Objective
To examine the effect of a single spinal manipulation therapy (SMT) on the in vitro
production of inflammatory cytokines, tumor necrosis factor α, and interleukin (IL) 1β, in relation to the systemic (in vivo) levels of neurotransmitter substance P (SP).
Methods
Sixty-four asymptomatic subjects were assigned to SMT, sham manipulation, or venipuncture
control group. SMT subjects received a single adjustment in the thoracic spine. Blood
and serum samples were obtained from subjects before and then at 20 minutes and 2
hours after intervention. Whole-blood cultures were activated with lipopolysaccharide
(LPS) for 24 hours. Cytokine production in culture supernatants and serum SP levels
were assessed by specific immunoassays.
Results
Over the study period, a significant proportion (P ≤ .05) of sham and control subjects demonstrated progressive increases in the synthesis
of tumor necrosis factor α and IL-1β. 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.
Conclusions
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.
Key Indexing Terms
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Manipulative & Physiological TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Somotoautonomic reflexes.in: Haldeman S Principles and practice of chiropractic. Mc Graw-Hill, New York2005: 301-314
- Spinovisceral reflexes evoked by noxious and innocuous stimulation of the lumbar spine.J Neuromusculoskel Syst. 1995; 3: 122-131
- Reflex responses of bladder motility after stimulation of interspinous tissue in the anesthetized rat.J Manipulative Physiol Ther. 1998; 21: 593-599
- Neural immunoregulation: emerging roles for nerves in immune homeostasis and disease.Immunol Today. 2000; 21: 281-289
- Neural-immune interactions in health and disease.J Clin Invest. 1997; 100: 2641-2647
- Dialogue between CNS and the immune system in lymphoid organs.Immunol Today. 1997; 19: 409-413
- New insights into the biology of the acute phase response.J Clin Immunol. 1999; 19: 203-214
- Effect of neuropeptides on production of inflammatory cytokines by human monocytes.Science. 1988; 241: 1218-1221
- Cutting edge: hemokinin has substance P–like function and expression in inflammation.J Immunol. 2004; 172: 6528-6532
- Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators.J Bone Joint Surg. 2002; 84-B: 196-201
- Enhanced phagocytic respiratory burst induced by spinal manipulation: potential role of substance P.J Manipulative Physiol Ther. 1991; 14: 399-410
- Enhanced neutrophils 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; 15: 83-89
- A convenient human whole blood culture system for studying the regulation of tumor necrosis factor release by bacterial lipopolysaccharide.Immunol Methods. 1991; 139: 233-240
- Cytokine production by normal human monocytes. Inter-subject variation and relationship to an IL-1 receptor antagonist (IL-1Ra) gene polymorphism.Clin Exp Immunol. 1995; 94: 303-310
- Dynamics of cytokine production in human peripheral blood mononuclear cells stimulated by LPS or infected by Borrelia.Phys Res. 2003; 52: 593-598
- Statistics in medicine.Little, Brown and Company, Boston1972
- Immunological changes in human skeletal muscles and blood after eccentric exercise and multiple biopsies.J Physiol. 2000; 529: 243-262
- Molecular basis of skeletal muscle regeneration.Can J Appl Physiol. 1996; 21: 155-184
- Hemorrhage increases cytokine expression in lung mononuclear cells in mice.J Clin Invest. 1997; 99: 1516-1524
- Lipopolysaccharide recognition: CD14, TLRs and the LPS activation cluster.Trends Immunol. 2002; 23: 301-305
- LPS-dependent changes in the expression of 57kDa and 53kDa cell membrane proteins without participation of CD14.J Endotoxin Res. 1999; 5: 62-65
- Rough and smooth forms of fluorescein-labelled bacterial endotoxin exhibit CD14/LBP dependent and independent binding that is influenced by endotoxin concentration.Eur J Biochem. 2000; 267: 2218-2226
- The production of cytokines by polymorphonuclear neutrophils.Immunol Today. 1995; 16: 21-26
- Direct stimulation of cytokines (IL-1β, TNFα, IL-6, IL-2, IFNγ and GM-CSF) in whole blood. Comparison with isolated PBMC stimulation.Cytokine. 1992; 4: 239-248
- Determining cavitation location during lumbar and thoracic spinal manipulation.Spine. 2004; 29: 1452-1457
- Integrated evolutionary, immunological, and neuroendocrine framework for the pathogenesis of chronic disabling inflammatory diseases.FASEB J. 2003; 17: 2176-2183
- Harnessing a neural-immune circuit to control inflammation and shock.J Exp Med. 2002; 195: F25-F28
- Role of vagus nerve signaling in CNI-1493–mediated suppression of acute inflammation.Auton Neurosci. 2000; 85: 141-147
- The inflammatory reflex.Nature. 2002; 420: 853-859
- Pharmacological stimulation of cholinergic anti-inflammatory pathway.J Exp Med. 2002; 195: 781-788
- Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin.Nature. 2000; 405: 458-462
- Mind over immunity.FASEB J. 2001; 15: 1575-1576
- The cholinergic anti-inflammatory pathway: a missing link in neuroimmunomodulation.Mol Med. 2003; 9: 125-134
- Nicotinic acetylcholine receptor α7 subunit is essential regulator of inflammation.Nature. 2003; 421: 384-388
- Spinal manipulation: current state of research and its indications.Neurol Clin. 1999; 17: 91-111
- Areas of capsaicin- induced secondary hyperalgesia and allodynia are reduced by a single chiropractic adjustment: a preliminary study.J Manipulative Physiol Ther. 2004; 27: 381-387
- TNF-α blockade for herniated intervertebral disc–induced sciatica: a way forward at last?.Rheumatology. 2004; 43: 119-121
- Neural-immune interactions: implications for pain management in patients with low-back pain and sciatica.Biol Res Nurs. 2005; 6: 196-206
Article info
Publication history
Received in revised form:
September 20,
2005
Received:
July 12,
2005
Footnotes
Sources of support: This study was supported by the Canadian Memorial Chiropractic College and a Public Health Service grant no. U24 AR45166 through the Consortial Center for Chiropractic Research. The contents of this article are solely the responsibility of the authors.
Identification
Copyright
© 2006 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
