Barilaro Giuseppe, Spaziani Testa Claudia, Cacciani Antonella, Donato Giuseppe, Dimko Mira, Mariotti Amalia
Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Nephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Immunol Res. 2016 Dec;64(5-6):1142-1149. doi: 10.1007/s12026-016-8871-1.
An immunologic adjuvant is a substance that enhances the antigen-specific immune response preferably without triggering one on its own. Silicone, a synthetic polymer used for reconstructive and cosmetic purposes, can cause, once injected, local and/or systemic reactions and trigger manifestations of autoimmunity, occasionally leading to an overt autoimmune disease. Siliconosis, calcinosis cutis with hypercalcemia and chronic kidney disease have all been reported in association with silicone injection. Here, we describe a case of autoimmune/auto-inflammatory syndrome induced by adjuvants, calcinosis cutis and chronic kidney disease after liquid silicone multiple injections in a young man who underwent a sex reassignment surgery, followed by a review of the literature. To our knowledge, this is the first report describing the concomitance of the three clinical conditions in the same patients. The link between silicone and the immune system is not completely understood yet and requires further reports and investigations with long-term data, in order to identify the main individual and genetical risk factors predisposing to the wide spectrum of the adjuvant-induced responses.
免疫佐剂是一种能够增强抗原特异性免疫反应的物质，最好是自身不会引发免疫反应。硅酮是一种用于重建和美容目的的合成聚合物，一旦注射，可能会引起局部和/或全身反应，并引发自身免疫表现，偶尔会导致明显的自身免疫性疾病。硅沉着病、伴有高钙血症的皮肤钙质沉着症和慢性肾病都与硅酮注射有关。在此，我们描述了一例在接受性别重置手术的年轻男性多次注射液体硅酮后发生的佐剂诱导的自身免疫/自身炎症综合征、皮肤钙质沉着症和慢性肾病病例，并对相关文献进行了综述。据我们所知，这是第一份描述同一患者同时出现这三种临床病症的报告。硅酮与免疫系统之间的联系尚未完全明确，需要进一步的报告和长期数据调查，以确定导致广泛的佐剂诱导反应的主要个体和遗传风险因素。
