Genetics and the placebo effect: the placebome
The placebo response contributes significantly to clinical outcomes, and being able to identify whom is likely to respond could influence treatment approaches. There are many variables that are thought to influence the placebo response, and there is growing evidence that individual’s genes could play an important factor.
This review outlines evidence from placebo studies and RCTs, and introduces the concept of ‘the placebome’; the impact of genetics to the placebo response. There is evidence for several genetic variations in neurotransmitters and neurological pathways mediating the placebo response, which could possibly explain the variations in clinical outcomes. Including an arm in randomised clinical trials, where subjects receive no treatment or interventions could help to further investigate placebos.
The authors appreciate the complexity of the ‘placebome’ and underscore the importance of understanding how this fits into larger more complex networks. Numerous questions need to be addresses before it can be integrated into drug development and clinical care. However, future knowledge on this matter has the potential to identify strategies that could help identify placebo responders and guide clinical trial design.
> From: Hall et al., Trends Mol Med 21 (2015) (Epub ahead of print). All rights reserved to Elsevier Ltd.. Click here for the Pubmed summary.