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Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?

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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.

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    Authors and Affiliations

    1. Department of Internal Medicine “T”, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Sheba Medical Center, Ramat Gan, Israel

      Idan Goren & Gad Segal

    2. 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

      Yehuda Shoenfeld

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    1. Idan Goren
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    2. Gad Segal
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    3. Yehuda Shoenfeld
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    Correspondence to Idan Goren.

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    Idan Goren and Gad Segal contributed equally to this work.

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    Goren, I., Segal, G. & Shoenfeld, Y. Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?. Clin Rheumatol 34, 1661–1666 (2015). https://doi.org/10.1007/s10067-015-2931-0

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