Ageing and Systemic Autoimmune Diseases Research Unit. Service of Internal Medicine-I. Aging Basic Research Unit, Molecular Biology and Biochemistry Research Centre for Nanomedicine (CIBBIM-Nanomedicine), Vall d'Hebron University Research Institute (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, Universitat Autonoma, Barcelona, Spain.
Semin Arthritis Rheum. 2013 Oct;43(2):241-58. doi: 10.1016/j.semarthrit.2013.02.001. Epub 2013 May 2.
An increasing number of persons seek medical solutions for esthetic indications and for diverse pathological conditions, such as malformations, trauma, or cancer. Despite manufacturers' and different authors' claims that fillers are non-immunogenic or that complications are uncommon, unwanted adverse reactions do occur.
To review the literature regarding the multiple types of immune-mediated adverse reactions related to medical dermal filler injections/prosthesis.
A comprehensive MEDLINE, PubMed, and Google Scholar electronic database search was performed (2000-January 2012). Selected articles published before 2000 referring to general concerns regarding the studied topic were also included. The search provided almost 300 articles. Finally, 235 studies were selected and included.
All known fillers present in the market have been shown to be able to provoke early- and late-onset inflammatory adverse reactions. Their true prevalence is unknown but appears to be significant. The majority of the late-onset adverse effects are inflammatory and immune-mediated in nature. Edema, granulomas, sarcoid-like disorders, and panniculitis are the findings most commonly seen. Rarely, systemic granulomatous and autoimmune diseases, and to lesser extent acute hypersensitivity reactions can be seen.
All implanted, injected, and blood-contact biomaterials trigger a wide variety of adverse reactions that may appear early or late and range from local to systemic. Most fillers act more as adjuvants than as direct T-cell activators, on a background of genetic predisposition. Their treatment has not been the subject of well-designed studies. Management of both acute and systemic reactions is often difficult and requires anti-inflammatory and occasionally immunosuppressive therapy.
越来越多的人为了美容目的和各种病理状况（如畸形、创伤或癌症）寻求医学解决方案。尽管制造商和不同的作者声称填充物是非免疫原性的或并发症不常见，但确实会发生不需要的不良反应。
回顾与医学真皮填充物注射/假体相关的多种免疫介导的不良反应类型的文献。
进行了全面的 MEDLINE、PubMed 和 Google Scholar 电子数据库搜索（2000 年-2012 年 1 月）。还包括 2000 年之前发表的、涉及研究主题的一般问题的选定文章。搜索提供了近 300 篇文章。最后，选择并包括了 235 项研究。
市场上所有已知的填充物都已被证明能够引发早期和晚期炎症不良反应。它们的真实流行率尚不清楚，但似乎很显著。大多数晚期不良反应是炎症和免疫介导的。最常见的发现是水肿、肉芽肿、类肉瘤样疾病和脂膜炎。罕见情况下，可出现全身性肉芽肿性和自身免疫性疾病，以及程度较轻的急性过敏反应。
所有植入、注射和血液接触的生物材料都会引发各种各样的不良反应，这些反应可能会在早期或晚期出现，从局部到全身。大多数填充物的作用更像是佐剂，而不是直接的 T 细胞激活剂，其背景是遗传易感性。它们的治疗尚未成为精心设计的研究的主题。急性和全身性反应的治疗通常很困难，需要抗炎治疗，有时还需要免疫抑制治疗。
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