[Autoimmune/infl ammatory syndrome induced by adjuvants, ASIA]

There have been many cases of the appearance of autoantibodies and symptoms of disease after exposure to adjuvants, not only after breast augmentation with silicone implants, but also as a very rare vaccination side effect, such as Gulf war syndrome or macrophagic myofasciitis syndrome. Diseases whose symptoms developed after such adjuvant exposure are called autoimmune/ in􀏐lammatory syndrome induced by adjuvants (ASIA). The group of adjuvants includes not only silicone implants, silica, squalen and aluminium, but also ink components used for making tattoos. Analyzing the available reports on the in􀏐luence of adjuvants on the development of autoimmune diseases, the conclusion is that apart from long -term silicone exposure, the coexistence of other factors such as genetic or environmental is also necessary. Metaanalyses clearly do not con􀏐irm an increased risk of developing autoimmune disease after breast augmentation with silicone implants, or tattooing, but it seems that among these patients there is a group that is more predestined to develop disease symptoms. In the general population the bene􀏐its of vaccination are obvious, and the risk of severe adverse events following immunisation is incomparably lower than the risk of developing a speci􀏐ic disease and its complications, also for patients with diagnosed autoimmune diseases. Because of data heterogeneity in previous studies and dif􀏐iculties in diagnosing ASIA it seems necessary to conduct further analyses of adjuvants’ in􀏐luence on autoimmune disease development, and to re􀏐ine ASIA diagnostic criteria, which now allow too easy a diagnosis of this syndrome.