Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023

Area of Science:

• Immunology
• Environmental Medicine
• Neurology

Background:

• Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA), or Shoenfeld's syndrome, was first described in 2011.
• ASIA proposes a common pathway for autoimmune pathogenesis triggered by environmental immune stimulators (adjuvants).
• Adjuvants include aluminum salts in vaccines, medical implants, and infectious agents, affecting genetically susceptible individuals.

Purpose of the Study:

• To review and update knowledge on ASIA syndrome.
• To discuss new adjuvants and vaccine-induced ASIA (e.g., HPV, COVID vaccines, polypropylene meshes).
• To explore the association between inflammatory/autoimmune diseases and ASIA, and propose expanded diagnostic criteria.

Main Methods:

• Literature review and synthesis of accumulated evidence over decades.
• Analysis of recent case studies and emerging data on ASIA.
• Discussion of potential new diagnostic markers and their role in ASIA pathogenesis.

Main Results:

• Evidence links environmental factors and adjuvants to autoimmune and inflammatory conditions.
• New adjuvants like polypropylene meshes and vaccines (HPV, COVID) are implicated in ASIA.
• Symptom improvement after adjuvant removal (e.g., silicone implants) supports ASIA criteria.

Conclusions:

• ASIA syndrome encompasses a range of autoimmune/inflammatory conditions triggered by adjuvants.
• Proposed additions to ASIA criteria include dysregulated autoantibodies against GPCRs and small fiber neuropathy (SFN).
• These additions may help explain dysautonomia observed in ASIA patients.