title: Human anti-hyaluronic acid antibodies: is it possible?
abstract: BACKGROUND
  Although hyaluronan has been acknowledged as being free of species and organ specificity, for 4 years I have encountered a variety of adverse reactions to injectable hyaluronic acid as used in aesthetic medicine.
  
  
  OBJECTIVE
  I have tried to prove that some of those side effects may be allergic reactions to the commercial preparations of injectable hyaluronic acid.
  
  
  METHODS
  I began with intradermal tests to the reactive patients and to 2 witnesses; then lymphocyte transforming tests were performed at the University of Geneva (Switzerland). Histology was performed on the skin tests and on reactive treated areas of the face of different patients. A serum analysis was then done by Pr. Sainte Laudy of Laboratoire Pasteur--Cerba (France).
  
  
  RESULTS
  The skin tests were positive for one or the other or both of the injectable hyaluronic acid preparations used in aesthetic medicine. The different biopsies have shown for some a chronic inflammatory reaction, even 11 months after the treatment or a severe granulamatous reaction to foreign bodies. Serum analysis revealed positive antibodies against Restylane and/or Hylaform and even IgG and E anti-hyaluronic acid.
  
  
  CONCLUSIONS
  Since 1995, I have 8 patients with adverse reactions to injectable hyaluronic acid, which after several tests, may be allergic to those products. Isn't it time to introduce intradermal tests before any injection of this type, as done with injectable bovine collagen?
authors.forename: P
authors.initials: P
authors.lastname: Micheels
mesh_terms: D000818:Animals; D000906:Antibodies / Q000097:blood*; D001706:Biopsy; D002645:Chickens; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000276:immunology*; D007267:Injections; D007428:Intradermal Tests; D008213:Lymphocyte Activation; D012867:Skin / Q000473:pathology; D015595:Skin Aging
chemical_list: D000906:Antibodies; D006820:Hyaluronic Acid