Autoimmune/inflammatory syndrome induced by adjuvants – a new diagnostic problem or the solution of a diagnostic riddle
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Submission date: 2013-08-26
Final revision date: 2013-10-10
Acceptance date: 2013-10-14
Online publication date: 2013-12-24
Publication date: 2013-12-20
Reumatologia 2013;51(6):437–444
Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a newly identified syndrome dealing with pathological effects of adjuvant use. In recent years observations have shown that a number of clinical situations displaying similar features can be associated with an overactive immune response and with the inflammatory effect of adjuvants administration. Chronic stimulation of the immune system by substances used as adjuvants may lead to the occurrence of numerous symptoms such as chronic fatigue, arthritis, myalgia, cognitive impairment and neurological disorders. The aim of this article is to present how and why adjuvants – while allegedly causing no specific immune response – may become a cause of development of autoimmune diseases.
Clinical Immunology: principles and practice. Rich RR et al. (eds.). 3rd ed. Mosby-Elsevier, Philadelphia 2008.
Grzesiowski P, Hryniewicz W. Immunologia szczepień ochronnych. W: Immunologia. Gołąb J, Jakóbisiak M, Lasek W (red.). PWN, Warszawa 2004; 362-364.
Hogenesch H. Mechanism of immunopotentiation and safety of Al adjuvants. Front Immunol 2012; 3: 406.
O’Hogan DT. New Generation Vaccine Adjuvants Encyclopedia of Life Sciences. John Wiley & Sons 2007.
Israeli E, Agmon-Levin N, Blank M, Shoenfeld Y. Adjuvants and autoimmunity. Lupus 2009; 18: 1217-1225.
Shakya AK, Nandakumar KS. Applications of polymeric adjuwants in studying autoimmune responses and vaccination against infectious diseases. J R Soc Interface 2013; 10: 20120536.
Shoenfeld Y, Agmon-Levin N. 'ASIA' – autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun 2011; 36: 4-8.
Israeli E. Gulf War syndrome as a part of the autoimmune (autoinflammatory) syndrome induced by adjuvant (ASIA). Lupus 2012; 21: 190-194.
Goldblum RM, Pelley RP, O'Donell AA, et al. Antibodies to silicone elastomers and reactions to ventriculoperitoneal shunts. Lancet 1992; 340: 510-513.
Evans D, Cauchemez S, Hayden FG. “Prepandemic” immunization for novel influenza viruses, "swine flu" vaccine, Guillain-Barré syndrome, and the detection of rare severe adverse events. J Infect Dis 2009; 200: 321-328.
Agmon-Levin N, Paz Z, Israeli E, Shoenfeld Y. Vaccines and autoimmunity. Nat Rev Rheumatol 2009; 5: 648-652.
Hogenesch H, Azcona-Olivera J, Scott-Moncrieff C, et al. Vaccine-induced autoimmunity in the dog. Adv Vet Med 1999; 41: 733-747.
Koppang EO, Bjerk?s I, Haugarvoll E, et al. Vaccination-induced systemic autoimmunity in farmed Atlantic salmon. J Immunol 2008; 181: 4807-4811.
Satoh M, Reeves WH. Induction of lupus-associated autoantibodies in BALB/c mice by intraperitoneal injection of pristane. J Exp Med 1994; 180: 2341-2346.
Zafrir Y, Agmon-Levin N, Paz Z, et al. Autoimmunity following hepatitis B vaccine as part of the spectrum of ‘Autoimmune (Auto-inflammatory) Syndrome induced by Adjuvants’ (ASIA): analysis of 93 cases. Lupus 2012; 21: 146-152.
Soriano A, Verrecchia E, Marinaro A, et al. Giant cell arteritis and polymyalgia rheumatica after influenza vaccination: report of 10 cases and review of the literature. Lupus 2012; 21: 153-157.
Lerner A. Al as an adjuvant in Crohn’s disease induction. Lupus 2012; 21: 231-238.
Rinaldi M, Perricone R, Blank M, et al. Anti-Saccharomyces cerevisiae autoantibodies in autoimmune diseases: from bread baking to autoimmunity. Clin Rev Allergy Immunol 2013; 45: 152-161.
Staines DR. Do cytosine guanine dinucleotide (CpG) fragments induce vasoactive neuropeptide meduiated fatigue related autoimmune disorders? Med Hypotheses 2005; 65: 370-373.
Nancy AL, Shoenfeld Y. Chronic fatigue syndrome with auto-antibodies – the result of an augmented adjuvant effect of hepatitis-B vaccine and silicone implant. Autoimmun Rev 2008; 8: 52-55.
Vista ES, Crowe SR, Thompson LF, et al. Influenza vaccination can induce new-onset anticardiolipins but not 2-glycoprotein-I antibodies among patients with systemic lupus erythematosus. Lupus 2012; 21: 168-174.
Tarján P, Sipka S, Lakos G, et al. Influenza vaccination and the production of anti-phospholipid antibodies in patients with systemic lupus erythematosus. Scand J Rheumatol 2006; 35: 241-243.
Katzav A, Kivity S, Blank M, et al. Adjuvant immunization induces high levels of pathogenic antiphospholipid antibodies in genetically prone mice: another facet of the ASIA syndrome. Lupus 2012; 21: 210-216.
Soldevilla HF, Briones SF, Navarra SV. Systemic lupus erythematosus following HPV immunization or infection? Lupus 2012; 21: 158-161.
Gatto M, Agmon-Levin N, Soriano A, et al. Human papillomavirus vaccine and systemic lupus erythematosus. Clin Rheumatol 2013; 32: 1301-1307.
Gulf War Illness and the Health of Gulf War Veterans: Scientific Findings and Recommendations. Binns JH (Committee Chair). U.S. Government Printing Office, Washington, D.C. 2008.
Committee on Gulf War and Health: Health Effects of Serving in the Gulf War, Update 2009 Board on the Health of Select Populations. Institute of Medicine of the National Academie the National Academies Press. Washington, D.C.
Petrik MS, Wong MC, Tabata RC, et al. Al adjuvant linked to Gulf War illness induces motor neuron death in mice. Neuromolecular Med 2007; 9: 83-100.
Gherardi RK, Coquet M, Chérin P, et al. Macrophagic myofasciitis: an emerging entity. Groupe d'Etudes et Recherche sur les Maladies Musculaires Acquises et Dysimmunitaires (GERMMAD) de l'Association Française contre les Myopathies (AFM). Lancet 1998; 352: 347-352.
Gherardi RK, Authier FJ. Macrophagic myofasciitis: characterization and pathophysiology. Lupus 2012; 21: 184-189.
Maubec E, Pinquier L, Viguier M, et al. Vaccination-induced cutaneous pseudolymphoma. J Am Acad Dermatol 2005; 52: 623-629.
Chérin P, Authier FJ, Gherardi RK, et al. Gallium-67 scintigraphy in macrophagic myofasciitis. Arthritis Rheum 2000; 43: 1520-1526.
Shoenfeld Y. Video Q&A What is ASIA? An interview with Yehuda Shoenfeld. BMC Med 2013; 11: 118.
Arepalli SR, Bezabeh S, Brown SL. Allergic reactions to platinum in silicone breast implants. J Long Term Eff Med Implants 2002; 12: 299-306.
Lykissa ED, Maharaj SV. Total platinum concentration and platinum oxidation states in body Fluids, Tissue, and Explants from Women Exposed to Silicone and Saline Breast Implants by IC-ICPMS. Analytical Chemistry 2006; 78: 2925-2933.
Hennekens CH, Lee IM, Cook NR, et al. Self-reported breast implants and connective-tissue diseases in female health professionals. A retrospective cohort study. JAMA 1996; 275: 616-621.
Janowsky EC, Kupper LL, Hulka BS. Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. N Engl J Med 2000; 342: 781-790.
Jara LJ, Medina G, Gómez-Ban~uelos E, et al. Still’s disease, lupus-like syndrome, and silicone breast implants. A case of 'ASIA' (Shoenfeld’s syndrome). Lupus 2012; 21: 140-145.
Kivity S, Katz M, Langevitz P, et al. Autoimmune syndrome induced by adjuvants (ASIA) in the Middle East: morphea following silicone implantation. Lupus 2012; 21: 136-139.
Lidar M, Agmon-Levin N, Langevitz P, Shoenfeld Y. Silicone and scleroderma revisited. Lupus 2012; 21: 121-127.
Vera-Lastra O, Medina G, Cruz-Dominguez Mdel P, et al. Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld's syndrome). Lupus 2012; 21: 128-135.
Agmon-Levin N, Kivity S, Szyper-Kravitz M, Shoenfeld Y. Transverse myelitis and vaccines: a multi-analysis. Lupus 2009; 18: 1198-1204.
Israeli E, Pardo A. The sick building syndrome as a part of the autoimmune (auto-inflammatory) syndrome induced by adjuvants. Mod Rheumatol 2011; 21: 235-239.
Tomljenovic L, Shaw CA. Mechanisms of Al adjuvant toxicity and autoimmunity in pediatric populations. Lupus 2012; 21: 223-230.
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