Síndrome de Asia: revisión sistemática de literatura
[Asia Syndrome: Systematic literature review]Yuly Andrea Márquez Castañeda1, Oscar Alejandro Bonilla Sepúlveda1, Diana Valentina Márquez2
1. Universidad Militar Nueva Granada, Bogotá Colombia; 2. Universidad del Tolima, Ibagué, Colombia;
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Resumen
Ha habido muchos casos de aparición de autoanticuerpos y síntomas de enfermedad después de la exposición a adyuvantes, no solo después del aumento de senos con implantes de silicona, sino también como un efecto secundario muy raro de la vacunación, como el síndrome de la guerra del Golfo o el síndrome de miofascitis macrofágica. Las enfermedades cuyos síntomas se desarrollaron después de dicha exposición adyuvante se denominan síndrome autoinmune/inflamatorio inducido por adyuvantes (ASIA). El grupo de adyuvantes incluye no solo implantes de silicona, sílice, escualeno y aluminio, sino también componentes de tinta utilizados para hacer tatuajes. Analizando los informes disponibles sobre la influencia de los adyuvantes en el desarrollo de enfermedades autoinmunes, se concluye que, además de la exposición prolongada a la silicona, también es necesaria la coexistencia de otros factores, como genéticos o ambientales. Los análisis claramente no confirman un mayor riesgo de desarrollar una enfermedad autoinmune después del aumento de senos con implantes de silicona o tatuajes, pero parece que entre estas pacientes hay un grupo que está más predestinado a desarrollar síntomas de la enfermedad. En la población general, los beneficios de la vacunación son obvios, y el riesgo de eventos adversos graves después de la inmunización es incomparablemente menor que el riesgo de desarrollar una enfermedad específica y sus complicaciones, también para pacientes con enfermedades autoinmunes diagnosticadas. Debido a la heterogeneidad de los datos en estudios previos y las dificultades para diagnosticar ASIA, parece necesario realizar más análisis de la influencia de los adyuvantes en el desarrollo de enfermedades autoinmunes y refinar los criterios de diagnóstico de ASIA, que ahora permiten un diagnóstico demasiado fácil de esta enfermedad.
Abstract
There have been many cases of occurrence of autoantibodies and disease symptoms after adjuvant exposure, not only after breast augmentation with silicone implants, but also as a very rare side effect of vaccination, such as Gulf War syndrome or macrophagic myofasciitis syndrome. Diseases whose symptoms developed after such adjuvant exposure are called adjuvant-induced autoimmune/inflammatory syndrome (ASIA). The adjuvant group includes not only silicone, silica, squalene and aluminum implants, but also ink components used to make tattoos. Analyzing the available reports on the influence of adjuvants on the development of autoimmune diseases, it is concluded that, in addition to prolonged exposure to silicone, the coexistence of other factors, such as genetic or environmental, is also necessary. The analyses clearly do not confirm an increased risk of developing an autoimmune disease after breast augmentation with silicone implants or tattoos, but it seems that among these patients there is a group that is more predestined to develop symptoms of the disease. In the general population, the benefits of vaccination are obvious, and the risk of serious adverse events after immunization is incomparably lower than the risk of developing a specific disease and its complications, also for patients with diagnosed autoimmune diseases. Due to the heterogeneity of data in previous studies and the difficulties in diagnosing ASIA, further analysis of the influence of adjuvants on the development of autoimmune diseases and refinement of the diagnostic criteria for ASIA, which now allow too easy diagnosis of this disease, seems necessary.
Citas
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