Autoimmune/inflammatory syndrome induced by adjuvants (ASIA): past, present, and future implications

Abstract

Summary Adjuvants, as the name indicates, are adjoined material aimed to assist in functioning as when added to vaccines they are meant to boost the effect and strongly stimulate the immune system. The response of the immune system can be unpredictable, and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was developed to address possible adverse reactions of an autoimmune and inflammatory type that may be caused by adjuvants. While ASIA, as a syndrome, was coined and defined in 2011; reports describing patients with vague and nonspecific clinical symptoms following vaccinations appeared much earlier. In other words, ASIA came to define, arrange, and unite the variety of symptoms, related to autoimmunity, caused not by the vaccine itself, rather by the adjuvant part of the vaccine such as aluminum, among others. Accordingly, the introduction of ASIA enabled better understanding, proper diagnosis, and early treatment of the disorder. Furthermore, ASIA was shown to be associated with almost all body systems and various rheumatic and autoimmune diseases such as SLE, APS, and systemic sclerosis. In addition, the correlation between COVID-19 and ASIA was noticed during the pandemic. In this review, we summarized the reported effects of adjuvants and medical literature before and after ASIA was defined, the several ways ASIA can manifest and impact different systems of the body, and the incidences of ASIA during the COVID-19 pandemic. It is important to clarify, that vaccines are among, if not the, most effective means of fighting infectious diseases however, we believe that vaccines manufacturing is not above criticism, particularly when it comes to added substances possessing a risk of side effects.

Immune Cells, Gut Microbiota, and Vaccines: A Gender Perspective

“…This encompasses a set of immune reactions caused by certain compounds found in vaccines, such as silicone, aluminum, or infectious components [ 191 , 192 ]. Watad et al studied 500 patients aged 43 ± 17 years with ASIA syndrome and found that 89% were women, thus suggesting a higher risk of developing this condition compared to men [ 193 , 194 ].…”

COVID-19 and SLE: Infection and autoimmunity at its best

“…Moreover, using adjuvants in the production of vaccines has been thought to be a major risk factor for triggering autoimmune diseases. 64 In addition, cross-reactivity between the vaccine and host cells is another possible mechanism as similarities were found between SARS-CoV-2 spike protein and human proteins. 65 As some COVID-19 vaccines are mRNA-based vaccines, they can increase the production of type 1 interferons which is implicated in the pathophysiology of SLE.…”