Immune Function
and Chiropractic

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

Chiropractic Research Results for Immune Function

	Maintenance Care, Wellness and Chiropractic A Chiro.Org article collection This page is devoted to reviewing articles that support wellness (and maintenance) care.
	The Potential Mechanisms of High-Velocity, Low-Amplitude, Controlled Vertebral Thrusts on Neuroimmune Function: A Narrative Review Medicina (Kaunas) 2021 (Jun); 57 (6): 536 ~ FULL TEXT There is substantial evidence suggesting that the nervous system, the hormonal system and the immune system communicate with one another and are intimately linked in their functions. [70, 93–97] This communication is essential for the body’s ability to protect itself and involves a variety of immune mediators, including cytokines, neurotransmitters, hormones, and humoral factors. [67, 68, 70, 94, 116, 117, 164, 234] Furthermore, the prefrontal cortex is critically involved in regulating the autonomic nervous system, the HPA axis, and the immune system. [94, 144–154] Neuro-immune communication is affected by emotional or pain-related stress. [69, 144, 151, 195, 260–262] Stress activates the SNS and HPA axis to increase inflammation in the body. Stress also suppresses the prefrontal cortex, which in turn reduces its inhibitory control on the HPA axis and inhibits the anti-inflammatory PNS activity.
	The Physiological Role of Tumor Necrosis Factor in Human Immunity Its Potential Implications in Spinal Manipulative Therapy: A Narrative Literature Review J Chiropractic Medicine 2016 (Sep); 15 (3): 190–196 ~ FULL TEXT Although tumor necrosis factor (TNF) is a well-known inflammatory cytokine in the pathological development of various human diseases, its physiological roles are not widely understood nor appreciated. The molecular mechanisms underlying spinal manipulation therapy (SMT) remain elusive. The relationship between TNF and SMT is unclear. Thus, we performed this literature review to better understand TNF physiology and its potential relationship with SMT, and we propose a novel mechanism by which SMT may achieve clinical benefits by using certain beneficial features of TNF.
	Immune Responses to Spinal Manipulation Dynamic Chiropractic (May 6, 2011) For many years, chiropractors have observed in their own practices that their patients sometimes demonstrate improvements of complaints related to immune problems: the disappearance or lessening of allergy symptoms, quicker recovery from or less frequent and severe colds and other respiratory infections, and so on. In the scientific literature, there have been occasional case reports that corroborate such findings, but no sound evidence to really document their veracity. These clinical observations remain suspended in that grey area unsubstantiated by scientific data to confirm their validity. Significant limitations of changes attributed to spinal manipulation in individual patients include 1) there is never a control group; 2) there is no blinding; 3) the improvement may simply be due to time; 4) they may be a nonspecific effect of care and attention; 5) it may be a regression to the mean; or 6) the result may be due to something other than spinal manipulation.
	Interleukin 2-regulated In Vitro Antibody Production Following A Single Spinal Manipulative Treatment in Normal Subjects Chiropractic & Osteopathy 2010 (Sep 8); 18: 26 The induction and regulation of immune responses involve complex interactions between the immune and nervous systems mediated by the biologic action of numerous humoral factors including neurotransmitters and immunoregulatory cytokines. [1, 2] It has been suggested that systemic somatoautonomic reflex effects following spinal manipulative therapy (SMT) might include modulation of immune reactions. [3, 4] Animal studies have found efferent sympathetic stimulation to be immunosuppressive [5]and it has been suggested that depressed levels of natural killer (NK) cells observed in low back patients [6] might be related to somatovisceral reflex stimulation. However, mechanisms of SMT action on immune modulation have remained illusive. [7]
	Reduction in High Blood Tumor Necrosis Factor-α Levels After Manipulative Therapy in 2 Cervicogenic Headache Patients J Manipulative Physiol Ther. 2009 (Sep); 32 (7): 586–591 ~ FULL TEXT This case report discusses the treatment of 2 patients with cervicogenic headache (CHA) attending the Outpatient Clinic of the Hungarian National Institute for Rheumatology and Physiotherapy (Budapest, Hungary) and reviews the pathophysiology, therapeutic strategy, and problems associated with the treatment of CHA.
	Spinal Manipulative Therapy Reduces Inflammatory Cytokines but Not Substance P Production in Normal Subjects J Manipulative Physiol Ther 2006 (Jan); 29 (1): 14–21 ~ FULL TEXT 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)
	Reflex Effects of Vertebral Subluxations: The Peripheral Nervous System. An Update J Manipulative Physiol Ther 2000 (Feb); 23 (2): 101–103 ~ FULL TEXT In contrast to others who manipulate the vertebral column, history records that a unique feature of the chiropractic profession is that many of the clinical activities of chiropractors have developed from a clinical hypothesis proposed by Palmer [1] concerning vertebral misalignment. Although others who manipulate the vertebral column may do so for other reasons, it is important for the chiropractic profession to determine the validity of the chiropractic vertebral subluxation hypothesis for 3 principle reasons.
	Reflex Effects of Subluxation: The Autonomic Nervous System J Manipulative Physiol Ther 2000 (Feb); 23 (2): 104–106 ~ FULL TEXT 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 Specific Upper Cervical Adjustments on the CD4 Counts of HIV Positive Patients Chiropractic Research J 1994;   3 (1):   32–39 These tests were performed by the patients independent medical center where they were under medical supervision for the regular group were dramatically increased over the counts of the control group. A 48% increase in CD4 cells was demonstrated over the six month duration of the study for the adjusted group.
	The Effects of Chiropractic on the Immune System: A Review of the Literature Chiropractic Journal of Australia 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.
	Enhanced Neutrophil Respiratory Burst as a Biological Marker for Manipulation Forces: Duration of the Effect and Association with Substance P and Tumor Necrosis Factor J Manipulative Physiol Ther 1992 (Feb);   15 (2):   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.
	Enhanced Phagocytic Cell Respiratory Burst Induced by Spinal Manipulation: Potential Role of Substance P J Manipulative Physiol Ther 1991 (Sep);   14 (7):   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.
	Immunologic Correlates of Reduced Spinal Mobility: Preliminary Observations in a Dog Model FCER's International Conference on Spinal Manipulation, 1991;   118–121 To avoid severe distortion of the spine, we have developed an experimental model which focuses on reduced spinal flexibility. Reduced spinal mobility was produced by fusing selected posterior facet joints of young adult male beagles with a non-toxic, non-immunogenic fibrin sealant. This report presents the preliminary results of measures of immune cell function in four dogs whose facet joints were fused compared with immune cell function in control dogs who underwent sham spinal fusion.
	Functional Ability of Natural Killer Cells as an Outcome Measure for Chiropractic Treatment Efficacy FCER's International Conference on Spinal Manipulation, 1991;   84–96 Previous work in our laboratory suggested that both the percentage and the absolute numbers of NK cells were significantly lower in patients presenting to the main clinic of The National College of Chiropractic (NCCC) than in asymptomatic controls (6). However, these results were obtained using conventional fluorescence microscopy. Using flow cytometry to quantitate cells and a standard cytotoxicity assay to measure cell function, we are currently assessing the numbers and functional ability of NK cells. The purpose is to develop sensitive cellular outcome measures for use in future clinical trials.
	A Comparative Study of the Health Status of Children Raised Under the Health Care Models of Chiropractic and Allopathic Medicine J Chiropractic Research 1989 (Summer);   5:   101–103 This 1989 study compared the health of two hundred children under chiropractic care and two hundred children under medical care. The chiropractic children had fewer ear infections, fewer allergies, fewer cases of tonsillitis, and needed less medical treatment (antibiotics and other medications). The authors noted that there is a “definite correlation between chiropractic care and superior health.” In fact, this study “has shown that children raised under chiropractic care are less prone to infectious processes such as otitis media and tonsillitis, and that their immune systems are better able to cope with allergens such as pollen,weeds, grasses, etc. compared to children raised under allopathic care. There is also a significant decreased history of antibiotic use among the ‘Chiropractic’ children, indicating a lower susceptibility to bacterial infections as a result of their greater immune system response.”
	An Overview of Neuroimmunomodulation and a Possible Correlation with Musculoskeletal System Function J Manipulative Physiol Ther 1989 (Aug);   12 (4):   289–292 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.

Other Management Approaches for Immune Enhancement

The Immunity and Nutrition Page A Chiro.Org article collection This compilation from our Nutrition Section details the impact of a variety of substances from Co–Q10 to Vitamin E on improving immune function.

Portal to the Interior: Viral Pathogenesis and Natural Compounds that Restore Mucosal Immunity and Modulate Inflammation Alternative Medicine Review 2003 (Nov); 8 (4): 395–409 ~ FULL TEXT Since mucosal immunity forms the first line of defense against many commonly transmitted pathogens, restoring and maintaining mucosal immunity is critical for disease prevention and intervention. This article discusses the nature of mucosal immunity and its relationship to viral infections and other conditions, and reviews natural compounds that help restore mucosal immunity.

Nutrients and HIV

	Part I: Beta Carotene and Selenium Alternative Medicine Review 1999; 4 (6): 403–413 ~ FULL TEXT HIV infection involves a progressive immune dysfunction and loss of CD4 T cells leading to opportunistic infection, wasting syndrome, malignancies, or CD4 depletion significant enough to qualify as CDC-defined AIDS. Several research studies have indicated that the apoptosis of CD4 cells contributing to HIV progression does not result solely from HIV infection, but largely from antioxidant imbalances in the host. [1–3] Activation of latent HIV state can be stimulated in the presence of reactive oxygen species (ROS) through the stimulation of oxygen-responsive transcription factors, specifically NF-kB, which induces HIV replication in the infected T-lymphocyte. The number of reactive oxygen species can be reduced by restoring proper redox balance through adequate availability of antioxidants.
	Part II: Vitamins A and E, Zinc, B-Vitamins, and Magnesium Alternative Medicine Review 2000; 5 (1): 39–51 ~ FULL TEXT Vitamin A deficiency is a common occurrence in HIV infection, and serum levels appear to decrease as the disease progresses. 1 Low serum levels of vitamin A were found in 12–19 percent of HIV-positive, asymptomatic subjects in the United States. 1,2 Vitamin A deficiency was found in an increasingly higher proportion of women than men (p< .01) in an HIV-infected, intravenous drug-using population.
	Part III: N-Acetylcysteine, Alpha-Lipoic Acid, L-Glutamine, and L-Carnitine Alternative Medicine Review 2000; 5 (4): 290–305 ~ FULL TEXT HIV infection and the progression to AIDS involves a long period of latent infection characterized by low levels of viral replication that slowly increase to the point of immunosuppression. [1] This progression is accelerated if the latent (non-reproducing) provirus in the nuclei of the lymphocyte is activated. [2] Oxidative stress induces both viral activation of HIV and DNA damage, leading to immunosuppression. [3–5] It is now generally accepted that a central pathologic feature of HIV disease involves oxidative stress, leading to programmed cell death (apoptosis) and depletion of CD4 cells. [6, 7] It has been hypothesized by Montagnier and others [8, 9] that the majority of T-helper (CD4+) cell loss (the cell most susceptible to fatal injury by HIV) actually occurs by apoptosis and not by direct HIV infection. This phenomenon has been seen in in vitro culture and in peripheral blood lymphocytes from HIV-infected patients.

	Nutritional Interventions to Assist with the Adaptation to Stress Alternative Medicine Review 1999 (Aug);   4 (4):   249–265 ~ FULL TEXT Prolonged stress, whether a result of mental/emotional upset or due to physical factors such as malnutrition, surgery, chemical exposure, excessive exercise, sleep deprivation, or a host of other environmental causes, results in predictable systemic effects. The systemic effects of stress include increased levels of stress hormones such as cortisol, a decline in certain aspects of immune system function such as natural killer cell cytotoxicity or secretory-IgA levels, and a disruption of gastrointestinal microflora balance. These systemic changes might be a substantial contributor to many of the stress-associated declines in health.
	Plant Sterols and Sterolins: A Review of Their Immune-Modulating Properties Alternative Medicine Review 1999 (Jun); 4 (3): 170–177 ~ FULL TEXT Beta-sitosterol (BSS) and its glycoside (BSSG) are sterol molecules which are synthesized by plants. In animals, BSS and BSSG have been shown to exhibit anti-inflammatory, anti-neoplastic, anti-pyretic, and immune-modulating activity. You also might enjoy this more recent 2001 Monograph.
	The Detoxification Enzyme Systems Alternative Medicine Review 1998 (Jun);   3 (3):   187–198 ~ FULL TEXT The human body is exposed to a wide array of xenobiotics in one's lifetime, from food components to environmental toxins to pharmaceuticals, and has developed complex enzymatic mechanisms to detoxify these substances. These mechanisms exhibit significant individual variability, and are affected by environment, lifestyle, and genetic influences. The scientific literature suggests an association between impaired detoxification and certain diseases, including cancer, Parkinson's disease, fibromyalgia, and chronic fatigue/immune dysfunction syndrome.
	Aging Gracefully With Antioxidants Living well includes getting enough relaxation, exercise, community spirit and nutritious foods. It may also include taking vitamins. An avalanche of research data suggests that high intakes of antioxidant-rich fruits, vegetables and supplements lowers the risk of old-age diseases.
	Bacteria That Strengthen The Immune System As a practicing physician and nutritionist, I hear that question at least three times a day. The good news is we can strengthen the immune system's resistance to infection by taking supplements of Lactobacillus acidophilus or Bifidobacterium bifidum, two breeds of "friendly" bacteria that normally live in the human gastrointestinal (G.I.) tract.   You may also enjoy these other Probiotic Abstracts.

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