Systemic complement activation has been noted in a variety of shock states, and there is growing evidence that, in addition to being proinflammatory effectors, products of complement activation contribute directly to generalized manifestations of shock, such as hypotension and acidosis. To study the effects of complement activation, we examined responses in rats to systemic activation of complement with cobra venom factor (CVF), including blood pressure, metabolic acidosis, changes in vascular permeability, and lung function. High doses of CVF produced circulatory collapse (mean arterial pressure = 110 +/- 16 and 35 +/- 9 mmHg in control and with CVF, respectively, P < 0.05), metabolic acidosis (HCO concentration = 27.8 +/- 1.7 and 9.6 +/- 3.4 meq/l in control and with CVF, respectively, P < 0.05), extravasation of albumin into the lung and gut, and modest arterial hypoxemia (PO2 = 486 +/- 51 and 201 +/- 36 Torr in control and during 100% O2 breathing, respectively, P < 0.05). Prior depletion of complement protected against these abnormalities. Other interventions, including neutrophil depletion and cyclooxygenase inhibition, prevented lung injury but had much less effect on systemic hemodynamics or gut permeability, suggesting that complement activation products induce injury by neutrophil- and cyclooxygenase-dependent pathways in the lung but not in the gut. These studies underscore the significant systemic abnormalities developing after systemic activation of complement.

BackgroundAutoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been associated with previous exposure to various agents such as silicone implants, which elicit chronic stimulation of the immune system against the prosthetic material and clinical manifestation of autoimmune disease. This is particularly the case in genetically susceptible hosts.ObjectivesThe aim is to describe de prevalence, family background and main autoimmune rheumatic disease (ARD) associated to silicone breast implant (SBI).MethodsWe study a cohort of 150 patients with diagnosis of ASIA associated injection of mineral oil and silicone breast implant (SBI) in a tertiary Hospital, from 2011 to 2016. All patients were evaluated for the fulfilment of ASIA criteria. We only included patients with ASIA criteria associated with SBI plus criteria for an autoimmune rheumatic disease according to The American College of Rheumatology or EULAR. We excluded patient with ASIA and without ARD.ResultsThere were 17 women patients with mean age 42.4±15.3 years, mean disease duration of disease 8±3. The clinical manifestation post SBI appeared 8±2 years later.The ARD were systemic sclerosis (SSc) 5, systemic lupus erythematosus (SLE) 3, rheumatoid arthritis (AR) 3, overlap syndrome 2 (SSc plus SS and SLE plus SSc, Sjogren syndrome 1, Takayasu arteritis 1, Still disease 1, antiphospholipid syndrome 1, and 3 patients also had secondary fibromyalgia. Five Patients had more than 2 autoantibodies, 4 patients had relatives with an ARD. All patients are being treated according to the ARD (steroids plus immunosuppressive 8 patients, immunosuppressive 7, and only steroids 2), in 4 patients the prosthesis were withdrawn with improvement of clinical manifestations.ConclusionsWe found a prevalence of ASIA associated to SBI of 11%. The main ARD were SSc, SLE and RA. In these cases of ASIA associated with SBI some had genetic predisposition to ARD. The use of SBI is not recommended in women who have a family history of ARD.References Colaris MJ et al. Two hundred cases of ASIA syndrome following silicone implants: a comparative study of 30 years and rewiew of current literature. Immunol Res 2016 Jul 13.Jara LJ, et al. Severe manifestation of autoimmune syndrome induced by adjuvants (Shoenfeld's syndrome) Immunol Res Jul 13.Watad et a. Autoimmune/Inflammatory induced by adjuvants (Shoenfeld's syndrome) UN update. Lupus 2017 Jan 1. Disclosure of InterestNone declared