Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld's syndrome): clinical and immunological spectrum

• Published in: Expert review of clinical immunology Vol. 9; no. 4; pp. 361 - 373
• Main Authors: Vera-Lastra, Olga, Medina, Gabriela, Cruz-Dominguez, Maria Del Pilar, Jara, Luis J, Shoenfeld, Yehuda
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.04.2013; Expert Reviews Ltd; Informa Healthcare
• Subjects: Adaptive Immunity; Adjuvants, Immunologic - administration & dosage; Adjuvants, Immunologic - adverse effects; Aluminum hydroxide; Aluminum Hydroxide - administration & dosage; Aluminum Hydroxide - adverse effects; Animals; Antigen-antibody reactions; ASIA; Autoimmune Diseases - chemically induced; Autoimmune Diseases - immunology; Autoimmunity; Cytokines; environmental factors; Fasciitis - chemically induced; Fasciitis - immunology; Gulf War syndrome; human adjuvant disease; Humans; Immunity, Innate; Immunotherapy; Inflammasomes - metabolism; Inflammation - chemically induced; Inflammation - immunology; macrophagic myofasciitis syndrome; mineral oil; Myositis - chemically induced; Myositis - immunology; Persian Gulf Syndrome - chemically induced; Persian Gulf Syndrome - immunology; postvaccination phenomena; silicone; Silicones - administration & dosage; Silicones - adverse effects; Silicosis - immunology; Squalene - administration & dosage; Squalene - adverse effects; Syndrome; Systemic lupus erythematosus; Toll-Like Receptors - metabolism; Asia
• ISSN: 1744-666X; 1744-8409
• DOI: 10.1586/eci.13.2

An adjuvant is a substance that enhances the antigen-specific immune response, induces the release of inflammatory cytokines, and interacts with Toll-like receptors and the NALP3 inflammasome. The immunological consequence of these actions is to stimulate the innate and adaptive immune response. The activation of the immune system by adjuvants, a desirable effect, could trigger manifestations of autoimmunity or autoimmune disease. Recently, a new syndrome was introduced, autoimmune/inflammatory syndrome induced by adjuvants (ASIA), that includes postvaccination phenomena, macrophagic myofasciitis, Gulf War syndrome and siliconosis. This syndrome is characterized by nonspecific and specific manifestations of autoimmune disease. The main substances associated with ASIA are squalene (Gulf War syndrome), aluminum hydroxide (postvaccination phenomena, macrophagic myofasciitis) and silicone with siliconosis. Mineral oil, guaiacol and iodine gadital are also associated with ASIA. The following review describes the wide clinical spectrum and pathogenesis of ASIA including defined autoimmune diseases and nonspecific autoimmune manifestations, as well as the outlook of future research in this field.