Adjuvant-associated systemic lupus erythematosus with urticarial vasculitis and sarcoid-like granulomas formation


DOI: https://dx.doi.org/10.18565/therapy.2023.1.89-99

Gaydukova I.Z., Skvortsova T.E., Vorobyev S.L.

1) I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 2) Clinical Rheumatological Hospital No. 25, Saint Petersburg; 3) National Center for Clinical Morphological Diagnostics LLC, Saint Petersburg
Abstract. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is one of the little-studied interdisciplinary problems of modern therapy. The article presents a clinical observation in which a 42-year-old female patient had a development of systemic lupus erythematosus with urticarial syndrome and sarcoid-like granulomas as a variant of ASIA after implantation of silicone breast implants and multiple intradermal injections of adjuvants. The data of the abovementioned observation are compared with the data of scientific publications, which consider the complex pathogenetic mechanisms of the formation of the immune response after the placement of adjuvants into human tissues.

Literature


1. Shoenfeld Y., Agmon-Levin N. ASIA – Autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011; 36(1): 4–8. https://dx.doi.org/10.1016/j.jaut.2010.07.003.


2. Carvalho J.F., Barros S.M., Branco J.C., Fonseca J.E. ASIA or Shoenfeld’s syndrome: Highlighting different perspectives for diffuse chronic pain. Acta Reumatol Port. 2011; 36(1): 10–12.


3. Meroni P.L. Autoimmune or auto-inflammatory syndrome induced by adjuvants (ASIA): Old truths and a new syndrome? J Autoimmun. 2011; 36(1): 1–3. https://dx.doi.org/10.1016/j.jaut.2010.10.004.


4. Watad A., Quaresma M., Brown S. et al. Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome) – An update. Lupus. 2017; 26(7): 675–81. https://dx.doi.org/10.1177/0961203316686406.


5. Jara L.J., Garcia-Collinot G., Medina G. et al. Severe manifestations of autoimmune syndrome induced by adjuvants (Shoenfeld’s syndrome). Immunol Res. 2017; 65(1): 8–16. https://dx.doi.org/10.1007/s12026-016-8811-0.


6. Watad A., Quaresma M., Bragazzi N.L. et al. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld’s syndrome: Descriptive analysis of 300 patients from the international ASIA syndrome registry. Clin Rheumatol. 2018; 37(2): 483–93. https://dx.doi.org/10.1007/s10067-017-3748-9.


7. Israeli E., Agmon-Levin N., Blank M., Shoenfeld Y. Adjuvants and autoimmunity. Lupus. 2009; 18(13): 1217–25.https://dx.doi.org/10.1177/0961203309345724.


8. Hogen Esch H. Mechanisms of stimulation of the immune response by aluminum adjuvants. Vaccine. 2002; 20(Suppl 3): S34–S39. https://dx.doi.org/10.1016/s0264-410x(02)00169-x.


9. Perricone C., Colafrancesco S., Mazor R.D. et al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun. 2013; 47 :1–16.https://dx.doi.org/10.1016/j.jaut.2013.10.004.


10. 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(2): 146–52.https://dx.doi.org/10.1177/0961203311429318.


11. Flores-Padilla G., Mora-Mendoza B., Pedraza-Montenegro A. Adjuvant induced autoimmune/inflammatory syndrome presenting as jointand lung manifestations. Reumatol Clin. 2014; 10(6): 406–8. https://dx.doi.org/10.1016/j.reumae.2014.01.007.


12. 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(2): 136–39. https://dx.doi.org/10.1177/0961203311429551.


13. Segal Y., Dahan S., Sharif K. et al. The value of autoimmune syndrome induced by adjuvant (ASIA) – Shedding light on orphan diseases in autoimmunity. Autoimmun Rev. 2018; 17(5): 440–48. https://dx.doi.org/10.1016/j.autrev.2017.11.037.


14. Narins R.S., Beer K. Liquid injectable silicone: A review of its history, immunology, technical considerations, complications, and potential. Plast Reconstr Surg. 2006; 118(3 Suppl.): 77s–84s. https://dx.doi.org/10.1097/01.prs.0000234919.25096.67.


15. Schaefer C.J., Wooley P.H. The influence of silicone implantation on murine lupus in MRL lpr/lpr mice. J Rheumatol. 1999; 26(10): 2215–21.


16. Schaefer C.J., Whalen J.D., Knapp T., Wooley P.H. The influence of silicone implantation on type II collagen-induced arthritis in mice. Arthritis Rheum. 1997; 40(6): 1064–72. https://dx.doi.org/10.1002/art.1780400611.


17. Ameratunga R., Langguth D., Hawkes D. Perspective: Scientific and ethical concerns pertaining to animal models of autoimmune/ autoinflammatory syndrome induced by adjuvants (ASIA). Autoimmun Rev. 2018; 17(5): 435–39.https://dx.doi.org/10.1016/j.autrev.2017.11.033.


18. Cohen Tervaert J.W., Kappel R.M. Silicone implant incompatibility syndrome (SIIS): A frequent cause of ASIA (Shoenfeld’s syndrome). Immunol Res. 2013; 56(2–3): 293–98. https://dx.doi.org/10.1007/s12026-013-8401-3.


19. Lee S., Hayashi H., Maeda M. et al. Environmental factors producing autoimmune dysregulation – Chronic activation of T cells caused by silica exposure. Immunobiology. 2012; 217(7): 743–48. https://dx.doi.org/10.1016/j.imbio.2011.12.009.


20. Kaiser W., Biesenbach G., Stuby U. et al. Human adjuvant disease: Remission of silicone induced autoimmune disease after explanation of breast augmentation. Ann Rheum Dis. 1990; 49(11): 937–38. https://dx.doi.org/10.1136/ard.49.11.937.


21. Caldeira M., Ferreira A.C. Siliconosis: Autoimmune/inflammatory syndrome induced by adjuvants (ASIA). Isr Med Assoc J. 2012; 14(2): 137–38. https://dx.doi.org/10.3389/fendo.2016.00150.


22. van Nunen S.A., Gatenby P.A., Basten A. Post-mammoplasty connective tissue disease. Arthritis Rheum. 1982; 25(6): 694–97.https://dx.doi.org/10.1002/art.1780250613.


23. Parks C.G., Conrad K., Cooper G.S. Occupational exposure to crystalline silica and autoimmune disease. Environ Health Perspect. 1999; 107(Suppl. 5): 793–802. https://dx.doi.org/10.1007/s11926-004-0011-6.


24. Tervaert J.W., Stegeman C.A., Kallenberg C.G. Silicon exposure and vasculitis. Curr Opin Rheumatol. 1998; 10(1): 12–17.


25. Hajdu S.D., Agmon-Levin N., Shoenfeld Y. Silicone and autoimmunity. Eur J Clin Invest. 2011; 41(2): 203–11.https://dx.doi.org/10.1111/j.1365-2362.2010.02389.x.


26. Jara L.J., Medina G., Gomez-Banuelos E. et al. Still’s disease, lupus-like syndrome, and silicone breast implants. A case of «ASIA» (Shoenfeld’s syndrome). Lupus. 2012; 21(2): 140–45. https://dx.doi.org/10.1177/0961203311430970.


27. Csako G., Costello R., Shamim E.A. et al. Serum proteins and paraproteins in women with silicone implants and connective tissue disease: a case-control study. Arthritis Res Ther. 2007; 9(5): R95. https://dx.doi.org/10.1186/ar2295.


28. Michaels B., Michaels J., Mobini N. Prominent lymphoid infiltrate with a pseudolymphoma-like morphology: A new histological finding of injectable liquid silicone. J Cutan Pathol. 2009; 36(11): 1224–26. https://dx.doi.org/10.1111/j.1600-0560.2009.01328.x.


29. Colafrancesco S., Perricone C., Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants and Sjogren’s syndrome. Isr Med Assoc J. 2016; 18(3–4): 150–53.


30. Harel M., Shoenfeld Y. Predicting and preventing autoimmunity, myth or reality? Ann N Y Acad Sci. 2006; 1069: 322–45.https://dx.doi.org/10.1196/annals.1351.031.


31. Janowsky E.C., Kupper L.L., Hulka B.S. Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. N Engl J Med. 2000; 342(11): 781–90. https://dx.doi.org/10.1056/nejm200003163421105.


32. Colaris M.J., de Boer M., van der Hulst R.R., Cohen Tervaert J.W. Two hundreds cases of ASIA syndrome following silicone implants: A comparative study of 30 years and a review of current literature. Immunol Res. 2017; 65(1): 120–28.https://dx.doi.org/10.1007/s12026-016-8821-y.


33. Maijers M.C., de Blok C.J., Niessen F.B. et al. Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study. Neth J Med. 2013; 71(10): 534–40.


34. Soriano A., Butnaru D., Shoenfeld Y. Long-term inflammatory conditions following silicone exposure: the expanding spectrum of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). Clin Exp Rheumatol. 2014; 32(2):151–54.


35. Brown S.L., Pennello G., Berg W.A. et al. Silicone gel breast implant rupture, extracapsular silicone, and health status in a population of women. J Rheumatol. 2001; 28(5): 996–1003.


36. Kappel R.M., Pruijn G.J. The monobloc hydrogel breast implant, experiences and ideas. Eur J Plast Surg. 2012; 35(3): 229–33.https://dx.doi.org/10.1007/s00238-011-0591-0.


37. Exley C., Siesjo P., Eriksson H. The immunobiology of aluminium adjuvants: How do they really work? Trends Immunol. 2010; 31(3): 103–9. https://dx.doi.org/10.1016/j.it.2009.12.009.


38. Di Pasquale A., Preiss S., Tavares Da Silva F., Garcon N. Vaccine adjuvants: From 1920 to 2015 and beyond. Vaccines (Basel). 2015; 3(2): 320–43. https://dx.doi.org/10.3390/vaccines3020320.


39. McGarvey P.B., Suzek B.E., Baraniuk J.N. et al. In silico analysis of autoimmune diseases and genetic relationships to vaccination against infectious diseases. BMC Immunol. 2014; 15: 61. https://dx.doi.org/10.1186/s12865-014-0061-0.


About the Autors


Inna Z. Gaydukova, MD, professor, deputy director of the Research Institute of Rheumatology and professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: ubp1976@list.ru. ORCID: https://orcid.org/0000-0003-3500-7256. SPIN-code: 3083-7996
Tatyana E. Skvortsova, PhD in Medical Sciences, associate professor of the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 47 (pav. 11) Piskarevsky Lane. E-mail: Tatyana.Skvortcova@szgmu.ru. ORCID: https://orcid.org/0000-0002-9362-9961
Sergei L. Vorobyov, PhD in Medical Sciences, pathologist of the highest category, head of the morphological diagnostics of oncological diseases, diseases of the gastrointestinal tract, endocrine organs, supervisor of National Center for Clinical Morphological Diagnostics LLC. Address: 192283, Saint Petersburg, 8 Oleko Dundicha Str.


Бионика Медиа