Cuéllar M L, Scopelitis E, Tenenbaum S A, Garry R F, Silveira L H, Cabrera G, Espinoza L R
Department of Medicine, LSU Medical Center at New Orleans, USA.
J Rheumatol. 1995 Feb;22(2):236-40.
Recent evidence suggests that immunologic abnormalities are not uncommon in individuals with silicone breast implants. The purpose of our study was to evaluate in a consecutive manner, the prevalence of autoimmunity as assessed by the presence of antinuclear antibodies in a larger number of patients with silicone breast implants.
Antinuclear antibody (ANA) testing using an indirect immunofluorescence technique was performed on 813 individuals with silicone breast implants. All subjects except for 3 transsexual males, were female. The overwhelming majority, over 99%, were white. The average age of the subjects was 46.2, with a range of 17 to 72 years.
ANA positivity was found in 244 of 813 individuals (30%) using a mouse kidney substrate; and in 470 of 813 (57.8%) using a HEp-2 cell line. The most common immunofluorescent pattern found using HEp-2 was speckled, present in 341 (72.5%) individuals, followed by homogeneous pattern in 113 (24%), nucleolar in 63 (13.4%), and 5 (1.06%) were anticentromere. Anti-dsDNA antibodies measured by an ELISA assay were found in 6 of 71 patients (8%). Rheumatoid factor and C-reactive protein were found above healthy controls in less than 10% of cases studied. The high prevalence of ANA found in patients with silicone breast implants agrees with similar observations by others. The finding of anticentromere and nucleolar patterns has great interest and relevance. These fairly distinct ANA patterns are most commonly seen in the idiopathic form of scleroderma and related conditions.
These findings suggest that ANA positivity is relatively common in individuals with silicone breast implants, and may support the existence of autoimmune mechanisms in the pathogenesis of the clinical manifestations seen in this population.
近期证据表明，硅胶乳房植入者中免疫异常并不罕见。我们研究的目的是连续评估大量硅胶乳房植入患者中抗核抗体检测评估的自身免疫患病率。
对813名硅胶乳房植入者采用间接免疫荧光技术进行抗核抗体（ANA）检测。除3名变性男性外，所有受试者均为女性。绝大多数（超过99%）为白人。受试者的平均年龄为46.2岁，范围为17至72岁。
使用小鼠肾底物时，813名个体中有244名（30%）ANA呈阳性；使用HEp-2细胞系时，813名中有470名（57.8%）呈阳性。使用HEp-2检测到的最常见免疫荧光模式为斑点状，341名（72.5%）个体呈现该模式，其次为均质型113名（24%）、核仁型63名（13.4%），5名（1.06%）为抗着丝点型。通过ELISA检测，71名患者中有6名（8%）发现抗双链DNA抗体。类风湿因子和C反应蛋白在不到10%的研究病例中高于健康对照。硅胶乳房植入患者中ANA的高患病率与其他人的类似观察结果一致。抗着丝点和核仁模式的发现具有极大的研究价值和相关性。这些相当独特的ANA模式最常见于特发性硬皮病及相关疾病。
这些发现表明，ANA阳性在硅胶乳房植入者中相对常见，可能支持该人群临床表现发病机制中自身免疫机制的存在。
