Goren Idan, Segal Gad, Shoenfeld Yehuda
Department of Internal Medicine "T", Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Sheba Medical Center, Ramat Gan, Israel.
The Zabludowicz Center of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Incumbent of Laura Swarz-Kip Chair for Research of Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel.
Clin Rheumatol. 2015 Oct;34(10):1661-6. doi: 10.1007/s10067-015-2931-0. Epub 2015 Apr 16.
Silicone implants have been in use since the mid-twentieth century, especially in the field of reconstructive breast surgery, and have long been considered as biologically inert and harmless. However, growing body of evidence from the past two decades links silicone with subsequent autoimmunity-related complications, collectively known as autoimmune/inflammatory syndrome induced by adjuvant--ASIA. Previous data suggest that while some patients tend to develop post-exposure autoimmune phenomena such as ASIA, other do not. However, thus far, no criteria for risk stratification were suggested. This current review summarizes the data linking silicone implants and autoimmunity, suggesting means of defining individuals who are at increased risk to develop silicone-induced ASIA, and therefore, a recommendation was made to avoid silicone implantation, e.g., individuals with previously diagnosed autoimmune disorders or with genetic preponderance for hyperactive immune system should not be considered as candidates for silicone implantation.
自20世纪中叶以来，硅酮植入物一直在使用，尤其是在乳房重建手术领域，长期以来一直被认为具有生物惰性且无害。然而，过去二十年中越来越多的证据将硅酮与随后的自身免疫相关并发症联系起来，这些并发症统称为佐剂诱导的自身免疫/炎症综合征（ASIA）。先前的数据表明，虽然一些患者倾向于在接触后出现自身免疫现象，如ASIA，但其他患者则不会。然而，到目前为止，尚未提出风险分层标准。本综述总结了将硅酮植入物与自身免疫联系起来的数据，提出了确定发生硅酮诱导的ASIA风险增加个体的方法，因此，建议避免硅酮植入，例如，先前被诊断患有自身免疫性疾病或具有免疫系统过度活跃遗传倾向的个体不应被视为硅酮植入的候选者。
