scholarly journals Classical Examples of the Concept of the ASIA Syndrome

Biomolecules ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1436
Author(s):  
Vânia Borba ◽  
Anna Malkova ◽  
Natalia Basantsova ◽  
Gilad Halpert ◽  
Laura Andreoli ◽  
...  
Keyword(s):  
Immune System ◽  
Clinical Manifestations ◽  
Breast Implants ◽  
Undifferentiated Connective Tissue Disease ◽  
Ptpn22 Gene ◽  
Silicone Breast Implants ◽  
Immune Mediated ◽  
Asia Syndrome ◽  
Skin Biopsies ◽  
Inflammatory Syndrome

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. In this review, five enigmatic conditions, including sarcoidosis, Sjögren’s syndrome, undifferentiated connective tissue disease, silicone implant incompatibility syndrome (SIIS), and immune-related adverse events (irAEs), are defined as classical examples of ASIA. Certainly, these disorders have been described after an adjuvant stimulus (silicone implantation, drugs, infections, metals, vaccines, etc.) among genetically predisposed individuals (mainly the HLA-DRB1 and PTPN22 gene), which induce an hyperstimulation of the immune system resulting in the production of autoantibodies, eventually leading to the development of autoimmune diseases. Circulating autonomic autoantibodies in the sera of patients with silicone breast implants, as well as anatomopathological aspects of small fiber neuropathy in their skin biopsies have been recently described. To our knowledge, these novel insights serve as a common explanation to the non-specific clinical manifestations reported in patients with ASIA, leading to the redefinition of the ASIA syndrome diagnostic criteria.

scholarly journals Autoimmune inflammatory syndrome induced by adjuvants (silicone breast implants and lip fillers)

2021 ◽  
Vol 72 (1) ◽  
pp. 1-5
Author(s):  
Božidar Pocevski ◽  
Slavica Pavlov-Dolijanović
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Breast Implants ◽  
Inflammatory Rheumatic Diseases ◽  
Silicone Breast Implants ◽  
Immune Mediated ◽  
Systemic Symptoms ◽  
Patients Experience ◽  
Inflammatory Syndrome

Introduction: Silicone breast implants (SBI) have been used since 1962 in the reconstruction of post-mastectomy cases, in augmentation of the breast, or for cosmetic purposes, while fillers with biopolymer (FB) have been used since the 1990s. Today, they are considered adjuvants of the immune system. Most complications of SBI and FB are local in nature, but some patients experience systemic symptoms, which are defined as adjuvant-induced autoimmune inflammatory syndrome (ASIA). Aim: The aim of this study is to demonstrate the possible association of silicone breast implants and FB with the development of immune-mediated inflammatory rheumatic diseases (IMIRD). Material and methods: The research represents retrospective study which involved 15 female patients with immune-mediated inflammatory rheumatic diseases, 6 of whom were patients with implanted silicone breast implants for cosmetic reasons, and 9 patients with placement of fillers with biopolymer on the lips. Results: The average time from silicone implantation to the onset of the first symptoms was 6.10 ± 5.3 (range 6 months to 24 years). The following immune-mediated inflammatory rheumatic diseases were recorded: 3 patients with systemic sclerosis (SSc), 3 patients with undifferentiated arthritis, 3 patients with seropositive rheumatoid arthritis, 1 patient with systemic lupus erythematosus, 2 patients with undifferentiated SCTD, 2 patients with mixed connective tissue disease, and one patient with unexplained systemic disease. Seven patients had the Raynaud phenomenon. Spontaneous abortions were reported in 2 patients. Conclusion: Earlier reports that silicone breast implants and biopolymer fillers are safe, today are changing with the description of ASIA syndrome.

Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome) – An update

Lupus ◽  
2017 ◽  
Vol 26 (7) ◽  
pp. 675-681 ◽  
Author(s):  
A Watad ◽  
M Quaresma ◽  
S Brown ◽  
J W Cohen Tervaert ◽  
I Rodríguez-Pint ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Silicone Implants ◽  
Systemic Lupus ◽  
Endogenous Factors ◽  
Immune Mediated ◽  
Autoimmune Conditions ◽  
Asia Syndrome ◽  
Inflammatory Syndrome ◽  
The Relationship

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants. In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).

scholarly journals Association between Silicone Breast Implants and Autoimmune Diseases

2017 ◽  
Author(s):  
Rute Carvalho ◽  
Ana Filipa S. Lima ◽  
Joana Barreira ◽  
Vânia Guedes
Keyword(s):  
Autoimmune Diseases ◽  
Meta Analysis ◽  
Breast Implants ◽  
Adult Women ◽  
Eligibility Criteria ◽  
Silicone Breast Implants ◽  
Mesh Terms ◽  
Long Time ◽  
Asia Syndrome ◽  
Inflammatory Syndrome

BACKGROUND AND AIM: Silicone breast implants have, for a long time, been considered as biologically inert and harmless. However the relationship between silicone breast implants and the risk of autoimmune diseases has generated intense medical interest. The aim of our review is to summarize the data linking silicone breast implants and autoimmune diseases, including the most recent association with autoimmune/inflammatory syndrome induced by adjuvants (ASIA).METHODS: The clinical research included articles from the last 16 years using the MeSH terms “breast implants” and “autoimmune diseases” and also the following terms: “autoimmune/inflammatory syndrome induced by adjuvants” and “Shoenfeld’s syndrome”. The Oxford 2011 Levels of Evidence was used to assign a level-of-evidence.Eligible articles included those who described a population of adult women (>17 years), which have breast implants versus women without implants. The clinical outcome measured was the development of an autoimmune disease.RESULTS: Of the 268 obtained articles, five matched eligibility criteria (one meta-analysis, two systematic reviews and two cohort studies). Results show that although studies could not confirm an association between silicone breast implants and classical autoimmune diseases, a few studies demonstrated an association between implantsand undefined symptoms such as fatigue, arthralgia, myalgia and cognitive symptoms, which resembled a newly introduced syndrome, known as ASIA.CONCLUSIONS: Evidence remains inconclusive about any association between silicone breast implants and classical autoimmune diseases. ASIA seems to be linked to previous exposition to an adjuvant such as silicone. However, we will need better evidence from large studies with accurate methodology to determine whether any true association exists between ASIA syndrome and silicone breast implants.

scholarly journals Autoimmune syndrome induced by adjuvants after breast enhancement with polyacrylamide hydrogel: a study in Poland

2020 ◽  
Vol 40 (11) ◽  
pp. 1851-1856
Author(s):  
Ewa Woźniak-Roszkowska ◽  
Maria Maślińska ◽  
Piotr Gierej ◽  
Bartłomiej Noszczyk
Keyword(s):  
Plastic Surgery ◽  
Postgraduate Medical Education ◽  
Breast Implants ◽  
Chronic Fatigue ◽  
The Body ◽  
Upper Extremities ◽  
Polyacrylamide Hydrogel ◽  
Silicone Breast Implants ◽  
Autoimmune Syndrome ◽  
Asia Syndrome

Abstract Autoimmune syndrome induced by adjuvants (ASIA) is the spectrum of diseases in which the substances considered inert to the body induce autoimmune reactions and inflammation. Some of the biomaterials recently used in plastic surgery, such as silicone or polyacrylamide hydrogel (PAAG) seem to trigger clinical features of ASIA. The aim of this study was to assess the incidence of these features within a group of women after breast augmentation with PAAG. As many as 30 consecutive patients (26–59 years, mean age 39.5) referred to the Clinic of Plastic Surgery after breast enhancement with PAAG were examined. The validated criteria of ASIA syndrome were employed. Descriptive statistics were chosen based on the distribution of variables. The research was approved by the Bioethical Committee of the Centre of Postgraduate Medical Education in Warsaw, Poland. Within the studied group, 50% of patients (n = 15) fulfilled ASIA diagnostic criteria. Apart from local complications, we encountered various general symptoms, among which fever (n = 13, 43.3%), tingling and numbness of upper extremities (n = 10, 33.3%) and chronic fatigue (n = 9, 30%) were the most common. These symptoms were present on an ambulatory visit, before qualification to the operation of hydrogel removal. All patients undergoing surgical PAAG removal (n = 8) declared alleviation or complete resolution of the symptoms. Polyacrylamide hydrogel breast filling, although limiting the invasiveness of the procedure in relation to silicone breast implants, also carries the risk of developing ASIA symptoms. The removal of PAAG may bring improvement in some cases.

scholarly journals SARS-CoV-2 and Autoimmune Cytopenia

Hemato ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 463-476
Author(s):  
Ryann Quinn ◽  
Irina Murakhovskaya
Keyword(s):  
Immune Response ◽  
Immune System ◽  
Severe Acute Respiratory Syndrome ◽  
Immune Thrombocytopenic Purpura ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Thrombocytopenic Purpura ◽  
Immune Mediated ◽  
Autoimmune Cytopenias ◽  
Autoimmune Cytopenia

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a variety of clinical manifestations related to viral tissue damage, as well as a virally induced immune response. Hyperstimulation of the immune system can serve as a trigger for autoimmunity. Several immune-mediated manifestations have been described in the course of SARS-CoV-2 infection. Immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA) are the most common hematologic autoimmune disorders seen in the course of SARS-CoV-2 infection. Vaccine-induced thrombocytopenia is a unique autoimmune hematologic cytopenia associated with SARS-CoV-2 vaccination. This paper will review the current literature on the association of SARS-CoV-2 infection and vaccination with autoimmune cytopenias and the clinical course of autoimmune cytopenias in patients with COVID-19.

scholarly journals Systemic Sclerosis: From Pathophysiology to Novel Therapeutic Approaches

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 163
Author(s):  
Devis Benfaremo ◽  
Silvia Svegliati ◽  
Chiara Paolini ◽  
Silvia Agarbati ◽  
Gianluca Moroncini
Keyword(s):  
Immune System ◽  
Systemic Sclerosis ◽  
Plasma Cells ◽  
Clinical Manifestations ◽  
Therapeutic Targets ◽  
Tissue Level ◽  
Internal Organs ◽  
Immune Mediated ◽  
Chronic Disorder ◽  
Substantial Progress

Systemic sclerosis (SSc) is a systemic, immune-mediated chronic disorder characterized by small vessel alterations and progressive fibrosis of the skin and internal organs. The combination of a predisposing genetic background and triggering factors that causes a persistent activation of immune system at microvascular and tissue level is thought to be the pathogenetic driver of SSc. Endothelial alterations with subsequent myofibroblast activation, excessive extracellular matrix (ECM) deposition, and unrestrained tissue fibrosis are the pathogenetic steps responsible for the clinical manifestations of this disease, which can be highly heterogeneous according to the different entity of each pathogenic step in individual subjects. Although substantial progress has been made in the management of SSc in recent years, disease-modifying therapies are still lacking. Several molecular pathways involved in SSc pathogenesis are currently under evaluation as possible therapeutic targets in clinical trials. These include drugs targeting fibrotic and metabolic pathways (e.g., TGF-β, autotaxin/LPA, melanocortin, and mTOR), as well as molecules and cells involved in the persistent activation of the immune system (e.g., IL4/IL13, IL23, JAK/STAT, B cells, and plasma cells). In this review, we provide an overview of the most promising therapeutic targets that could improve the future clinical management of SSc.

Silicone breast implants: The role of immune system on capsular contracture formation

1995 ◽  
Vol 29 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Donatella Granchi ◽  
Daniela Cavedagna ◽  
Gabriela Ciapetti ◽  
Susanna Stea ◽  
Patrizia Schiavon ◽  
...  
Keyword(s):  
Immune System ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Silicone Breast Implants ◽  
Contracture Formation
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