COVID-19 is nearing its first birthday and a question many chiropractors and students are undoubtedly asking themselves is something along the lines of, “What can I do to help?” Unfortunately, Chiropractic is not the one-stop-shop for pandemic solutions. But there are certainly ways that Chiropractic can benefit a population that is at risk of coming in contact with the virus.
Andrew Verdaguer
Inflammation in the body is mediated by markers called cytokines. There are 2 cytokines in particular that are important regarding the coronavirus: IL-6 and IL-1β. They are both forms of Interleukin, inflammatory cytokines that are released in elevated levels in response to tissue damage and infections. Normally these inflammatory substances play a beneficial role in the healing process. They can be responsible for increased platelet formation, angiogenesis, and T-Cell differentiation. All of these processes can help the body heal from prior damage. However, in many other cases this inflammation is a double-edged sword.
Increased levels of Interleukin is a risk factor for some autoimmune diseases such as Juvenile Rheumatoid Arthritis and Scleroderma1. These cytokines play a similar role in COVID-19 infection. One of the most dangerous effects of the coronavirus is its ability to trigger Acute Respiratory Distress Syndrome (ARDS) and subsequent Interleukin release in response to tissue damage. IL-1β specifically mediates lung inflammation, fibrosis, and fever. Progressive fibrosis of the lung tissue can continue even after the viral infection has been resolved2. Patients with the virus have a 22 times higher likelihood of suffering respiratory failure if their IL-6 measures greater than 80pg/ml3.
While the function and impact of small proteins in inflammation can be hard to conceptualize, the role of chiropractors is much easier to grasp. Chiropractic care reduces interference and inflammation within the body. In fact, although we do not yet fully understand the mechanism behind it, one study shows that spinal manipulation can significantly reduce levels of inflammatory cytokines like IL-1β and TNF-α4.
Chiropractic as a profession has come under fire recently for claims that spinal manipulation can “improve nervous function” and “boost the immune system” during the COVID-19 pandemic. The role of Chiropractic care in immune function has not yet been fully explained but the evidence suggesting spinal manipulation may help decrease levels of inflammatory cytokines warrants further exploration. Chiropractic care could potentially be a valuable addition to the management and rehabilitation of mild COVID-19 cases.
References
- Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):a016295. Published 2014 Sep 4. doi:10.1101/cshperspect.a016295
- Conti P, Ronconi G, Caraffa A, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies [published online ahead of print, 2020 Mar 14]. J Biol Regul Homeost Agents. 2020;34(2):1. doi:10.23812/CONTI-E
- https://www.medrxiv.org/content/10.1101/2020.04.01.20047381v2
- Teodorczyk-Injeyan JA, Injeyan HS, Ruegg R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulative Physiol Ther. 2006;29(1):14-21. doi:10.1016/j.jmpt.2005.10.002