Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Expert Rev Clin Immunol. 2013 Apr;9(4):361-73. doi: 10.1586/eci.13.2.
An adjuvant is a substance that enhances the antigen-specific immune response, induces the release of inflammatory cytokines, and interacts with Toll-like receptors and the NALP3 inflammasome. The immunological consequence of these actions is to stimulate the innate and adaptive immune response. The activation of the immune system by adjuvants, a desirable effect, could trigger manifestations of autoimmunity or autoimmune disease. Recently, a new syndrome was introduced, autoimmune/inflammatory syndrome induced by adjuvants (ASIA), that includes postvaccination phenomena, macrophagic myofasciitis, Gulf War syndrome and siliconosis. This syndrome is characterized by nonspecific and specific manifestations of autoimmune disease. The main substances associated with ASIA are squalene (Gulf War syndrome), aluminum hydroxide (postvaccination phenomena, macrophagic myofasciitis) and silicone with siliconosis. Mineral oil, guaiacol and iodine gadital are also associated with ASIA. The following review describes the wide clinical spectrum and pathogenesis of ASIA including defined autoimmune diseases and nonspecific autoimmune manifestations, as well as the outlook of future research in this field.
佐剂是一种增强抗原特异性免疫反应、诱导炎症细胞因子释放、与 Toll 样受体和 NALP3 炎性小体相互作用的物质。这些作用的免疫学后果是刺激先天和适应性免疫反应。佐剂对免疫系统的激活，这是一种理想的效果，可能引发自身免疫或自身免疫性疾病的表现。最近，引入了一种新的综合征，即佐剂诱导的自身免疫/炎症综合征 (ASIA)，它包括疫苗接种后现象、巨噬细胞肌筋膜痛、海湾战争综合征和硅肺。该综合征的特征是非特异性和特异性自身免疫性疾病表现。与 ASIA 相关的主要物质是角鲨烯（海湾战争综合征）、氢氧化铝（疫苗接种后现象、巨噬细胞肌筋膜痛）和硅肺中的硅。矿物油、愈创木酚和碘钆也与 ASIA 相关。以下综述描述了 ASIA 的广泛临床谱和发病机制，包括明确的自身免疫性疾病和非特异性自身免疫表现，以及该领域未来研究的展望。
