title: Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?
abstract: Silicone implants have been in use since the mid-twentieth century, especially in the field of reconstructive breast surgery, and have long been considered as biologically inert and harmless. However, growing body of evidence from the past two decades links silicone with subsequent autoimmunity-related complications, collectively known as autoimmune/inflammatory syndrome induced by adjuvant--ASIA. Previous data suggest that while some patients tend to develop post-exposure autoimmune phenomena such as ASIA, other do not. However, thus far, no criteria for risk stratification were suggested. This current review summarizes the data linking silicone implants and autoimmunity, suggesting means of defining individuals who are at increased risk to develop silicone-induced ASIA, and therefore, a recommendation was made to avoid silicone implantation, e.g., individuals with previously diagnosed autoimmune disorders or with genetic preponderance for hyperactive immune system should not be considered as candidates for silicone implantation.
authors: Department of Internal Medicine "T", Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Sheba Medical Center, Ramat Gan, Israel. Idan.Goren@sheba.health.gov.il.
authors: Idan
authors: I
authors: Goren
authors: Department of Internal Medicine "T", Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Sheba Medical Center, Ramat Gan, Israel.
authors: Gad
authors: G
authors: Segal
authors: The Zabludowicz Center of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Incumbent of Laura Swarz-Kip Chair for Research of Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel.
authors: Yehuda
authors: Y
authors: Shoenfeld
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications; D015551:Autoimmunity / Q000276:immunology*; D019928:Breast Implantation / Q000009:adverse effects*; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D016462:Mammaplasty / Q000009:adverse effects; D011183:Postoperative Complications / Q000276:immunology*; D011475:Prosthesis Failure; D012307:Risk Factors; D012828:Silicones / Q000009:adverse effects*
chemical_list: D012828:Silicones
keywords: ASIA; Adjuvant; Autoimmune disease; Autoimmune/inflammatory syndrome induced by adjuvant; Autoimmunity; Relative risk; Silicone