Once again I am delighted to be informing you of the particulars and progress of the asthma multisite clinical trial that is currently underway in Australia and supported by FCER and NCMIC and YOU. This trial is of paramount importance in addressing the major flaws in a previous and unfortunately highly visible clinical trial published in The New England Journal of Medicine. [1] It also represents one of the few investigations that taps into the field of endocrinology—an area that must be addressed if one is to gain further insight into the systemic effects of spinal dysfunctions and their management by chiropractic care. This research represents only a handful of investigations that have addressed the consequences of manipulation involving chemical (as opposed to electrical) messengers within the body.

A third attribute is that this particular investigation focuses on the stress response [2-4] in the asthmatic. In the attempt to maintain homeostasis, bronchial hyperresponsiveness remains the defining characteristic in asthma. From earlier investigations, interventions which control stress appear to have a significant palliative effect in the management of asthma, with cortisol appearing to be an important marker. [5] Among the 14 sites and 150 patients involved in this study, retrospective data will be provided on the efficacy of four different interventions offered by chiropractors: Activator Method, Gonstead Technique, Motion Palpation, and the Sacro-Occipital Technique. Patient treatments are expected to be completed by the end of this year, after which it is expected that results will be reported both in public forums* and in the peer-reviewed medical literature.

Although data on asthma symptoms, quality of life and distress are forthcoming in this particular investigation, preliminary cortisol measurements are already bearing fruit. The Australian research team indicates that with manipulation (as opposed to simply visiting the treatment center), levels do decrease. [6] An important marker of immune activity (immunoglobulin A), on the other hand, appears to increase in patients attending chiropractic centers.⁶ This last result is particularly noteworthy in that transient deficiencies of mucosal and salivary immunoglobulin A have already been shown to lead to the development of bronchial hyperresponsiveness and asthma. [7]

Clearly, you can see where this important trial appears to be headed in making what we believe will be a major impact upon the clinical research literature—to say nothing of offering a multiplicity of means of support for both the theory and scope of practice of chiropractic healthcare. We hope that you will find it possible to support this groundbreaking research in its last few months and become part of what I consider to be a milestone in FCER’s short but highly productive history.

Your support of this important study has our deep appreciation. Your gift now will help us to close out the funding and will be a tremendous encouragement. You may use the response form enclosed, or call our office at 800-622-6309. Click here to donate now on our secure server. Be watching for the next progress report. Thank you.

Sincerely,

Vincent P. Lucido

President

Note:

You may not realize that, until 25 years ago, chiropractic research was vastly underdeveloped and appeared to some as an oxymoron. In 1975, a conference at the NIH concluded that "There are little scientific data of significance to evaluate this [chiropractic's] clinical approach to health and to the treatment of disease." [5] From that time onward, both clinical and basic research have advanced to the point at which [i] over 40 randomized clinical trials comparing spinal manipulation with other treatments in the management of back pain have been published in the scientific literature, [6, 7] [ii] meta-analysis and systematic reviews attesting to the support of spinal manipulation in the management of back pain [8, 9] have also appeared, and [iii] multidisciplinary panels representing the governments of the United States, [10] Canada, [11] Great Britain, [12] Sweden, [13] Denmark, [14] Australia, [15] and New Zealand [16] have expressed similar recognition of the robust evidence base in support of spinal manipulation for managing low back conditions.

REFERENCES

By providing support for over 175 research projects and 150 individuals engaged in postgraduate study, FCER can claim primary responsibility for this good fortune. In fact, virtually all of the first government grants awarded for chiropractic research [essentially nonexistent prior to 1993] were made possible by earlier studies that were funded by FCER.

References:

¹   Balon J, et al.
A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment
for Childhood Asthma
New England Journal of Medicine 1998; 339(15): 1013-1020

²   Seyle H.
Stress and duress.
Comprehensive Therapy 1975; 1: 9-13.

³   Morgan LG.
Psychoneuroimmunology, the placebo effect and chiropractic.
Journal of Manipulative and Physiological Therapeutics 1998; 21(7): 484-491.

⁴   Rosner A.
Endocrine disorders.
In Masarsky CS, Todres-Masarsky M,
Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach.
New York, NY: Churchill Livingstone, 2001, pp. 187-202.

⁵   Field T, Henteleff T, Hernandez M, Martinez E, Mavunda K, Kuhn C, Schanberg S.
Children with asthma have improved pulmonary functions after massage therapy.
Journal of Pediatrics 1998; 32(5): 854-858.

⁶   Ali S, Hayek R, Holland R, McKelvy S-E, Boyce K, Curson P.
Effect of Chiropractic Treatment on the Endocrine and Immune System in Asthmatic Patients
Proceedings of the 9th International Conference on Spinal Manipulation.
Des Moines, IA: Foundation for Chiropractic Education and Research. In press, 2002.

⁷   Gleeson M, Clancy RL, Hensley MJ, Cripps AW, Henry RL, Wlodarczyk JH, Gibson PG.
Development of bronchial hyperreactivity following transient absence of IgA.
American Journal of Respiratory and Critical Care Medicine 1996; 153[6 Pt 1]: 1785-1789.

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