Chiropractic and Immune Function

Peer Reviewed Research:

Chiropractic and the Neuroimmune Connection
Ari Cohn, DC
[September 30, 2008, pp 1-5]

 

Chiropractic Care for Children Found Safe and Effective

Preliminary results of two survey studies is finding chiropractic care for children to be safe, effective and offer additional health benefits as well.

Here are the abstracts from the ICPA:

1-Treatment-related aggravations, complications and improvements attributed to chiropractic spinal manipulative therapy of pediatric patients: a practice-based survey of practitioners.

Alcantara, J, Ohm, J, and Kunz, D

Objective
To investigate the iatrogenesis and symptom improvements associated with chiropractic spinal manipulative therapy (SMT) of pediatric patients.

Conclusion
This study suggests that the chiropractic SMT care of children is safe and effective.

Read the abstract here

2-Treatment-related aggravations, complications and improvements attributed to chiropractic spinal manipulative therapy of pediatric patients: a survey of parents.

Alcantara, J, Ohm, J, and Kunz, D

Conclusion
This study provides supporting evidence on the safety and effectiveness of chiropractic SMT in children based on parental reports.   

Read the abstract here

---

Long Term Assessment of Blood Indices and Immune Panel Profiling of Subjects Receiving Chiropractic Care: A Pilot Study
WR Boone Bio, Ph.D., DC; Paul Oswald Bio, B.Sc.; Kelly Holt, Bio, B.Sc.; Randy Beck Bio, Ph.D., DC.; Kanwal Singh Bio, MD; Andrew Ashton Bio, B.Sc.
Journal of Veretebral Subluxation Research June 7, 2006, pp 1-11

• Objective: A pilot study to evaluate the approach of monitoring immune status as a feasible means of assessing physiological health in longitudinal studies that seek to ascertain changes in patient health status under chiropractic care.
• Conclusion: It is concluded that the approach of monitoring immune status is feasible as a means of assessing physiological health in longitudinal studies that seek to ascertain changes in patient health status.
  
  

Physical, physiological, and immune status changes, coupled with self-perceptions of health and quality of life, in subjects receiving chiropractic care: A pilot study
WR Boone Bio, Ph.D., DC; Paul Oswald Bio, B.Sc.; Kelly Holt, Bio, B.Sc.; Randy Beck Bio, Ph.D., DC.; Kanwal Singh Bio, MD; Andrew Ashton Bio, B.Sc.
Journal of Vertebral Subluxation Research July 5, 2006, pp 1-6

• Objective: A pilot study to gather preliminary information regarding chiropractic care and possible links to immune status and improved aspects of health and quality of life.
• Conclusion: This pilot study has provided some preliminary information regarding chiropractic care and possible links to immune status and improved aspects of health and quality of life. Limited numbers of subjects, however, preclude definitive conclusions. Larger studies, including ill and healthy populations, to investigate the parameters presented herein and others such as killer cell activity will be necessary to test the conclusions presented.

Spinal Manipulative Therapy Reduces Inflammatory Cytokines but Not Substance P Production in Normal Subjects
J Manipulative Physiol Ther 2006 (Jan);   29 (1):   14–21

Over the study period, a significant proportion (P ≤ .05) of sham and control subjects demonstrated progressive increases in the synthesis of tumor necrosis factor alpha and IL-1beta. Conversely, in a comparable proportion of cultures from SMT-derived subjects, the production of both cytokines decreased gradually. Normalization of the observed alterations to reflect the changes relative to self-baselines demonstrated that, within 2 hours after intervention, the production of both cytokines increased significantly (P < .001 to .05) in both controls. In contrast, a significant (P < .001 to .05) reduction of proinflammatory cytokine secretion was observed in cultures from SMT-receiving subjects. In all study groups, serum levels of SP remained unaltered within 2 hours after intervention. SMT-treated subjects show a time-dependent attenuation of LPS-induced production of the inflammatory cytokines unrelated to systemic levels of SP. This suggests SMT-related down-regulation of inflammatory-type responses via a central yet unknown mechanism. This work was originally funded by the   Consortial Center of Chiropractic Research (CCCR)

Vertebral Subluxation Correlated with Somatic,Visceral and Immune Complaints: An Analysis of 650 Children Under Chiropractic Care
Ogi Ressel BSc, DC, DACBR(C), FICPA Bio and Robert Rudy BSc, DC, FICPA Bio
Journal of Vertebral Subluxation Research October 18, 2004 pp 1-23

• Background:We evaluated children and their neuromuscular, biomechanical, neuro-homeostatic development and patterning in order to gain some insight into the perplexing problem of health attainment. We describe the nuances and effects of a new subluxation pattern seen in children - the Pelvic Distortion Subluxation Complex (PDSC). We feel that the PDSC is responsible, partially or fully, for a number of adaptive neurological patterns and kinesiopathological reflexes that can propagate a myriad of conditions - these seem to arise in childhood and plague individuals into adulthood. The authors maintain that PDSC is an entity amenable to correction - thereby restoring homeostasis.
• Objective: It is the author’s contention that many, if not the preponderance of conditions seen in adults, have their origins in the childhood years. The objective of this paper is to describe a new subluxation pattern seen in children - the Pelvic Distortion Subluxation Complex which we found to be a common denoninator in many children’s health issues
• Conclusion: The process of neurological learning or programming of the central nervous system with respect to locomotion, posture, proprioception, and body kinetics begins within a few short months after birth. Our study revealed a pattern of pelvic dysfunction correlated with numerous somatic, visceral and immune complaints. These dysfunctions should be discovered as early as possible in a child’s development to effect a correction and the relationship between these dysfunctions and ill health should be further studied.
  
  

Studies on Effects of Spinal Manipulation on the Immune Response   Stephen H. Injeyan, DC, PhD   This work is in progress under a grant from the Consortial Center for Chiropractic Research and the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM)

• The immune and endocrine systems are integrated through mutual communication mediated by endogenous mediators such as cytokines and neuroendocrine peptides. Scientific evidence also shows that activation of the autonomic nervous system may lead to alteration in various physiological responses including the immune and inflammatory responses.
• Published evidence in the chiropractic literature suggests that spinal manipulative treatment (SMT) may affect the immune system. In the present study, the effect(s) of a single SMT on various aspects of the immune response is being investigated. To: 1) determine whether a single chiropractic treatment induces alterations in the T-cell-mediated humoral (B cell) response, 2) establish if spinal manipulation affects the production of soluble mediators (cytokines) of the immune and inflammatory responses.

 

Changes in Health Measures in HIV+ Chiropractic Patients   Lisa A. Caputo, DC   This work is in progress under a grant from the Consortial Center for Chiropractic Research and the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM)

• The long-term objectives of this research are to examine the effects of chiropractic care on health-related quality of life (HRQoL) in people living with HIV/AIDS (PLA). The specific aims of this study are:
  1. To determine the profile of a population of HIV+ patients in a hospital-based chiropractic clinic with respect to clinical staging and response profiles to the Medical Outcome Study-HIV Health Survey (MOS-HIV), Oswestry Disability Questionnaire (ODQ) and/or Neck Disability Index (NDI) and Numeric Rating Scale-11 (NRS-11); and
  2. To determine if there is a change in self-reported HRQoL, levels of pain and perceived disability in PLA receiving chiropractic care.

Effect of Vertebral Loading on Sympathetic Nerve Regulation   Joel G. Pickar, DC, PhD   This work is in progress (See it at the bottom of the page) under a grant from the Consortial Center for Chiropractic Research and the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM)

• The nervous system plays a pivotal role in chiropractic theory and practice. The concepts forming the cornerstones of chiropractic, namely the "subluxation" and the "adjustment" have continually emphasized this point. Chiropractic has long held that subluxations can produce disorders of internal organs and spinal manipulation can ameliorate and/or alleviate these disorders via their effects on the nervous system.
• The purpose of this project was to determine if sensory input from paraspinal tissues affects sympathetic nerve activity and thus could contribute directly to the function of an internal organ. The specific aims of this study were to determine if mechanical loading of a vertebra alters the magnitudes of, patterns of, or relationships between sympathetic nerve discharge to discrete organ systems.

Chiropractic RX for Chronic Otitis Media With Effusion   David Eisenberg, MD   This work is in progress under a grant from the Consortial Center for Chiropractic Research and the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM)

• The aim of the proposal is to examine whether chiropractic treatment will reduce the likelihood of the persistence of effusion in children with otitis media with effusion (OME) when compared to usual care.
  
• The innervation of the tensor veli palatini (tvp) muscle is through the motor fibers of the mandibular branch of the trigeminal nerve. These fibers unite to form portions of the superior cervical ganglion located between the C-1 and C-4 nerve roots. Neurological compromise of this muscle by osseous or soft tissue structures may contribute to the malfunction of the tvp muscle causing inadequate patency of the tube resulting in the pathological response of OME. Chiropractic therapy may improve the function of the TVP.

The Reflex Effects of Subluxation:   The Autonomic Nervous System   Brian Budgell, D.C.   J Manipulative Physiol Ther 2000 (Feb);   23 (2):   104-106

• There is no shortage of theories to explain the role of the subluxation in disease and the effect of the adjustment in relieving symptomatology. The autonomic nervous system has often been invoked in constructing mechanisms to account for the effects of spinal dysfunction. Recent investigations justify the attention which has been focused on this component of the nervous system.
  
• Recent neuroscience research supports a neurophysiologic rationale for the concept that aberrant stimulation of spinal or paraspinal structures may lead to segmentally organized reflex responses of the autonomic nervous system, which in turn may alter visceral function.
  

The Effects of Chiropractic on the Immune System:   A Review of the Literature   James M. Allen   Chiro J Aust 1993 (Dec);   23 (4):   132-135

• This paper outlines the many components of the mammalian immune system and the anatomical and physiological connections suggesting that the nervous system plays a role in the modulation of immune response. The few studies attempting to measure the effect of chiropractic or manipulative treatment on the immune system are reviewed. Their results suggest that chiropractic or manipulative treatment may influence T and B lymphocyte numbers, NK cell numbers, antibody levels, phagocytic activity and plasma beta-endorphin levels. The influence of these effects on the outcome of host resistance is unknown. There is now a need for large, well-planned clinical trials using some of the more sophisticated measures of immune function to establish whether chiropractic treatment can influence the immune response in a clinically significant manner.

Enhanced Neutrophil Respiratory Burst as a Biological Marker for Manipulation Forces: Duration of the Effect and Association with Substance P and Tumor Necrosis Factor   Brennan PC, Triano JJ, McGregor M, Kokjohn K, Hondras MA, Brennan DC   J Manipulative Physiol Ther 1992;   15 (2) Feb:   83-89

• A critical need in assessing the clinical utility of manipulative therapy for back pain is the identification of biological changes associated with the forces applied by spinal manipulation. Such changes could then serve as markers for both sham treatment and manipulation. We determined the priming of polymorphonuclear neutrophils for an enhanced respiratory burst and its duration, the priming of mononuclear cells for enhanced endotoxin-stimulated tumor necrosis factor production and plasma levels of substance P following a single thoracic spine manipulation. There was a significant difference in the respiratory burst of polymorphonuclear neutrophils in response to a particulate challenge, depending on the time of blood sample collection.
  
• The response of polymorphonuclear neutrophils isolated from blood collected 15 min after manipulation was significantly higher than the response of cells isolated from blood collected 15 min before and 30 and 45 min after manipulation. Mononuclear cells were also primed for enhanced endotoxin-stimulated tumor necrosis factor production by spinal manipulation. Both of these priming effects were accompanied by a slight, but significant elevation in plasma substance P. The mean manipulation force associated with these biological effects was 878 +/- 99 N. These biological effects may provide a means of monitoring the delivery of both sham and manipulative treatment and, therefore, provide a crucial tool for understanding the efficacy of manipulative therapy.

Enhanced Phagocytic Cell Respiratory Burst Induced by Spinal Manipulation: Potential Role of Substance P   Brennan PC, Kokjohn K, Kaltinger CJ, Lohr GE, Glendening C, Hondras MA, McGregor M, Triano JJ   J Manipulative Physiol Ther 1991;   14 (7) Sep:   399-408

• The effect of spinal manipulation on the respiratory burst of polymorphonuclear neutrophils (PMN) and monocytes from treated adults was measured by zymosan-stimulated chemiluminescence (CL). Peripheral blood was collected 15 min before and 15 min after treatment (sham manipulation, thoracic spine manipulation, or soft tissue manipulation), the cells were isolated, challenged with a standardized, opsonized luminol-containing suspension of zymosan, and monitored for CL. Plasma from two subsets of subjects was radioimmunoassayed for Substance P (SP). PMN were also preincubated with SP in vitro over the dose range 5 x 10(-12) M to 5 x 10(-8) M and the CL responsemonitored.



• The CL responses of both PMN and monocytes from subjects who received spinal manipulation were significantly higher after than before treatment, and significantly higher than the response in sham or soft-tissue treated subjects. Measurement of the force applied by sham and spinal manipulation suggested a force threshold for the enhancement of the CL response. Plasma levels of SP before and after treatment in sham treated subjects did not differ significantly; however, elevated plasma SP was observed in subjects after spinal manipulation. Preincubation of PMN with 1 x 10(-11) M, 5 x 10(-11) M or 1 x 10(-10) M SP in vitro primed PMN for an enhanced respiratory burst when the cells were subsequently challenged.

An Overview of Neuroimmunomodulation and a Possible Correlation with Musculoskeletal System Function   Fidelibus JC   J Manipulative Physiol Ther 1989;   12 (4) Aug:   289-292

• There is an increasing body of evidence that the nervous system is capable of modulating the immune response. Receptors for neuromodulators and neurohormones have been found on human T lymphocytes. Activation of these receptors can be stimulatory or inhibitory depending on the neuroactive substance. The immune system may be able to communicate with the nervous system using neuromodulators and neurohormones secreted by lymphocytes. Sympathetic innervation of lymphoid tissues is not restricted to blood vessels and smooth muscle, but directly supplies lymphocytes and blood precursor cells. It is theorized that spinal fixations may adversely affect the immune response through somatosympathetic reflexes. Spinal manipulation can correct the spinal fixations and may eliminate the adverse affects of somatosympathetic reflexes.

Review more articles on Chiropractic and the Immune System at Chiro.Org