Background Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA) is associated with adjuvants such as: squalene, aluminum, silicone and injections of mineral oil (MO).
Objectives We aimed clinical and autoantibodies features in patients with ASIA induced by injection of MO used with cosmetic purposes and silicone breast implants (SBI).
Methods 29 women patients with injection of MO, other substances (methacrylate, silicone fluid, guaiacol) and SBI that developed clinical manifestations of defined autoimmune rheumatic disease (ARD) or non-specific manifestation of autoimmune rheumatic disease (NSARD) were included. Antinuclear antibodies (ANA) were done in all patients by immnofluorescense (HEp-2 slide). Autoantibody profile was done by immunoprecipitation and by ELISA (anti-dsDNA, beta2 glycoprotein I, anti-Ro 52 and anti-U1RNP-70kD)
Results Mean age (47±10) years, 22 patients were injected with MO (in 5 patients the MO were combined with other substances: collagen, guaiacol, silicone liquid), 2 with methacrylate, 1 with mercury and 4 had SBI. The clinical manifestations were: chronic fatigue 82%, skin lesion 76%, arthralgias 68%, myalgias 62%, sleep disturbances 62%, fever 62%, arthritis 45%, cognitive disturbances 34%, weakness 34%, xerostomy 18%, gastrointestinal disturbances 14%, respiratory disturbances 7% and myopathy 7%. The main diagnosis were: NSARD: 59%, ARD 41%: panniculitis, thyroiditis, systemic sclerosis (SSc), Still disease, SLE, dermatomyositis, angiomatosis, hemolytic anemia. All patients with SBI met criteria for SSc, SLE and Still's disease. ANA were present in 66% of patients, being the most common pattern nuclear and nucleolar (26% each) followed by mithocondrial-like 16%, cytoplasmic dots, centromere (11% each), cytoplasmic dots and DFS70-like in 5% each. Anti-U1RNP and anti-Su/Argonaute in 2 (SLE and NSARD) were found in 7% (2/29) each, anti-Ro 52kD and anti-Ro 60kD were in 10% each (3/29). Two cases of anti-centromere were also positive by anti-CENP-B ELISA 7%. Anti-β2GP1 was in one case 3%.
Conclusions This study demonstrated the induction of ASIA after injection of MO and SBI. For first time we reporting patients injected with MO in whom the immunologic response with anti-Su antibodies production is very similar to observed in nonautoimmune strains of mice exposed to pristane, a component of MO. The induction of ASIA after MO and SBI exposition may be relevant to understanding the mechanism and origen of autoantibodies and the pathogenesis of ARD.
Vera-Lastra O, Medina G, Cruz-Dominguez Mdel P, Jara LJ, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld's syndrome): clinical and immunological spectrum. Expert Rev Clin Immunol. 2013(4):361-73.
Vera-Lastra O, Medina G, Cruz-Dominguez Mdel P, Ramirez P, Gayosso-Rivera JA, Anduaga-Dominguez H, Lievana-Torres C, Jara LJ. Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld's syndrome). Lupus. 2012;21(2):128-35
Disclosure of Interest None declared