title: Cellular immune reactivities in women with silicone breast implants: a preliminary investigation.
abstract: BACKGROUND
  Surgical implantation of silicone breast prostheses has been conducted and considered safe for over 30 years. Some implant recipients, however, complain of a group of symptoms similar to those observed in connective tissue disorders, rheumatoid arthritis, systemic lupus erythematosus, or polymyositis. To date, immunologic sequelae have not been confirmed and remain controversial.
  
  
  OBJECTIVE
  To examine an autoimmune-like basis for the "silicone associated disease" reported by some women with silicone breast prostheses.
  
  
  METHODS
  Proliferative responses of peripheral blood mononuclear cells against a panel of control and connective tissue proteins and to compounds common to silicone prostheses were measured in 26 women who received silicone breast implants (with implants in place an average of 166.4 [standard deviation (SD) 58.3] months), and 23 age-matched and sex-matched healthy controls.
  
  
  RESULTS
  The frequency and intensity of cellular immune responses against collagen I, collagen III, fibrinogen, and fibronectin were significantly increased in silicone breast implant recipients versus controls. In implant subjects, the highest frequency of immune reactivity was directed against collagen I (11/26, 42%) with collagen III being the most immunostimulatory self-antigen with a mean stimulation index (SI) of 8.2 [95% confidence interval (95% CI) 3.2]. In addition, 10/26 (39%) of the implant recipients responded to more than one of the connective tissue antigens versus 0/23 (0%, P = .0007) healthy controls. Immunologic reactivities to other antigens, including silicone-based compounds, were remarkably similar.
  
  
  CONCLUSIONS
  The identification of self-reactivity towards these connective tissue antigens may provide important information for attempts at associating silicone breast implants with disease.
authors.affiliation: Department of Pathology, University of Florida, Gainesville 32610-0275, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Ellis
authors.forename: N S
authors.initials: NS
authors.lastname: Hardt
authors.forename: L
authors.initials: L
authors.lastname: Campbell
authors.forename: D A
authors.initials: DA
authors.lastname: Piacentini
authors.forename: M A
authors.initials: MA
authors.lastname: Atkinson
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D000917:Antibody Formation; D018427:Breast Implants / Q000009:adverse effects*; D003094:Collagen / Q000097:blood / Q000276:immunology; D003240:Connective Tissue Diseases / Q000276:immunology; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000276:immunology; D005353:Fibronectins / Q000097:blood / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D007963:Leukocytes, Mononuclear / Q000737:chemistry; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000276:immunology; D012828:Silicones / Q000009:adverse effects*
chemical_list: D000974:Antibodies, Antinuclear; D005353:Fibronectins; D012828:Silicones; D005340:Fibrinogen; D003094:Collagen