Classical Examples of the Concept of the ASIA Syndrome.
Classical Examples of the Concept of the ASIA Syndrome.
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DOI：
10.3390/biom10101436
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发表时间：
2020-10-12
期刊：
影响因子：
5.5
通讯作者：
Shoenfeld Y
中科院分区：
文献类型：
--
作者：
Borba V;Malkova A;Basantsova N;Halpert G;Andreoli L;Tincani A;Amital H;Shoenfeld Y
由佐剂诱导的自身免疫/炎症综合征（ASIA）于2011年由Shoenfeld等人首次提出，包括一系列相关的免疫介导疾病，这些疾病是由于佐剂暴露在遗传易感个体中而发生的。自认识到亚洲综合征以来，迄今已报告了4400多例文献病例，其临床表现和严重程度各不相同。在这篇综述中，五种神秘的情况，包括结节病、Sjögren综合征、未分化结缔组织病、硅胶植入物不相容综合征（SIIS）和免疫相关不良事件（irAEs），被定义为亚洲的典型例子。当然，这些疾病是在遗传易感个体（主要是HLA-DRB1和PTPN22基因）的辅助刺激（硅胶植入、药物、感染、金属、疫苗等）后描述的，这些刺激诱导免疫系统过度刺激，导致自身抗体的产生，最终导致自身免疫性疾病的发展。在硅胶乳房植入物患者的血清中循环自主抗体，以及皮肤活检中小纤维神经病变的解剖病理学方面，最近已经被描述。据我们所知，这些新的见解可以作为对ASIA患者报告的非特异性临床表现的共同解释，从而重新定义了ASIA综合征的诊断标准。
Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. In this review, five enigmatic conditions, including sarcoidosis, Sjögren’s syndrome, undifferentiated connective tissue disease, silicone implant incompatibility syndrome (SIIS), and immune-related adverse events (irAEs), are defined as classical examples of ASIA. Certainly, these disorders have been described after an adjuvant stimulus (silicone implantation, drugs, infections, metals, vaccines, etc.) among genetically predisposed individuals (mainly the HLA-DRB1 and PTPN22 gene), which induce an hyperstimulation of the immune system resulting in the production of autoantibodies, eventually leading to the development of autoimmune diseases. Circulating autonomic autoantibodies in the sera of patients with silicone breast implants, as well as anatomopathological aspects of small fiber neuropathy in their skin biopsies have been recently described. To our knowledge, these novel insights serve as a common explanation to the non-specific clinical manifestations reported in patients with ASIA, leading to the redefinition of the ASIA syndrome diagnostic criteria.
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