Schedlowski_Portrait Kopie

Manfred Schedlowski
Professor and Director of the Institute of Medical Psychology and Behavioral Immunobiology at the Medical Faculty, University of Duisburg-Essen, Germany, and Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden

Teach the T cells: Learned immunosuppressive placebo responses

Akin to other physiological responses, immune functions can be modified in humans through associative conditioning procedures as part of learned placebo responses. The potential clinical applicability of learned immunosuppressive responses has been convincingly demonstrated in rodents, where conditioned immune responses significantly reduced the mortality in animals with inflammatory autoimmune disease, significantly reduced allergic responses or prolonged the survival time of transplanted vascularized organs. In an established taste-immune learning paradigm in rodents and humans, the calcineurin-inhibitor and immunosuppressant cyclosporine A (CsA) as an unconditioned stimulus (US) is paired with a gustatory stimulus as a conditioned stimulus (CS) during acquisition. Subjects are re-exposed to the CS during evocation, inducing immunosuppressive responses similar to the drug effects. However, it is unclear so far, whether learned immune responses can be produced in patient populations already on immunosuppressive regimen.

In a recent study, we demonstrated in renal transplant patients who were already on immunosuppressive treatment, that learned immunosuppressive placebo responses increased efficacy of immunosuppressive medication reflected by significant reduction of T cell proliferative capacity. These data demonstrate, that behavioral conditioning of drug responses may be a promising tool that could be used as a placebo-based dose reduction strategy in ongoing immunopharmacological regimen the aim being to limit unwanted drug side effects and to improve treatment efficacy.

 

Biosketch

Manfred Schedlowski is Professor and Director of the Institute of Medical Psychology and Behavioral Immunobiology at the Medical Faculty, University of Duisburg-Essen, Germany. Born 1957 in Hannover, Germany, he obtained his degree in Psychology and his PhD at the Department of Medical Psychology, Hannover Medical School, Germany. Since October 1997, Manfred Schedlowski is Full Professor and Director of the Institute of Medical Psychology and Behavioral Immunobiology at the Medical Faculty, University Essen-Duisburg interrupted by a research stay as Professor of Psychology and Behavioral Immunobiology at the Swiss Federal Institute of Technology (ETH) in Zürich, Switzerland (2004-2007). Manfred Schedlowski’s current primary focus of research is the neurobiology of placebo and nocebo responses, in particular the mechanisms and clinical relevance of behavioral or Pavlovian conditioning of immune and neuroendocrine functions.