Immune System Function
This is one of the most exciting areas of
chiropractic. More and more research is pointing to an immune
system enhancement effect of the spinal adjustment.
The effects
of chiropractic on the immune system: a review of the literature.
Allen JM, Chiropractic Journal of Australia, 1993; 23:132-135.
This
is a summary of recent research implying a connection between
chiropractic adjustments and immunocompetence. The literature
suggests that the nervous system plays a role in the modulation
of the immune response and that chiropractic adjustments influence
T and B lymphocyte numbers, natural killer cell numbers, antibody
levels, phagocytic activity and plasma endorphin levels. The
few studies attempting to measure the effect of chiropractic
or manipulative treatment on the immune response are reviewed.
The
anatomical and physiological connections between the immune
system and the nervous system suggest that the nervous system
plays a role in the modulation of the immune response.
Noradrenergic
sympathetic neural interactions with the immune system: structure
and function. Felton, D.L., Felton, S.Y., Bellinger, D.L.,
et al. Immunol Rev 100:225-260, 1987.
This is one of a growing
number of papers by researchers in the field of psychoneuroimmunology
exploring the relationship between the nervous system and the
immune system. Potential mechanisms of action are discussed.
A
comparative study of the health status of children raised under
the health care models of chiropractic and allopathic medicine.
Van Breda, Wendy M. and Juan M. Journal of Chiropractic Research
Summer 1989.
Children under chiropractic had less use of medications,
including antibiotics.
An overview of neuroimmunomodulation
and a possible correlation with musculoskeletal system function.
Fidelibus J. Journal of Manipulative and Physiological Therapeutics,
12:4, 1989.
Receptors for neuromodulators and neurohormones
have been identified on human T-lymphocytes. It is believed
that the immune system can communicate with the nervous system
using neuromodulators and neurohormones secreted by lymphocytes.
Chronic
hyperemesis in two siblings with AIDS. Fallon, J Int’l
Chiropractic Association Review Summer 2002.
Two male siblings
ages 4 and 6 with “HIV infections” and “full-blown
AIDS.”
Both boys suffered from severe hyperemesis (vomiting)
associated with a hyperactive gag reflex and were on a liquid
diet: the six-year-old by mouth and the 4-year-old by gastric
tube. The 6-year-old had a viral load of 1,200+ and was on
a regime of antiviral drugs. His 4-year-old brother, with a
viral load of 1,000,000+ was on a cocktail of HIV medications
(after the monotherapy failed).
The 4-year-old had a history
of chronic ear infections and the 6-year-old had severe learning
disabilities. Both boys needed a walker or bilateral canes.
The older boy had uncontrollable dribbling.
Spinal examination
of the 4-year-old revealed subluxations at occiput/atlas, C1,
C4, T4, T9 and Tl2. Spinal examination of the 6-year-old revealed
subluxations at C1, T1, T8 and AS of the right ileum.
Adjustments
of the subluxated segments were begun; each boy was initially
seen 2 times a week for three weeks.
Within three weeks of initial
care the older boy could walk better, he was able to use only
one cane instead of two, he ate solid food for the first time
since birth, his chronic drooling stopped as did his gagging
and vomiting. However, if he went longer than 30 days without
an adjustment his gag reflex returned as well as the uncontrolled
vomiting.
The younger boy was able to stop the gastric feeding
and take liquid food orally, his vomiting reduced and his chronic
ear infections ceased. In a few months he was able to eat
solid food. His viral load dropped from 1,000,000+ to 5!
As long as he was adjusted 1-2 times per month, his vomiting
did not return.
Chiropractic treatment and antibody levels.
Alcorn, S. Journal of the Australian Chiropractic Association.
1977.
This paper reported increased levels of immunoglobulins
in the blood serum of three patients under chiropractic care.
A fourth patient did not respond to care.
The author speculates
the vertebral subluxation complex (VSC) acts as a stressor,
which causes increased secretion of cortical from the adrenal
cortex. If cortisol levels exceed optimum levels, immunoglobulin
secretion would be inhibited.
Enhanced phagocytic cell respiratory
burst induced by spinal manipulation: potential role of substance
P. Brennan PC, Kokjohn DC, Killinger CL et al. Journal of Manipulative
and Physiological Therapeutics Vol. 14 No 7 Sept 1991 p 399-408.
An
interesting property of phagocytic cells (polymorphonuclear
neutrophils or PMNs and monocytes in this study) is put to
use in this study, that is, they emit light during phagocytosis
(called “respiratory burst”).
Using 67 male and
32 female volunteers, blood was taken 15 minutes before and
after subjects had a sham manipulation, a thoracic spine manipulation
or a soft tissue manipulation.
More light was emitted from monocytes
and PMNs after spinal manipulation than from the sham or soft
tissue work. Substance P (SP) is a neurotransmitter released
from the dorsal root ganglion and its plasma level was elevated
after the manipulation. SP appears to be able to prime phagocytes
for enhanced respiratory burst.
From the discussion: “Thus
the data provide evidence in man that spinal manipulation elicits
viscerosomatic responses; specifically, our study shows that
manipulation affects cells involved in inflammatory and immune
responses, at least over the short term.”
Note from Dr. Koren: Although the authors state that “trained
manipulators are able to deliver controlled, discriminable
efforts,” it is not apparent how their concept of manipulation
relates to the chiropractic adjustment of the vertebral subluxation
complex. The authors admit that there appears to be a “threshold
effect” of force but is that force due to the correction
of the vertebral subluxation complex or the body’s
response to physical stress? Is a manipulation different
from an adjustment? This makes the paper limited from a practical
therapeutic standpoint.
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 et al.
Journal of Manipulative and Physiological Therapeutics Vol.
15 no. 2 Feb.1992. P. 83-89.
This paper builds upon the one
above. Using blood collected from 27 males and 19 females after
a manipulation of the thoracic spine, the plasma levels of
substance P (SP) and respiratory burst response of PMLNs was
found to be higher 15 minutes after manipulation than from
blood collected 15 minutes before or 30 and 45 minutes after
manipulation. In addition to priming PMNs for enhanced respiratory
burst (RB), SP also stimulates production of mononuclear cell
tumor necrosis factor (TNF). Mononuclear cells are also primed
for enhanced endotoxin-stimulated TNF production after manipulation.
From
the discussion:
The data presented confirm and extend our previous
reports that a high-velocity, low-amplitude thrust to the thoracic
spine primes PMN for an enhanced respiratory burst in response
to a particulate challenge. Spinal manipulation also primes
mononuclear cells for enhanced endotoxin stimulated TNF production...this
has not been previously reported.... Thus these data further
support the notion that spinal manipulation elicits viscerosomatic
responses....”
Note from Dr. Koren: This paper has the weaknesses of the
one above i.e. If it is chiropractic research, where’s
the subluxation? How does the vertebral subluxation complex
relate to this? Are chiropractors merely manipulating spines
or specifically adjusting subluxations and how does their “thoracic
manipulation” fit into this?
The effect of chiropractic
spinal manipulative therapy on salivary cortisol levels. Tuchin
PJ. Journal of Australasian Chiropractic and Osteopathy, July
1998; 7(2), pp. 86-92
This is the study of six males and three
females who had their baseline cortisol levels established
and then received two-weeks of care (4 adjustments) follow
by a two-week post adjustment period.
Saliva samples were analyzed
and results showed reduction or no increase of salivary cortisol
suggesting that chiropractic care had a measurable calming,
physically soothing and restorative effect.
Immunologic correlates
of reduced spinal mobility: preliminary observations in a dog
model. Brennan PC, Kokjohn K, Triano JJ et al. In: Proceeding
of the 1991 International Conference on Spinal Manipulation,
FCER; 118-121.
The posterior facet joints of four beagles were
surgically fused at L1/L2 and L2/L3 by injecting a sealant.
T11/12 and T12/13 joints were fused on two of the beagles.
Four beagles were used as controls.
The respiratory burst (RB)
of the polymorphonuclear neutrophils (PMN) were depressed in
the dogs who underwent the surgical fusion in contrast to the
4 dogs who had a sham surgical fusion. The results of this
study suggest that spinal joint fixation results in immunosupression.
Note
from Dr. Koren: This study is similar in some ways to an earlier
animal experiment by DeBoer and McKnight (Surgical model of
a chronic subluxation in rabbits. DeBoer KF and McKnight ME
Journal of Manipulative and Physiological Therapeutics 11:366-372)
where researchers created severe spinal distortions in rabbits.
This experiment tried to do the opposite by creating a lessening
of motion, a surgical fusion. These experiments are testing
one component of the vertebral subluxation complex, kinesiopathology.
Clinically chiropractors have found that both hypomobility
and hypermobility are related to the vertebral subluxation
complex.
The effects of specific upper cervical adjustments
on the CD4 counts of HIV positive patients. Selano JL, Hightower
BC, Pfleger B, et al. Chiropractic Research Journal. 1994;
3(1): 32-39.
This was a study to determine if chiropractic care
could help individuals diagnosed with HIV.
Five patients were
adjusted and five were controls. After 6 months, in the control
group (not under chiropractic care), the CD4 levels declined
by 7.96% while the group receiving chiropractic adjustments
experienced a 48% increase in CD4 cell counts. This indicates
that correction of upper cervical subluxation could improve
immunocompetence.
Comment from Dr. Koren: It was reported to
me that this study was originally intended to go on for one
year, but after two patients in the control group died of AIDS,
Dr. Grostic decided to end the study and put the surviving
controls under chiropractic care.
Chiropractic and HIV infection.
Martin, C. Journal of the American Chiropractic Association.
1995;3212:41-44.
Recent research and case history analysis suggests
that vertebral manipulation may have wide-ranging effects.
From improvement in symptoms like peripheral neuropathy to
stimulation of immune system, chiropractic appears to encourage
individual well-being.
The reduction of stress, education of
the patient towards an immunopositive lifestyle and the removal
of nervous system interference are the central benefits which
chiropractic offers.
Priming of neutrophils for enhanced respiratory
burst by manipulation of the thoracic spine. Brennan P. and
Hondras M Proceedings of the 1989 International Conference
on Spinal Manipulation. Pub: FCER: Arlington, VA. pp.160-163.;
Manipulation
of the thoracic spine appeared to increase the sensitivity
of the white blood cells as indicated by respiratory burst.
Chiropractic
care in adult spina bifida: a case report. Thomas RJ, Wilkinson
RR. Chiropractic Technique, 1990; 2:191-193.
This is the case
of a 31-year-old female with spina bifida at T11-L2 who presented
with multiple symptoms that included muscle spasms, poor bladder
control, recurrent bladder infection, swollen cervical lymph
nodes, and possible immunosupression.
Chiropractic adjustments
consisted of Logan Basic and other minimal force techniques.
After 5 years of chiropractic care, her bladder has been infection-free
for a period of more than a year; bladder control has improved
and leg spasms have decreased in frequency and severity. Menstrual
cramping also reduced.
Based on the case history of recurrent
infection, the author hypothesized that one effect of the vertebral
subluxation complex was immunosupression, which was relieved
by chiropractic adjustments.
The side effects of the chiropractic
adjustment. Burnier, A. Chiropractic Pediatrics Vol. 1 No.
4 May 1995.
L.T. female age 7 ½ has been under chiropractic
care since birth. She has never had the need to seek medical
care, nor taken a single medication or over over-the-counter
drug to date. Her presenting vertebral subluxation: Atlas ASLA,
D3/D4 PI.
Original Adjustment: Structural manual adjustment
of D3/D4 in extension prone and Atlas in supine position.
S.
Family 4 children age 1,2,3,5. All the children have been under
regular chiropractic care since birth and have not needed for
medication or over-the-counter drugs. Each child was checked
soon after birth and then weekly thereafter. Adjustments were
only given if and when subluxations were present. The children
were adjusted in one or two places on an average of 21 day
intervals.
Copyright 2004 Koren Publications, Inc. & Tedd
Koren, D.C.
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