The learned immune response: Pavlov and beyond

Self Cite

Current placebo research postulates that conditioning processes are one of the major mechanisms of the placebo response. Behaviourally conditioned changes in peripheral immune functions have been demonstrated in experimental animals, healthy subjects and patients. The physiological mechanisms responsible for this 'learned immune response ' are not yet fully understood, but some relevant afferent and efferent pathways in the communication between the brain and the peripheral immune system have been identified. In addition, possible benefits and applicability in clinical settings have been demonstrated where behaviourally conditioned immunosuppression attenuated the exacerbation of autoimmune diseases, prolonged allograft survival and affected allergic responses. Here, we summarize data describing the mechanisms and the potential clinical benefit of behaviourally conditioned immune functions, with particular focus on learned placebo effects on allergic reactions.

Section: Clinical Implications Of the Behaviourally Conditioned Immunmentioning

confidence: 99%

Section: How Conditioning Of Peripheral Immune Functions Work: Princmentioning

confidence: 99%

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Behavioural conditioning as the mediator of placebo responses in the immune system

Vits¹,

Cesko

Enck³

et al. 2011

Self Cite

“…(b) Immune responses Similar to endocrine responses, also many immunomodulatory effects can undergo behavioural conditioning and be conceptualized as placebo (or nocebo) effects (for a review, see [53,54]). For instance, both in multiple sclerosis patients [55] and in healthy subjects [56], immunosuppression after placebo could be induced after conditioning with immunosuppressive drugs, possibly by calcineurin inhibition [57].…”

Section: Placebo Responses Can Employ Brain -Body Pathwaysmentioning

confidence: 99%

Placebo mechanisms across different conditions: from the clinical setting to physical performance

Pollo

Carlino

Benedetti

2011

Although the great increase in interest in the placebo phenomenon was spurred by the clinical implications of its use, the progressive elucidation of the neurobiological and pharmacological mechanisms underlying the placebo effect also helps cast new light on the relationship between mind (and brain) and body, a topic of foremost philosophical importance but also a major medical issue in light of the complex interactions between the brain on the one hand and body functions on the other. While the concept of placebo can be a general one, with a broad definition generally applicable to many different contexts, the description of the cerebral processes called into action in specific situations can vary widely. In this paper, examples will be given where physiological or pathological conditions are altered following the administration of an inert substance or verbal instructions tailored to induce expectation of a change, and explanations will be offered with details on neurotransmitter changes and neural pathways activated. As an instance of how placebo effects can extend beyond the clinical setting, data in the physical performance domain and implications for sport competitions will also be presented and discussed.

“…For example, the majority of studies scrutinizing the nocebo effect have actually been investigated in asthmatic patients, and there is now clear evidence that the expectation of bronchoconstriction impairs lung function. Finally, immunological placebo responses have been demonstrated in animal experiments, healthy subjects and patients, and parts of the physiological mechanisms responsible for these distinct changes in immune functions have recently been described [23]. First studies in patients suggest that conditioned immunosuppression may not only affect allergic responses but actually attenuate the course of disease of autoimmune illnesses [24].…”

Section: Introductionmentioning

confidence: 99%

Introduction to placebo effects in medicine: mechanisms and clinical implications

Meißner

Kohls

Colloca

2011

The field of placebo research has made considerable progress in the last years and it has become a major focus of interest. We know now that the placebo effect is a real neurobiological phenomenon and that the brain's 'inner pharmacy' is a critical determinant for the occurrence of psychobiological and behavioural changes relevant to healing processes and well-being. However, harnessing the advantages of placebo effects in healthcare is still a challenge. The first part of the theme issue summarizes and discusses the various kinds of placebo mechanisms across medical fields, thereby not only focusing on two main explanatory models-expectation and conditioning theory-but also taking into account empathy and social learning, emotion and motivation, spirituality and the healing ritual. The second part of the issue focuses on questions related to transferring knowledge from placebo research into clinical practice and discusses implications for the design and interpretation of clinical trials, for the therapeutic settings in daily patient care, and for future translational placebo research.