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Clin Immunol. 2019 Jun;203:1-8. doi: 10.1016/j.clim.2019.03.007. Epub 2019 Mar 25.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) demonstrates distinct autoimmune and autoinflammatory disease associations according to the adjuvant subtype: Insights from an analysis of 500 cases.

Author information

1
Department of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK.
2
Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
3
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK.
4
Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.
5
Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale maggiore Policlinico, Milano, Italy; Clinical Dermatology, Department of Biomedical, Surgical and Dental Sciences, Istituto Ortopedico Galeazzi, University of Milan, 20126 Milan, Italy.
6
Unit of Systemic Autoimmune Diseases, Internal Medicine Service, University Hospital Vall d'Hebron, Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat Autònoma, Barcelona, Spain.
7
Unit of Systemic Autoimmune Diseases, Internal Medicine Service, University Hospital Vall d'Hebron, Barcelona, Spain; Internal Medicine Service, Althaia, Xarxa Assistencial de Manresa, Manresa, Barcelona, Spain.
8
Department of Medicine A, Centro Hospitalar do Porto, Porto, Portugal.
9
Department of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
10
Department of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of the Mosaics of Autoimmunity, Saint Petersburg University, Saint Petersburg, Russian Federation. Electronic address: shoenfel@post.tau.ac.il.

Abstract

BACKGROUND:

We investigated the pattern of reported immune diseases in the international ASIA syndrome registry.

METHODS:

Data from 500 subjects exposed to adjuvants from the ASIA syndrome international registry were analysed.

RESULTS:

The patient mean age was 43 ± 17 years and 89% were female. Within the reported immune diseases, 69% were well-defined immune diseases (autoimmune, autoinflammation, and mixed pattern diseases). Among the well-defined immune diseases following the exposure to adjuvants, polygenic autoimmune diseases were significantly higher than autoinflammatory disorders (92.7% vs 5.8%, respectively, p < 0.001). Polygenic autoimmune diseases such as connective tissue diseases were significantly linked to the exposure to HBV vaccine (OR 3.15 [95%CI 1.08-9.23], p = 0.036). Polygenic autoinflammatory diseases were significantly associated with the exposure to influenza vaccination (OR 10.98 [95%CI 3.81-31.67], p < 0.0001).

CONCLUSIONS:

Immune conditions following vaccination are rare, and among these, polygenic autoimmune diseases represent the vast majority of the well-defined immune diseases reported under the umbrella ASIA syndrome. However, vaccines benefit outweighs their autoimmune side effects.

KEYWORDS:

ASIA syndrome; Foreign material; International syndrome registry; Silicone breast implants; Vaccines

PMID:
30922961
DOI:
10.1016/j.clim.2019.03.007
[Indexed for MEDLINE]
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