Smith H R
Department of Medicine, Meridia Huron Hospital, Case Western Reserve University, Cleveland, OH 44112, USA.
J Biomater Sci Polym Ed. 1995;7(2):115-21. doi: 10.1163/156856295x00634.
Current estimates are that up to a million women in the U.S. have breast implants with the predominant type being the silicone gel implant. Concerns have been raised regarding the safety of silicone gel breast implants with focus upon whether escaped gel might cause inflammatory and immune responses that subsequently lead to autoimmune rheumatic diseases such as progressive systemic sclerosis (scleroderma), systemic lupus erythematosus (SLE), Sjögren's syndrome or rheumatoid arthritis. A spectrum of illnesses ranging from local symptoms to systemic disease is seen in some patients with silicone breast implants, however, it remains to be determined whether such illnesses in these patients are coincidentally associated or are secondary to the implants. Our understanding of the relationship between the presence of autoimmune rheumatic diseases and silicone breast implants is limited. The available data indicate that silicone elicits a minimal immunological response as compared to conventional antigens. The histological, immunological and epidemiological experimental data derived from patients with silicone implants, as well as those from animal studies, are reviewed. These data do not convincingly demonstrate that there is a cause and effect relationship between silicone breast implants and autoimmune diseases. Further investigations are needed to clarify the interaction of silicone with the cellular and humoral immune systems, as well as with host and environmental factors.
目前估计，美国有多达100万女性植入了乳房假体，其中主要类型是硅胶凝胶假体。人们对硅胶凝胶乳房假体的安全性表示担忧，重点在于漏出的凝胶是否会引发炎症和免疫反应，进而导致自身免疫性风湿性疾病，如进行性系统性硬化症（硬皮病）、系统性红斑狼疮（SLE）、干燥综合征或类风湿性关节炎。一些植入硅胶乳房假体的患者出现了从局部症状到全身性疾病的一系列病症，然而，这些患者的此类病症是巧合关联还是假体所致仍有待确定。我们对自身免疫性风湿性疾病与硅胶乳房假体之间关系的了解有限。现有数据表明，与传统抗原相比，硅胶引发的免疫反应极小。本文综述了来自硅胶植入患者以及动物研究的组织学、免疫学和流行病学实验数据。这些数据并未令人信服地证明硅胶乳房假体与自身免疫性疾病之间存在因果关系。需要进一步研究以阐明硅胶与细胞和体液免疫系统以及宿主和环境因素之间的相互作用。
