Re-Evaluation of Autoantibodies and Clinical Overview of Silicone-Related Disorders

Abstract

In a recent study to characterize antinuclear autoantibodies (ANAs) in women with silicone breast implants [1], it was reported that in 11 patients who had symptoms and signs that met criteria for defined autoimmune diseases such as scleroderma and systemic lupus erythematosus, all had the presence of ANAs which on further characterization could be shown to be antigen-antibody systems characteristic of diopathic autoimmune diseases. Silicone breast implant patients who had the diagnosis of scleroderma had antibodies such as anti-Scl-70 (DNA topoisomerase I), anti-RNA olymerase I and anti-centromere protein antigens CENP-A and B. These antigenantibody systems had been shown previously to be present in patients with the spontaneous form of scleroderma or with the CREST (calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) subset of scleroderma. Silicone breast implant patients who had the diagnosis of systemic lupus erythematosus or mixed connective tissue disease also had characteristic antigenantibody systems present in the spontaneous forms of these diseases, including antibodies to double-stranded DNA, Sm antigen and small nuclear ribonucleoprotein (snRNP) antigens. These findings showed that both clinically as well as in immune response parameters, patients with silicone breast implants who had diagnoses such as scleroderma and lupus could not be regarded as unique compared to those with the spontaneous form of these diseases.

Supported in part by NIH grants AI34594 and DK49413. This is publication No. 9344-MEM from The Scripps Research Institute