Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. In this review, five enigmatic conditions, including sarcoidosis, Sjögren’s syndrome, undifferentiated connective tissue disease, silicone implant incompatibility syndrome (SIIS), and immune-related adverse events (irAEs), are defined as classical examples of ASIA. Certainly, these disorders have been described after an adjuvant stimulus (silicone implantation, drugs, infections, metals, vaccines, etc.) among genetically predisposed individuals (mainly the HLA-DRB1 and PTPN22 gene), which induce an hyperstimulation of the immune system resulting in the production of autoantibodies, eventually leading to the development of autoimmune diseases. Circulating autonomic autoantibodies in the sera of patients with silicone breast implants, as well as anatomopathological aspects of small fiber neuropathy in their skin biopsies have been recently described. To our knowledge, these novel insights serve as a common explanation to the non-specific clinical manifestations reported in patients with ASIA, leading to the redefinition of the ASIA syndrome diagnostic criteria.

中文翻译：

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亚洲综合症概念的经典例子

佐剂诱导的自身免疫/炎症综合征 (ASIA) 于 2011 年由 Shoenfeld 等人首次引入。并且包括一组相关的免疫介导的疾病，这些疾病由于佐剂暴露而在具有遗传倾向的个体中发展。自从发现 ASIA 综合征以来，迄今已报告了 4400 多例记录在案的病例，这些病例的临床表现和严重程度各不相同。在这篇综述中，包括结节病、干燥综合征、未分化结缔组织病、硅胶植入物不相容综合征 (SIIS) 和免疫相关不良事件 (irAE) 在内的五种神秘疾病被定义为 ASIA 的典型例子。当然，这些疾病是在辅助刺激（硅胶植入、药物、感染、金属、疫苗等）之后描述的。) 遗传易感个体（主要是 HLA-DRB1 和 PTPN22 基因），这会导致免疫系统过度刺激，导致自身抗体的产生，最终导致自身免疫性疾病的发展。最近已经描述了硅胶乳房植入物患者血清中的循环自主自身抗体，以及皮肤活检中小纤维神经病变的解剖病理学方面。据我们所知，这些新见解作为对 ASIA 患者报告的非特异性临床表现的共同解释，导致了 ASIA 综合征诊断标准的重新定义。最终导致自身免疫性疾病的发展。最近已经描述了硅胶乳房植入物患者血清中的循环自主自身抗体，以及皮肤活检中小纤维神经病变的解剖病理学方面。据我们所知，这些新见解作为对 ASIA 患者报告的非特异性临床表现的共同解释，导致了 ASIA 综合征诊断标准的重新定义。最终导致自身免疫性疾病的发展。最近已经描述了硅胶乳房植入物患者血清中的循环自主自身抗体，以及皮肤活检中小纤维神经病变的解剖病理学方面。据我们所知，这些新见解作为对 ASIA 患者报告的非特异性临床表现的共同解释，导致了 ASIA 综合征诊断标准的重新定义。