28 September 2008

Lymphatic Pump Increases Immune Response

In the past decade there has been a growing interest in osteopathic manipulative medicine. A Doctor of Osteopathic (DO) have the same benefits and training to practice as an Allopathic Doctor (MD), but are trained to treat holistically by examining the whole body versus the symptomatic approach of allopathic medicine. In addition, DOs have the benefit of manipulation to induce the body’s self-healing process and to reduce injury and diseases. A few manipulation techniques include: muscle energy (muscle contraction), strain-counterstrain (localizing and reliving painful spots), myofascial release (gentle force to reduce neurological muscle tightness), and lymphatic pump treatment (increase lymph flow). The lymphatic pump treatment (LPT) is particularly interesting in terms of treating patients with edema and infections.

The lymphatic system is organized as a network of fluid collecting vessels in order to maintain macromolecular homeostasis, lipid absorption, and lymphocyte transportation. The lymph system serves as a reservoir of surplus tissue fluid, known as lymph, and the removal of cellular debris from cellular breakdown and infection. Unlike the circulatory system where the heart pumps blood through the body, the lymphatic vessels depend on the contraction/relaxation or compression/expansion of the lymphatic vessels via skeletal muscle movements and lymphatic valves. In summary, the movement or contraction of the skeletal muscles allows the lymph to flow against a gradient or gravity, and the valves on each vessel segment prevent the backflow of the lymph.

Studies have shown that LPT indirectly increases lymph flow and patient’s immune response to infections, but have not shown firm evidence that patients benefit from LPT. Current and ongoing research, however, are finding that LPT not only increases lymph flow but increases leukocyte count and flux.

H. Fred Downey et al. has conducted studies on dogs to determine if LPT and exercise changes lymph flow with or without the expansion of extracellular fluid volume (ECE). They have concluded that LPT with ECE greatly increases lymph flow rate than just LPT alone and is found to be similar with exercise; however, exercise was found to have higher lymph flow rate than LPT.

In another study conducted by Lisa Hodge et al., LPT was found to increase leukocyte count and flux. During LPT, lymph was collected and discovered to have an increase in macrophages, neutrophils, total lymphocytes, and T and B cell counts. They concluded that the increase in lymph flow during LPT enhanced the mobilization of lymphocytes and maybe responsible for patients’ improved immune responses.

With these data, it can be suggested that LPT would most benefit patients who are well hydrated and are partially or wholly immobilized (astronauts or individuals with paralysis or muscular diseases). Many have suggested that moderate exercise during a viral or bacterial infection helps to “sweat out the illness”, or in scientific terms increase lymphatic and lymphocyte flow to fight off the infection.

I have never tried LPT or exercised at the peak of a cold (the thought of exercising when feeling terrible just does not sound appealing), but has anyone in our group tried or knows anyone who have done these strategies and recovered quickly from a viral or bacterial infection?


References:

Degenhardt, Brian. (2000). Osteopathic manipulative medicine: Optimizing patient-focused health care. The Advisor, 21(1). Retrieved September 28, 2008, from
http://www.aacom.org/about/osteomed/Pages/Degenhardt.aspx

Downey, H. Fred. (2008). Lymph flow in the thoracic duct of conscious dogs during lymphatic pump treatment, exercise, and expansion of extracellular fluid volume. Lymphatic Research and Biology, 6(1), 3-13.

Hodge, Lisa. (2007). Abdominal lymphatic pump treatment increases leukocyte count and flux in thoracic duct lymph [Abstract]. The Journal of Immunology, 178(99), 13. Retrieved from PubMed database.

Knott, Marty E. (2005). Increased lymphatic flow in the thoracic duct during manipulative intervention. Journal of the American Osteopathic Association, 105(10), 447-456.

Zawheja, David. (2005). Lymphatic biology and the microcirculation: Past, present, and future. Microcirculation, 12, 141-150.

1 comment:

christinew7630 said...

My husband is a DO and Emergency Medicine Physician and I am a MD Pediatrician. Needless to say we have had some good discussions about manipulation and LPT.

I have tried manipulations for musculoskeletal pain and find it very helpful. We tried LPT after I had thyroid surgery with significant lymphatic drainage damage and it didn't seem to make a difference.

I think studying LPT in women with breast cancer with lymphatic drainage problems s/p resection would be interesting and a good test of the process.