Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
Proc Natl Acad Sci U S A. 2018 Apr 17;115(16):4223-4227. doi: 10.1073/pnas.1720548115. Epub 2018 Apr 2.
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 (ƞ = 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.
器官移植后的患者或患有慢性炎症性自身免疫性疾病的患者需要终身使用免疫抑制药物治疗，这些药物具有毒副作用。最近对安慰剂反应的神经生物学的深入了解表明，联想条件作用程序可以作为免疫药理学方案中安慰剂诱导的剂量减少策略。然而，尚不清楚在已经接受免疫抑制方案的患者人群中是否可以产生学习性免疫反应。因此，30 名肾移植患者接受了味觉免疫条件作用范式，在此范式中，在学习阶段将免疫抑制药物（非条件刺激）与味觉刺激（条件刺激）配对。在唤起阶段，在重新暴露于 CS 后，与常规药物摄入下 T 细胞功能的基线动力学相比，T 细胞增殖能力显着降低（ƞ = 0.34）。这些数据证明，学习性免疫抑制安慰剂反应可用作支持性、基于安慰剂的剂量减少策略，以提高正在进行的免疫药理学方案中的治疗效果。
