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Learned immunosuppressive placebo responses in renal transplant patients
#MMPMID29610294
Kirchhof J
; Petrakova L
; Brinkhoff A
; Benson S
; Schmidt J
; Unteroberdörster M
; Wilde B
; Kaptchuk TJ
; Witzke O
; Schedlowski M
Proc Natl Acad Sci U S A
2018[Apr]; 115
(16
): 4223-4227
PMID29610294
show ga
Patients after organ transplantation or with chronic, inflammatory autoimmune
diseases require lifelong treatment with immunosuppressive drugs, which have
toxic adverse effects. Recent insight into the neurobiology of placebo responses
shows that associative conditioning procedures can be employed as placebo-induced
dose reduction strategies in an immunopharmacological regimen. However, it is
unclear whether learned immune responses can be produced in patient populations
already receiving an immunosuppressive regimen. Thus, 30 renal transplant
patients underwent a taste-immune conditioning paradigm, in which
immunosuppressive drugs (unconditioned stimulus) were paired with a gustatory
stimulus [conditioned stimulus (CS)] during the learning phase. During evocation
phase, after patients were reexposed to the CS, T cell proliferative capacity was
significantly reduced in comparison with the baseline kinetics of T cell
functions under routine drug intake (?(p)(2) = 0.34). These data demonstrate,
proof-of-concept, that learned immunosuppressive placebo responses can be used as
a supportive, placebo-based, dose-reduction strategy to improve treatment
efficacy in an ongoing immunopharmacological regimen.
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