Vojdani A, Brautbar N, Campbell A W
Immunosciences Laboratory, Inc., Beverly Hills, CA 90211.
Immunopharmacol Immunotoxicol. 1994 Nov;16(4):497-523. doi: 10.3109/08923979409019737.
Silicone implants have been associated with the development of multiple organ system abnormalities, including rheumatic disorders, nervous system, pulmonary dysfunction associated with autoantibodies and abnormalities of cellular immunity. In this regards a number of case reports and series of articles have been described. We hypothesized that an immune reaction to silicone breast implants would include the host reactivity against silicone and the macromolecules within the microenvironment of the implant, and these autoantibodies may react with other tissue antigens far from the site of the implant. To test this hypothesis 520 Symptomatic women with Silicone Implants which have developed Silicone related Immunological disorders and have typically complained of breast pain, Myalgia-Arthralgia, fatigue, or generalized pain, were examined by their physician. Blood samples were obtained and examined for the presence of Silicone antibodies, Myelin Basic Protein and human serum albumin antibodies. These samples were then compared to 520 matched controls without implants. At least at the level of two standard deviation silicone specific antibodies, IgG, IgA IgM, IgE and IgG+IgA+IgM antibodies were detected above the mean of normal controls. When these antibodies were classified based on the specialty of the examining physician, the % of patients with Silicone Antibodies were varied; general practice 51.6, Rheumatology 58.7, and Plastic Surgery 83.3, which may relate to the severeness of the disease. Being that a large % of patients demonstrated very high levels of Myelin Basic Protein Antibodies, possible cross reactive antibodies were sought. However, absorption of highly positive sera for Silicone Antibodies with MBP did not change the levels of Silicone Antibodies. On the other hand, Silicone-HSA was able to reduce the antibody values significantly. This reduction in antibody levels by Silicone is the best indication for the specificity of these antibodies. Moreover when data for silicone antibodies and MBP antibodies was analyzed in patients some with high and others with medium or low levels of silicone antibodies, MBP antibodies did not correspond to the silicone antibody levels. Similarly human serum albumin antibodies which was significantly higher in patients with silicone implants did not correlate with levels of silicone antibodies. These results indicate that immune reaction to silicone and different tissue antigens do occur and they are initiated through different mechanisms. And since predominant antibody class against silicone, MBP and HSA was IgM, clonal activation of IgM is possible which certainly warrants further investigation.
硅胶植入物与多器官系统异常的发生有关，包括风湿性疾病、神经系统疾病、与自身抗体相关的肺功能障碍以及细胞免疫异常。关于这一点，已有多篇病例报告和系列文章进行了描述。我们推测，对硅胶乳房植入物的免疫反应将包括宿主对硅胶以及植入物微环境内大分子的反应性，并且这些自身抗体可能会与远离植入部位的其他组织抗原发生反应。为了验证这一假设，520名出现硅胶相关免疫性疾病且通常主诉乳房疼痛、肌痛 - 关节痛、疲劳或全身疼痛的有症状硅胶植入女性患者接受了医生检查。采集血样并检测其中是否存在硅胶抗体、髓鞘碱性蛋白和人血清白蛋白抗体。然后将这些样本与520名匹配的未植入对照组进行比较。至少在两个标准差水平上，硅胶特异性抗体IgG、IgA、IgM、IgE以及IgG + IgA + IgM抗体的检测值高于正常对照组的平均值。当根据检查医生的专业对这些抗体进行分类时，硅胶抗体阳性患者的百分比有所不同；全科医学为51.6%，风湿病学为58.7%，整形外科为83.3%，这可能与疾病的严重程度有关。鉴于很大比例的患者显示出非常高水平的髓鞘碱性蛋白抗体，因此寻找可能的交叉反应抗体。然而，用髓鞘碱性蛋白吸收硅胶抗体高度阳性的血清并没有改变硅胶抗体的水平。另一方面，硅胶 - 人血清白蛋白能够显著降低抗体值。硅胶导致的抗体水平降低是这些抗体特异性的最佳指标。此外，当分析患者中硅胶抗体和髓鞘碱性蛋白抗体的数据时，一些患者的硅胶抗体水平高，另一些患者的硅胶抗体水平中等或低，髓鞘碱性蛋白抗体与硅胶抗体水平并不对应。同样，硅胶植入患者中显著更高的人血清白蛋白抗体与硅胶抗体水平也不相关。这些结果表明，对硅胶和不同组织抗原确实会发生免疫反应，并且它们是通过不同机制引发的。而且由于针对硅胶、髓鞘碱性蛋白和人血清白蛋白的主要抗体类别是IgM，IgM的克隆激活是可能的，这当然值得进一步研究。
