title: Study to determine the presence of antipolymer antibodies in a group of Dutch women with a silicone breast implant.
abstract: OBJECTIVE
  To determine whether there exists a population of Dutch women with a high prevalence of antipolymer antibodies (APA) and severe health complaints/symptoms, and exposure to a silicone breast implant (SBI). As the antigen-specific nature of the antipolymer antibody has not yet been established, we refer to the term polymer binding immunoglobulins.
  
  
  METHODS
  The study population was selectedfrom a voluntary registry of SBI recipients of a Dutch consumers organisation. The final selection was based on the severity of self-reported complaints in a questionnaire. A total of 42 SBI recipients were included in the study, clinically examined and blood samples were obtained.
  
  
  RESULTS
  In 12 of 42 SBI recipients an increase in the level of polymer binding immunoglobulins was detected compared to a negative reference sample, 3 of these 12 showing a positive and 9 a weakly positive response. In 3 out of 12 non-SBI recipients, included for control on the performance of the APA assay, an increased level of polymer binding immunoglobulins was demonstrated, 2 of these 3 showing a positive and 1 a weakly positive response. The study population of SBI recipients was categorised in severity subgroups (limited, mild, moderate, advanced) based on the fuctional capacity and the physicians general assessment of pain and disease activity. Most (34 of 42) SBI recipients belonged to the limited severity subgroup.
  
  
  CONCLUSIONS
  Our methods failed to select a group of severely symptomatic Dutch SBI recipients reported to have a high prevalence of polymer binding antibodies. A discrepancy was present between the self reported severe complaints and the observed mild clinical symptoms. In the group of SBI recipients with self reported severe complaints recruited we did not find a high prevalence of polymer binding immunoglobulins. SBI exposure (mean 17 years) did not result in induction of polymer binding immunoglobulins in this minimal symptomatic study group.
authors.affiliation: Laboratory for Pathology and Immunobiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. w.de.jong@rivm.nl
authors.forename: W H
authors.initials: WH
authors.lastname: De Jong
authors.forename: C A
authors.initials: CA
authors.lastname: Goldhoorn
authors.forename: M
authors.initials: M
authors.lastname: Kallewaard
authors.forename: R E
authors.initials: RE
authors.lastname: Geertsma
authors.forename: H
authors.initials: H
authors.lastname: Van Loveren
authors.forename: J W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: J S A G
authors.initials: JS
authors.lastname: Schouten
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood; D018427:Breast Implants / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011108:Polymers / Q000009:adverse effects*; D015995:Prevalence; D012042:Registries; D012720:Severity of Illness Index; D020034:Silicone Gels / Q000009:adverse effects*
chemical_list: D000906:Antibodies; D007136:Immunoglobulins; D011108:Polymers; D020034:Silicone Gels