age: 53, SD: 18) in the UK Household Longitudinal Study with proteome profiling. Cross-sectional associations between ACEng and 184 cardiometabolic and neurological proteins were explored using multivariable linear regression, followed by functional enrichment analysis. Mediation analyses assessed whether identified proteins explained associations between ACEng and 15 cardiovascular, respiratory, musculoskeletal, metabolic, neurological and mental health conditions across a median of 20 years of follow up. Geater ACEng was associated with lower levels of 12 proteins and higher levels of six proteins after adjusting for sociodemographic confounders and multiple test corrections. Enriched biological pathways included cell proliferation, receptor-mediated signalling, immune regulation and inflammatory signalling. ACEng was associated with reduced prospective risk of most tested health conditions, and 70% of proteins were associated with at least one health condition. Proteins mediated the association between ACEng and disease risk; for example, TN-R mediated 10.23% of the association with asthma, SKR3 mediated 10.39% of the association with COPD, while MSR1 showed the largest mediation effects for stroke (11.81%), hypertension (11.27%), and diabetes (12.73%). Overall, all significant proteins mediated 15.95-37.70% of the associations between ACEng and the tested health outcomes. Main findings were replicated in extensive sensitivity analyses. These findings present, for the first time, proteomic signatures of ACEng and deepen our understanding of the mechanisms by which ACEng is linked to human health and disease.