The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld’s syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry
- 947 Downloads
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a recently identified condition in which the exposure to an adjuvant leads to an aberrant autoimmune response. We aimed to summarize the results obtained from the ASIA syndrome registry up to December 2016, in a descriptive analysis of 300 cases of ASIA syndrome, with a focus on the adjuvants, the clinical manifestations, and the relationship with other autoimmune diseases. A Web-based registry, based on a multicenter international study, collected clinical and laboratory data in a form of a questionnaire applied to patients with ASIA syndrome. Experts in the disease validated all cases independently. A comparison study regarding type of adjuvants and differences in clinical and laboratory findings was performed. Three hundred patients were analyzed. The mean age at disease onset was 37 years, and the mean duration of time latency between adjuvant stimuli and development of autoimmune conditions was 16.8 months, ranging between 3 days to 5 years. Arthralgia, myalgia, and chronic fatigue were the most frequently reported symptoms. Eighty-nine percent of patients were also diagnosed with another defined rheumatic/autoimmune condition. The most frequent autoimmune disease related to ASIA syndrome was undifferentiated connective tissue disease (UCTD). ASIA syndrome is associated with a high incidence of UCTD and positive anti-nuclear antibodies (ANA) test. Clinical and laboratory features differ from the type of adjuvant used. These findings may contribute to an increased awareness of ASIA syndrome and help physicians to identify patients at a greater risk of autoimmune diseases following the exposure to vaccines and other adjuvants. The ASIA syndrome registry provides a useful tool to systematize this rare condition.
KeywordsAdjuvants ANA Autoantibodies Autoimmune diseases Chronic fatigue syndrome (CFS) Fibromyalgia Silicone Systemic lupus erythematosus Vaccines
Compliance with ethical standards
Conflict of interest
YS appears in the Special vaccine compensation court in Washington US.
- 8.Watad A, Azrielant S, Bragazzi NL, Sharif K, David P, Katz I, Aljadeff G, Quaresma M, Tanay G, Adawi M, Amital H, Shoenfeld Y (2017) Seasonality and autoimmune diseases: the contribution of the four seasons to the mosaic of autoimmunity. J Autoimmun. doi: 10.1016/j.jaut.2017.06.001
- 16.Rodriguez-Pinto I, Moitinho M, Santacreu I, Shoenfeld Y, Erkan D, Espinosa G, Cervera R (2016) Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of 500 patients from the International CAPS Registry. Autoimmun Rev 15(12):1120–1124. doi: 10.1016/j.autrev.2016.09.010 CrossRefPubMedGoogle Scholar
- 17.Dahan S, Shoenfeld Y (2017) Letter to the editor—HPV vaccine and autoimmunity incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease after quadrivalent human papillomavirus vaccination: a cohort study. J Intern Med 281(3):313–315. doi: 10.1111/joim.12575 CrossRefPubMedGoogle Scholar
- 19.Inbar R, Weiss R, Tomljenovic L, Arango MT, Deri Y, Shaw CA, Chapman J, Blank M, Shoenfeld Y (2017) Behavioral abnormalities in female mice following administration of aluminum adjuvants and the human papillomavirus (HPV) vaccine Gardasil. Immunol Res 65(1):136–149. doi: 10.1007/s12026-016-8826-6 CrossRefPubMedGoogle Scholar
- 21.Colafrancesco S, Perricone C, Shoenfeld Y (2016) Autoimmune/inflammatory syndrome induced by adjuvants and Sjogren’s syndrome. Israel Med Assoc J : IMAJ 18(3–4):150–153Google Scholar
- 22.Scanzi F, Andreoli L, Martinelli M, Taraborelli M, Cavazzana I, Carabellese N, Ottaviani R, Allegri F, Franceschini F, Agmon-Levin N, Shoenfeld Y, Tincani A (2017) Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures. Immunol Res 65(1):150–156. doi: 10.1007/s12026-017-8912-4 CrossRefPubMedGoogle Scholar
- 24.van Assen S, Agmon-Levin N, Elkayam O, Cervera R, Doran MF, Dougados M, Emery P, Geborek P, Ioannidis JP, Jayne DR, Kallenberg CG, Muller-Ladner U, Shoenfeld Y, Stojanovich L, Valesini G, Wulffraat NM, Bijl M (2011) EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 70(3):414–422. doi: 10.1136/ard.2010.137216 CrossRefPubMedGoogle Scholar
- 25.Schelke LW, van den Elzen HJ, Canninga M, Neumann MH (2009) Complications after treatment with polyalkylimide. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 35 Suppl 2:1625-1628. doi: 10.1111/j.1524-4725.2009.01340.x