Introdução: A Síndrome Autoimune/inflamatória Induzida por Adjuvantes (ASIA) engloba um grupo de doenças imunomediadas relacionadas, que se desenvolvem entre indivíduos geneticamente propensos como resultado da exposição ao agente adjuvante. Dentro desse grupo estão incluídas quatro doenças: Siliconose, Síndrome da Guerra do Golfo, Miofasceíte Macrofágica e fenômenos adversos pós-vacinais. Esse assunto tem ganhado notoriedade em função do extenso número de mulheres com silicone e que sofrem suas consequências. Objetivos: Elucidar sobre a ASIA com enfoque na Siliconose. Material e Métodos: Foi realizada uma revisão bibliográfica, buscando-se nas bases de dados PubMed, SciELO e Google Acadêmico, utilizando-se artigos publicados entre 2010 e 2020. Resultados: Os adjuvantes são indutores de autoimunidade, sendo que o silicone tem potencial de agir como um, e podem contribuir com o desenvolvimento de doenças inflamatórias e autoimunes em indivíduos geneticamente suscetíveis. Eles atuam como padrões moleculares associados a patógenos (PAMPs), favorecendo a produção de citocinas, quimiotaxia e maturação de monócitos. Além disso, a interação com os receptores do complexo principal de histocompatibilidade (HLA) e sinais coestimulatórios favorecem a produção de anticorpos. O dano tecidual resultante desses eventos inflamatórios leva à modificação das próprias proteínas, exposição de epítopos e a ativação subsequente de linfócitos auto-reativos, desencadeando uma doença autoimune. As manifestações clínicas da ASIA são numerosas e inespecíficas, podendo ser sistêmicas ou locais. Shoenfeld et al. sugeriu critérios para o diagnóstico da ASIA, sendo que os pacientes devem apresentar, pelo menos, 2 critérios principais ou 1 critério principal e 2 critérios secundários. Vale ressaltar que esse diagnóstico é complexo e de exclusão. O tratamento é baseado na eliminação do estímulo externo, sendo que na maioria dos casos não tem necessidade de iniciar tratamento com imunomodulador. Conclusão: Muitos avanços foram feitos na investigação dos mecanismos biológicos subjacentes a esta condição, porém ainda é necessário validar os critérios diagnósticos existentes e determinar qual deles é o mais específico para ser utilizado na prática clínica e na pesquisa. Da mesma forma, é necessário identificar fatores de risco para o desenvolvimento de fenômenos autoimunes em indivíduos que receberão algum tipo de adjuvante para prevenir casos de ASIA.
Publicado
2021-04-24
Como Citar
Soares, G. S., & De Faria, T. G. (2021). RELAÇÃO DA SÍNDROME AUTOIMUNE INDUZIDA POR ADJUVANTES (ASIA) COM O IMPLANTE MAMÁRIO. Revista Multidisciplinar Em Saúde, 2(2), 08. https://doi.org/10.51161/rems/947
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