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autoimmune diseases

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Is Chiropractic a Treatment for this Disease?

Autoimmune Disorder

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.

The chiropractic management of a paralytic autoimmune disorder Amalu WC. Today’s Chiropractic. March/April 2002;51-57.

This is the case of a 33-year-old female with stocking-glove numbness, bilateral upper and lower extremity weakness and twitching and overall fatigue over a three-month period.  Six months earlier she had awoken with numbness in her left pinky finger and within two months the symptoms progressed to complete quadriplegia.  MRI, CT scans, spinal taps and lab exams failed to identify her problem.  When intravenous immunoglobulin (IVIG) therapy brought cessation of all signs and symptoms, a diagnosis of autoimmune disorder with associated peripheral neuropathy was made.  Her symptoms would disappear after IVIG therapy but slowly returned to complete paralysis until another IVIG treatment followed by 10 days of prednisone to counteract the side effects.  Chiropractic spinal analysis using infrared imaging, muscle analysis and precision X-ray analysis revealed upper cervical (atlanto-occipital, atlano-axial) subluxations.  The atlas was adjusted knee-chest posture on the posterior arch.  Post adjustment spinal scans revealed resolution of subluxation symptom complex. The patient was adjusted once weekly for three months of care.  Stocking-glove numbness increased for two days after the first adjustment followed by a significant decrease in symptoms including a mild improvement in muscle strength and fatigue.  She continued to improve. Her upper extremity strength increased, she was able to increase her workload, had more energy, and discontinued her IVIG and prednisone therapy. After one year the patient continued her improvement; apart from some lower extremity weakness with stair use she remains active and symptom free.

 

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The following is provided for the hearing impaired

What are autoimmune diseases?

Our bodies have an immune system that protects us from disease and infection. But if you have an autoimmune disease, your immune system attacks itself by mistake, and you can get sick. Autoimmune diseases can affect connective tissue in your body (the tissue which binds together body tissues and organs). Autoimmune disease can affect many parts of your body, like your nerves, muscles, endocrine system (system that directs your body’s hormones and other chemicals), and digestive system.

Who is at risk for getting autoimmune diseases?

Most autoimmune diseases occur in women, and most often during their childbearing years. Some of these diseases also affect African American, American Indian, and Latina women more than Caucasian women. These diseases tend to run in families, so your genes, along with the way your immune system responds to certain triggers or things in the environment, affect your chances of getting one of these diseases. If you think you may have an autoimmune disease, ask your family members if they have had symptoms like yours. The good news is that if you have an autoimmune disease, there are things you can do to feel better!

What are the most common symptoms of autoimmune diseases?

There are more than 80 types of autoimmune diseases. Learning the symptoms of some of the more common autoimmune diseases can help you recognize the signs, if you get one.  But some autoimmune diseases share similar symptoms. This makes it hard for doctors to find out if you really have one of these diseases, and which one it might be. This can make your trip to doctors long and stressful. But if you are having symptoms that bother you, you need to persist to make sure you get relief.

Side Effects of Prednisone

The most commonly encountered side effects are:

 

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