Press R I, Peebles C L, Kumagai Y, Ochs R L, Tan E M
W. M. Keck Autoimmune Disease Center, La Jolla, California.
Lancet. 1992 Nov 28;340(8831):1304-7. doi: 10.1016/0140-6736(92)92491-w.
Clinical syndromes resembling autoimmune diseases have been reported in women who have had breast augmentation procedures. To see whether there is a humoral immune response in these diseases that is similar to the immune response in their idiopathic counterparts, we assessed the immunological specificity of antinuclear antibodies (ANAs) and certain epidemiological features in 24 patients, all of whom (with 1 exception) had received silicone gel breast implants. ANA specificities were identified by indirect immunofluorescence, immunodiffusion, western blot analysis, and immunoprecipitation of radiolabelled intracellular proteins. Of 11 patients who had symptoms and signs that met criteria for defined autoimmune diseases, 7 had scleroderma or subsets of this disorder and the others had systemic lupus erythematosus, rheumatoid arthritis, or overlapping autoimmune diseases. High ANA titres were present in 10 of these 11 patients and the ANA specificities were similar to those found in the idiopathic forms of the corresponding autoimmune diseases. Trauma, with resultant rupture of implants, accelerated onset of symptoms. 13 other patients had autoimmune disorders of a less clearly defined nature and low titres of ANAs whose specificities could not be identified. ANAs are associated with the development of autoimmune complications in women with silicone breast implants. Further studies are needed to see whether this relation is one of cause and effect and whether ANAs might be early serological markers preceding development of autoimmune symptoms.
据报道，接受过隆胸手术的女性中出现了类似自身免疫性疾病的临床综合征。为了探究这些疾病中是否存在与特发性自身免疫性疾病相似的体液免疫反应，我们评估了24例患者抗核抗体（ANA）的免疫特异性及某些流行病学特征，所有患者（仅1例除外）均接受了硅胶乳房植入物。通过间接免疫荧光、免疫扩散、蛋白质印迹分析以及放射性标记细胞内蛋白质的免疫沉淀法来确定ANA的特异性。在11例有符合明确自身免疫性疾病标准的症状和体征的患者中，7例患有硬皮病或该疾病的亚型，其他患者患有系统性红斑狼疮、类风湿性关节炎或重叠性自身免疫性疾病。这11例患者中有10例ANA滴度较高，且ANA特异性与相应特发性自身免疫性疾病中发现的特异性相似。外伤导致植入物破裂会加速症状的出现。另外13例患者患有性质不太明确的自身免疫性疾病，ANA滴度较低且无法确定其特异性。ANA与硅胶乳房植入女性自身免疫性并发症的发生有关。需要进一步研究来确定这种关系是否为因果关系，以及ANA是否可能是自身免疫症状出现之前的早期血清学标志物。
