Autoimmune dysautonomia in women with silicone breast implants
Autoimmune dysautonomia in women with silicone breast implants
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DOI：
10.1016/j.jaut.2021.102631
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发表时间：
2021-03-31
影响因子：
12.8
通讯作者：
Shoenfeld, Yehuda
中科院分区：
文献类型：
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作者：
Halpert, Gilad;Watad, Abdulla;Shoenfeld, Yehuda
重要性和目标：了解与硅胶乳房植入体（SBI）相关的一系列临床表现的致病机制，如严重疲劳、广泛疼痛、心悸、口干和眼干、抑郁、听力损失等，这一医学需求尚未得到满足。我们旨在确定抗自主神经系统受体的自身抗体是否可以解释SBI女性报告的神秘和主观的临床表现。结果：循环水平的自身抗体对G蛋白偶联受体（GPCRs）的自主神经系统（肾上腺素能，毒蕈碱，内皮素和血管紧张素受体）已被评估在有症状的妇女与SBI使用ELISA方法。这些患有SBI的女性由于各种主观和与药物相关的表现，如慢性严重疲劳，认知障碍，广泛疼痛，记忆丧失，睡眠障碍，心悸，抑郁，听力异常等，而来到我们的诊所。我们首次报告，抗β 1肾上腺素能受体血清水平显着降低（p < 0.001）、抗血管紧张素II 1型受体（p < 0.001）和抗内皮素受体A型（p = 0.001）自身抗体。重要的是，抗β 1肾上腺素能受体自身抗体被发现显着相关的表现，如：睡眠障碍和抑郁症的女性SBIS.Conclusions：慢性免疫刺激硅材料可能会导致自身免疫性自主神经功能障碍的一个亚组的潜在遗传易感的女性SBIs。自主神经系统GPCRs自身抗体的出现可以解释女性SBI患者主观上的神经系统相关表现。
Importance and objectives: There is unmet medical need to understand the pathogenic mechanism of the panoply of clinical manifestations associated with silicone breast implants (SBIs) such as severe fatigue, widespread pain, palpitations, dry mouth and eyes, depression, hearing loss etc. We aimed to determine whether autoantibodies against the autonomic nervous system receptors can explain the enigmatic and subjective clinical manifestation reported by women with SBIs.Results: Circulating level of autoantibodies against G protein-coupled receptors (GPCRs) of the autonomic nervous system (adrenergic, muscarinic, endothelin and angiotensin receptors) have been evaluated in symptomatic women with SBIs using an ELISA method. These women with SBIs addressed our clinic due to various subjective and autonomic-related manifestations such as chronic severe fatigue, cognitive impairment, widespread pain, memory loss, sleep disorders, palpitations, depression, hearing abnormalities etc. We report for the first time, a significant reduction in the sera level of anti-beta 1 adrenergic receptor (p < 0.001), anti-angiotensin II type 1 receptor (p < 0.001) and anti-endothelin receptor type A (p = 0.001) autoantibodies in women with SBIs (n = 93) as compared with aged matched healthy women (n = 36). Importantly, anti-beta 1 adrenergic receptor autoantibody was found to significantly correlate with autonomic-related manifestations such as: sleep disorders and depression in women with SBIs.Conclusions: Chronic immune stimulation by silicone material may lead to an autoimmune dysautonomia in a subgroup of potentially genetically susceptible women with SBIs. The appearance of autoantibodies against GPCRs of the autonomic nervous system serve as an explanation for the subjective autonomic-related manifestations reported in women with SBIs.