Autoimmune/inflammatory syndrome induced by adjuvants

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.

Diagnosis

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.