Smalley D L, Shanklin D R, Hall M F, Stevens M V, Hanissian A
Baptist Memorial Health Care System, Memphis, Tennessee 38105.
FASEB J. 1995 Mar;9(5):424-7. doi: 10.1096/fasebj.9.5.7896014.
Difficulties in showing the biologic activity of silicones in vitro have contributed to the controversy over effects of silicone mammary implants in vivo. We adapted a standard lymphocyte stimulation test to detect evidence of cellular immunity in patients with silicone gel implants. Initially, lymphocytes were harvested from 70 implant patients, 76 normal controls without implants or symptoms, and 18 patients with classic rheumatic disorders and without a history of silicone implants. The harvested lymphocytes were stimulated with PWM, PHA, Con A, and pharmaceutical grade colloidal silicon dioxide (silica). Implant patients showed increased SI compared to controls and those with rheumatic disorders. The mean SI of implant patients was 195.0 +/- 19.3, 18-fold that of normal controls (< 0.0001). Patients with rheumatic disease showed the same SI as controls (P = 0.3577). A follow-up study included 220 normal controls without implants, 942 silicone gel implant patients with demonstrable rheumatic symptoms, and 34 implant patients without symptoms at the time of the study. The average SI for the 220 normal controls was 10.0 +/- 0.41. Among the symptomatic implant women, 860 (91.3%) had SI significantly above those of the normal controls. Of these, 171 (18.2%) had SI between 25 and 50, 316 (33.5%) had SI between 50 and 100, and 373 (39.6%) had SI over 100. The data presented confirms that silicone implant patients respond immunologically to the silicon dioxide contained in mammary prostheses.
在体外显示硅酮生物活性存在困难，这引发了关于硅酮乳房植入物在体内影响的争议。我们采用了标准的淋巴细胞刺激试验来检测硅胶植入物患者的细胞免疫证据。最初，从70名植入物患者、76名无植入物或症状的正常对照者以及18名患有经典风湿性疾病且无硅酮植入物病史的患者中采集淋巴细胞。用PWM、PHA、Con A和药用级胶体二氧化硅（硅胶）刺激采集的淋巴细胞。与对照者和风湿性疾病患者相比，植入物患者的刺激指数（SI）有所增加。植入物患者的平均SI为195.0±19.3，是正常对照者的18倍（P<0.0001）。风湿性疾病患者的SI与对照者相同（P = 0.3577）。一项随访研究纳入了220名无植入物的正常对照者、942名有明显风湿症状的硅胶植入物患者以及34名在研究时无症状的植入物患者。220名正常对照者的平均SI为10.0±0.41。在有症状的植入物女性中，860名（91.3%）的SI显著高于正常对照者。其中，171名（18.2%）的SI在25至50之间，316名（33.5%）的SI在50至100之间，373名（39.6%）的SI超过100。所呈现的数据证实，硅酮植入物患者对乳房假体中所含的二氧化硅有免疫反应。
