{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T13:46:41Z","timestamp":1762609601684,"version":"3.40.5"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jom-2023-0198_abs_001\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Anecdotal evidence suggested that osteopathic manipulative treatment (OMT) may have imparted survivability to patients in osteopathic hospitals during the 1918 influenza pandemic. In addition, previous OMT research publications throughout the past century have shown evidence of increased lymphatic movement, resulting in improved immunologic function qualitatively and quantitatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2023-0198_abs_002\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The following is a description of a proposed protocol to evaluate OMT effects on antibody generation in the peripheral circulation in response to a vaccine and its possible use in the augmentation of various vaccines. This protocol will serve as a template for OMT vaccination studies, and by adhering to the gold standard of randomized controlled trials (RCTs), future studies utilizing this outline may contribute to the much-needed advancement of the scientific literature in this field.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2023-0198_abs_003\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This manuscript intends to describe a protocol that will demonstrate increased antibody titers to a vaccine through OMT utilized in previous historical studies. Confirmation data will follow this manuscript validating the protocol. Study participants will be divided into groups with and without OMT with lymphatic pumps. Each group will receive the corresponding vaccine and have antibody titers measured against the specific vaccine pathogen drawn at determined intervals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2023-0198_abs_004\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>These results will be statistically evaluated. Our demonstration of a rational scientific OMT vaccine antibody augmentation will serve as the standard for such investigation that will be reported in the future. These vaccines could include COVID-19 mRNA, influenza, shingles, rabies, and various others. The antibody response to vaccines is the resulting conclusion of its administration. Osteopathic manipulative medicine (OMM) lymphatic pumps have, in the past through anecdotal reports and smaller pilot studies, shown effectiveness on peripheral immune augmentation to vaccines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2023-0198_abs_005\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This described protocol will be the template for more extensive scientific studies supporting osteopathic medicine\u2019s benefit on vaccine response. The initial vaccine studies will include the COVID-19 mRNA, influenza, shingles, and rabies vaccines.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jom-2023-0198","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T15:11:51Z","timestamp":1701097911000},"page":"163-170","source":"Crossref","is-referenced-by-count":1,"title":["Augmentation of immune response to vaccinations through osteopathic manipulative treatment: a study of procedure"],"prefix":"10.1515","volume":"124","author":[{"given":"Jesus","family":"Sanchez","sequence":"first","affiliation":[{"name":"Department of Neuromusculoskeletal Medicine\/Osteopathic Manipulative Medicine , College of Osteopathic Medicine of the Pacific at Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Neuromusculoskeletal Medicine\/Osteopathic Manipulative Medicine , College of Osteopathic Medicine of the Pacific at Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-0329","authenticated-orcid":false,"given":"Brian","family":"Loveless","sequence":"additional","affiliation":[{"name":"Department of Neuromusculoskeletal Medicine\/Osteopathic Manipulative Medicine , College of Osteopathic Medicine of the Pacific at Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-2301","authenticated-orcid":false,"given":"Julieanne P.","family":"Sees","sequence":"additional","affiliation":[{"name":"Fellow Osteopathic Medicine , National Academy of Medicine , Washington , DC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Zammuto","sequence":"additional","affiliation":[{"name":"Associate Professor of Family Medicine , Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6970-9566","authenticated-orcid":false,"given":"Hendrik","family":"Szurmant","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences , College of Osteopathic Medicine of the Pacific at Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastien","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences , College of Osteopathic Medicine of the Pacific at Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Crone","sequence":"additional","affiliation":[{"name":"Western University of Health Sciences , Pomona , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-3588","authenticated-orcid":false,"suffix":"Jr","given":"Robert","family":"Hostoffer","sequence":"additional","affiliation":[{"name":"University Hospitals , Cleveland Medical Center , Cleveland , OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"2024032106185969075_j_jom-2023-0198_ref_001","doi-asserted-by":"crossref","unstructured":"Chaplin, DD. Overview of the immune response. J Allergy Clin Immunol 2010;125:S3\u201323. https:\/\/doi.org\/10.1016\/j.jaci.2009.12.980.","DOI":"10.1016\/j.jaci.2009.12.980"},{"key":"2024032106185969075_j_jom-2023-0198_ref_002","unstructured":"Morris, B, Courtice, FC. Cells and immunoglobulins in lymph. Lymphology 1977;10:62\u201370."},{"key":"2024032106185969075_j_jom-2023-0198_ref_003","unstructured":"Chikly, BJ. Manual techniques addressing the lymphatic system: origins and development. J Am Osteopath Assoc 2005;105:457\u201364."},{"key":"2024032106185969075_j_jom-2023-0198_ref_004","doi-asserted-by":"crossref","unstructured":"Hruby, RJ, Hoffman, KH. Avian influenza: an osteopathic component to treatment. Osteopath Med Prim Care 2007;1:1\u201319. https:\/\/doi.org\/10.1186\/1750-4732-1-10.","DOI":"10.1186\/1750-4732-1-10"},{"key":"2024032106185969075_j_jom-2023-0198_ref_005","doi-asserted-by":"crossref","unstructured":"Pal, I, Ramsey, JD. The role of the lymphatic system in vaccine trafficking and immune response. Adv Drug Deliv Rev 2011;63:909\u201322. https:\/\/doi.org\/10.1016\/j.addr.2011.05.018.","DOI":"10.1016\/j.addr.2011.05.018"},{"key":"2024032106185969075_j_jom-2023-0198_ref_006","unstructured":"Whiting, CA. Investigations of the phagocytic index [reprint]. 1916. 1955 Yearbook of the Academy of Applied Osteopathy. Carmel, Calif: Academy of Applied Osteopathy; 1955:107\u20139 p."},{"key":"2024032106185969075_j_jom-2023-0198_ref_007","doi-asserted-by":"crossref","unstructured":"Measel, JWJr. The effect of the lymphatic pump on the immune response: I. Preliminary studies on the antibody response to pneumococcal polysaccharide assayed by bacterial agglutination and passive hemagglutination. J Am Osteopath Assoc 1982;82:28\u201331. https:\/\/doi.org\/10.1515\/jom-1982-820915.","DOI":"10.1515\/jom-1982-820915"},{"key":"2024032106185969075_j_jom-2023-0198_ref_008","doi-asserted-by":"crossref","unstructured":"Trombetta, CM, Remarque, EJ, Mortier, D, Montomoli, E. Comparison of hemagglutination inhibition, single radial hemolysis, virus neutralization assays, and ELISA to detect antibody levels against seasonal influenza viruses. Influenza Other Respir Viruses 2018;12:675\u201386. https:\/\/doi.org\/10.1111\/irv.12591.","DOI":"10.1111\/irv.12591"},{"key":"2024032106185969075_j_jom-2023-0198_ref_009","doi-asserted-by":"crossref","unstructured":"Iyer, AS, Jones, FK, Nodoushani, A, Kelly, M, Becker, M, Slater, D, et al.. Persistence and decay of human antibody responses to the receptor binding domain of SARS-CoV-2 spike protein in COVID-19 patients. Sci Immunol 2020;5:eabe0367. https:\/\/doi.org\/10.1126\/sciimmunol.abe0367.","DOI":"10.1126\/sciimmunol.abe0367"},{"key":"2024032106185969075_j_jom-2023-0198_ref_010","doi-asserted-by":"crossref","unstructured":"Khoury, DS, Cromer, D, Reynaldi, A, Schlub, TE, Wheatley, AK, Juno, JA, et al.. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection. Nat Med 2021;27:1205\u201311. https:\/\/doi.org\/10.1038\/s41591-021-01377-8.","DOI":"10.1038\/s41591-021-01377-8"},{"key":"2024032106185969075_j_jom-2023-0198_ref_011","doi-asserted-by":"crossref","unstructured":"Earle, KA, Ambrosino, DM, Fiore-Gartland, A, Goldblatt, D, Gilbert, PB, Siber, GR, et al.. Evidence for antibody as a protective correlate for COVID-19 vaccines. Vaccine 2021;39:4423\u20138. https:\/\/doi.org\/10.1016\/j.vaccine.2021.05.063.","DOI":"10.1016\/j.vaccine.2021.05.063"},{"key":"2024032106185969075_j_jom-2023-0198_ref_012","unstructured":"Centers for Disease Control and Prevention. COVID-19 vaccination schedule for ages 6\u00a0months and older; 2023. https:\/\/www.cdc.gov\/vaccines\/covid-19\/downloads\/COVID-19-immunization-schedule-ages-6months-older.pdf [Accessed 1 Oct 2023]."},{"key":"2024032106185969075_j_jom-2023-0198_ref_013","unstructured":"U.S. Food and Drug Administration. Pfizer-BioNTech COVID-19 vaccine; 2023. https:\/\/www.fda.gov\/vaccines-blood-biologics\/coronavirus-covid-19-cber-regulated-biologics\/pfizer-biontech-covid-19-vaccine [Accessed 3 Oct 2023]."},{"key":"2024032106185969075_j_jom-2023-0198_ref_014","unstructured":"Centers for Disease Control and Prevention. Immunization schedules; 2023. https:\/\/www.cdc.gov\/vaccines\/schudeles\/index.html [Accessed 1 Oct 2023]."},{"key":"2024032106185969075_j_jom-2023-0198_ref_015","doi-asserted-by":"crossref","unstructured":"Pardi, N, Tuyishime, S, Muramatsu, H, Kariko, K, Mui, BL, Tam, YK, et al.. Expression kinetics of nucleoside-modified mRNA delivered in lipid nanoparticles to mice by various routes. J Control Release 2015;217:345\u201351. https:\/\/doi.org\/10.1016\/j.jconrel.2015.08.007.","DOI":"10.1016\/j.jconrel.2015.08.007"},{"key":"2024032106185969075_j_jom-2023-0198_ref_016","unstructured":"Idsociety.org. Vaccines FAQ [online]; 2021. https:\/\/www.idsociety.org\/covid-19-real-time-learning-network\/vaccines\/vaccines-information--faq\/[Accessed 20 Sep 2023]."},{"key":"2024032106185969075_j_jom-2023-0198_ref_017","doi-asserted-by":"crossref","unstructured":"Wisnewski, AV, Campillo Luna, J, Redlich, CA. Human IgG and IgA responses to COVID-19 mRNA vaccines. PLoS One 2021;16:e0249499. https:\/\/doi.org\/10.1371\/journal.pone.0249499.","DOI":"10.1371\/journal.pone.0249499"},{"key":"2024032106185969075_j_jom-2023-0198_ref_018","doi-asserted-by":"crossref","unstructured":"Peluso, MJ, Takahashi, S, Hakim, J, Kelly, JD, Torres, L, Iyer, NS, et al.. SARS-CoV-2 antibody magnitude and detectability are driven by disease severity, timing, and assay. Sci Adv 2021;7:eabh3409. https:\/\/doi.org\/10.1126\/sciadv.abh3409.","DOI":"10.1126\/sciadv.abh3409"},{"key":"2024032106185969075_j_jom-2023-0198_ref_019","doi-asserted-by":"crossref","unstructured":"Naaber, P, Tserel, L, Kangro, K, Sepp, E, J\u00fcrjenson, V, Adamson, A, et al.. Dynamics of antibody response to BNT162b2 vaccine after six months: a longitudinal prospective study. Lancet Reg Health 2021;10:100208. https:\/\/doi.org\/10.1016\/j.lanepe.2021.100208.","DOI":"10.1016\/j.lanepe.2021.100208"},{"key":"2024032106185969075_j_jom-2023-0198_ref_020","doi-asserted-by":"crossref","unstructured":"Goel, RR, Apostolidis, SA, Painter, MM, Mathew, D, Pattekar, A, Kuthuru, O, et al.. Distinct antibody and memory B\u00a0cell responses in SARS-CoV-2 na\u00efve and recovered individuals following mRNA vaccination. Sci Immunol 2021;6:eabi6950. https:\/\/doi.org\/10.1126\/sciimmunol.abi6950.","DOI":"10.1101\/2021.03.03.21252872"},{"key":"2024032106185969075_j_jom-2023-0198_ref_021","doi-asserted-by":"crossref","unstructured":"Doria-Rose, N, Suthar, MS, Makowski, M, O'Connell, S, McDermott, AB, Flach, B, et al.. Antibody persistence through 6 months after the second dose of mRNA-1273 vaccine for Covid-19. N Engl J Med 2021;384:2259\u201361. https:\/\/doi.org\/10.1056\/NEJMc2103916. Erratum in: N Engl J Med 2022;386:500.","DOI":"10.1056\/NEJMx220001"},{"key":"2024032106185969075_j_jom-2023-0198_ref_022","doi-asserted-by":"crossref","unstructured":"Thomas, SJ, Moreira, EDJr, Kitchin, N, Absalon, J, Gurtman, A, Lockhart, S, et al.. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine through 6\u00a0months. N Engl J Med 2021;385:1761\u201373. https:\/\/doi.org\/10.1056\/NEJMoa2110345.","DOI":"10.1056\/NEJMoa2110345"},{"key":"2024032106185969075_j_jom-2023-0198_ref_023","doi-asserted-by":"crossref","unstructured":"Neeland, MR, Shi, W, Collignon, C, Taubenheim, N, Meeusen, EN, Didierlaurent, AM, et al.. The lymphatic immune response induced by the adjuvant AS01: a comparison of intramuscular and subcutaneous immunization routes. J Immunol 2016;197:2704\u201314. https:\/\/doi.org\/10.4049\/jimmunol.1600817.","DOI":"10.4049\/jimmunol.1600817"},{"key":"2024032106185969075_j_jom-2023-0198_ref_024","unstructured":"Knott, EM, Tune, JD, Stoll, ST, Downey, HF. Increased lymphatic flow in the thoracic duct during manipulative intervention. J Am Osteopath Assoc 2005;105:447\u201356."},{"key":"2024032106185969075_j_jom-2023-0198_ref_025","doi-asserted-by":"crossref","unstructured":"Hodge, LM, King, HH, Williams, AG, Reder, SJ, Belavadi, T, Simecka, JW, et al.. Abdominal lymphatic pump treatment increases leukocyte count and flux in thoracic duct lymph. Lymphat Res Biol 2007;5:127\u201334. https:\/\/doi.org\/10.1089\/lrb.2007.1001.","DOI":"10.1089\/lrb.2007.1001"},{"key":"2024032106185969075_j_jom-2023-0198_ref_026","doi-asserted-by":"crossref","unstructured":"Schander, A, Downey, HF, Hodge, LM. Lymphatic pump manipulation mobilizes inflammatory mediators into lymphatic circulation. Exp Biol Med 2012;237:58\u201363. https:\/\/doi.org\/10.1258\/ebm.2011.011220.","DOI":"10.1258\/ebm.2011.011220"},{"key":"2024032106185969075_j_jom-2023-0198_ref_027","doi-asserted-by":"crossref","unstructured":"Huff, JB, Schander, A, Downey, HF, Hodge, LM. Lymphatic pump treatment augments lymphatic flux of lymphocytes in rats. Lymphat Res Biol 2010;8:183\u20137. https:\/\/doi.org\/10.1089\/Irb.2010.0009.","DOI":"10.1089\/lrb.2010.0009"},{"key":"2024032106185969075_j_jom-2023-0198_ref_028","doi-asserted-by":"crossref","unstructured":"Schander, A, Padro, D, King, HH, Downey, HF, Hodge, LM. Lymphatic pump treatment repeatedly enhances the lymphatic and immune systems. Lymphat Res Biol 2013;11:219\u201326. https:\/\/doi.org\/10.1089\/Irb.2012.0021.","DOI":"10.1089\/lrb.2012.0021"},{"key":"2024032106185969075_j_jom-2023-0198_ref_029","doi-asserted-by":"crossref","unstructured":"Hodge, LM, Bearden, MK, Schander, A, Huff, JB, Williams, A, King, HH, et al.. Lymphatic pump treatment mobilizes leukocytes from the gut associated lymphoid tissue into lymph. Lymphat Res Biol 2010;8:103\u201310. https:\/\/doi.org\/10.1089\/lrb.2009.0011.","DOI":"10.1089\/lrb.2009.0011"},{"key":"2024032106185969075_j_jom-2023-0198_ref_030","doi-asserted-by":"crossref","unstructured":"Hodge, LM, King, HH, Creasy, C, Carter, KR, Orlowski, A, Schander, A. Lymphatic pump treatment as an adjunct to antibiotics for pneumonia in a rat model. J Am Osteopath Assoc 2015;115:306\u201316. https:\/\/doi.org\/10.7556\/jaoa.2015.061.","DOI":"10.7556\/jaoa.2015.061"},{"key":"2024032106185969075_j_jom-2023-0198_ref_031","doi-asserted-by":"crossref","unstructured":"Walkowski, S, Singh, M, Puertas, J, Pate, M, Goodrum, K, Benencia, F. Osteopathic manipulative therapy induces early plasma cytokine release and mobilization of a population of blood dendritic cells. PLoS One 2014;9:e90132. https:\/\/doi.org\/10.1371\/journal.pone.0090132.","DOI":"10.1371\/journal.pone.0090132"},{"key":"2024032106185969075_j_jom-2023-0198_ref_032","unstructured":"Jackson, KM, Steele, TF, Dugan, EP, Kukulka, G, Blue, W, Roberts, A. Effect of lymphatic and splenic pump techniques on the antibody response to hepatitis B vaccine: a pilot study. J Am Osteopath Assoc 1998;98:155\u201360."},{"key":"2024032106185969075_j_jom-2023-0198_ref_033","unstructured":"Noll, DR, Shores, JH, Gamber, RG, Herron, KM, Swift, JJ. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia. J Am Osteopath Assoc 2000;100:776\u201382."},{"key":"2024032106185969075_j_jom-2023-0198_ref_034","doi-asserted-by":"crossref","unstructured":"Noll, DR, Degenhardt, BF, Morley, TF, Blais, FX, Hortos, KA, Hensel, K, et al.. Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial. Osteopath Med Prim Care 2010;4:2. https:\/\/doi.org\/10.1186\/1750-4732-4-2.","DOI":"10.1186\/1750-4732-4-2"}],"container-title":["Journal of Osteopathic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jom-2023-0198\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jom-2023-0198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T06:19:44Z","timestamp":1711001984000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jom-2023-0198\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,28]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,1,24]]},"published-print":{"date-parts":[[2024,3,22]]}},"alternative-id":["10.1515\/jom-2023-0198"],"URL":"https:\/\/doi.org\/10.1515\/jom-2023-0198","relation":{},"ISSN":["2702-3648"],"issn-type":[{"type":"electronic","value":"2702-3648"}],"subject":[],"published":{"date-parts":[[2023,11,28]]}}}