Autoimmune/inflammatory syndrome induced by adjuvants

Last revised by Henry Knipe on 15 Feb 2023

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) encompasses non-specific symptoms that occur following exposure to inert material (e.g. silicone, aluminum salts), which are thought to trigger an abnormal autoimmune response 1-3. Whether this is association or causation is still under active research 4.


Proposed diagnostic criteria include 2,3:

  • major criteria

    • external stimuli exposure (e.g. infection, vaccine, silicone, adjuvant) prior to clinical manifestations

    • appearance of ’typical’ clinical manifestations:

      • myalgia, myositis or muscle weakness

      • arthralgia and/or arthritis

      • chronic fatigue, un-refreshing sleep or sleep disturbances

      • neurological manifestations (especially associated with demyelination)

      • cognitive impairment, memory loss

      • pyrexia, dry mouth

    • removal of inciting agent induces improvement

    • typical biopsy of involved organs

  • minor criteria

    • appearance of autoantibodies or antibodies directed at the suspected adjuvant

    • other clinical manifestations (e.g. irritable bowel syndrome)

    • specific HLA (i.e. HLA DRB1, HLA DQB1)

    • evolvement of an autoimmune disease (e.g. multiple sclerosis)

History and etymology

ASIA syndrome was first proposed by Schoenfeld and Agmon-Levin in 2011 1,2.

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