OSTEOPATHIC MANIPULATIVE TREATMENT AS A COMPLEMENTARY THERAPY FOR THE TREATMENT OF PNEUMONIA

Purpose: The lymphatic pump treatment (LPT), designed by the osteopathic medical profession, targets the musculoskeletal system and enhances the flow of lymph through the lymphatic system. Clinical studies showed that LPT plus antibiotic treatment enhances the recovery of pneumonia infections. Animal studies from our lab demonstrate that LPT significantly enhances thoracic and mesenteric lymph flow, mobilizes leukocytes from the gastrointestinal lymphoid tissue (GALT) into lymph circulation, and significantly increases the lymphatic flux of leukocytes, cytokines, chemokines, superoxide dismutase and reactive nitrogen species in lymph. We hypothesize that by increasing lymph flow, LPT can enhance immunity and drug delivery during pneumonia. Methods: To test this hypothesis rats were nasally infected with 1x108 Streptococcus pneumoniae colony forming units (CFU's) on day zero. Twenty-four hours post-infection, rats were randomized into control, sham, LPT, control plus 40 mg/kg (subcutaneous) levofloxacin, sham plus 40 mg/kg levofloxacin or LPT plus 40 mg/kg levofloxacin. Rats received treatment once daily for three consecutive days. Sham and LPT were applied as previously described. On day four post-infection, lungs were removed and bacteria were enumerated. Results: Three daily treatments of LPT significantly reduced (p<0.05) S. pneumoniae CFU's in the lung compared to control and sham. All Levofloxacin treated groups significantly reduced (p<0.05) S. pneumoniae CFU's compared to control, sham, and LPT. LPT plus Levofloxacin significantly reduced (p<0.01) S. pneumoniae CFU's compared to all treatment groups. These results suggest that LPT protects against pneumonia. Conclusions: Our study suggests that as a complementary therapy to antibiotics, LPT can enhance the clearance of bacteria from the lungs. In future studies, we will determine if LPT enhances the delivery of levofloxacin to the lung by measuring the concentration of levofloxacin in the serum and bronchiolar alveolar lung fluid (BALF). The results provide scientific support for the clinical use of LPT as a complementary therapy for the treatment of pneumonia.