Vitamin D deficiency as a risk factor for the development of autoantibodies in patients with ASIA and silicone breast implants: a cohort study and review of the literature

Abstract

The development of autoimmunity and/or autoimmune diseases is multifactorial. Vitamin D is one of the factors that might play a role. We postulated that both the presence of adjuvants and insufficient levels of vitamin D may result in the development of autoimmunity in patients with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in relation to silicone implant incompatibility. We measured vitamin D levels in 135 patients with ASIA in relation to silicone implant incompatibility and related findings to the presence of autoantibodies that are commonly used to diagnose systemic autoimmune diseases. Furthermore, we systematically reviewed the literature regarding vitamin D deficiency as a risk factor for the development of autoantibodies. Vitamin D measurements were available for analysis in 131 of 135 patients with ASIA in relation to SIIS. Twenty-three patients (18%) tested positive for autoantibodies, from which 18 patients (78%) had either a vitamin D deficiency or insufficiency (median vitamin D level 60.5 mmol/L), whereas five patients (22%) had sufficient vitamin D levels. The risk to develop autoantibodies was significantly increased in vitamin D deficient and/or insufficient patients [RR 3.14; 95% CI, 1.24–7.95; p = 0.009]. Reviewed literature suggested an association between vitamin D levels and the presence and/or titer levels of autoantibodies in different autoimmune diseases. From our current study and from our review of the literature, we conclude that vitamin D deficiency is related to the presence of autoantibodies. Whether vitamin D supplementation results in a decrease of autoimmunity needs to be studied prospectively.

Scleroderma-like syndrome in a woman with silicone breast implants – case report and critical review of the literature

“…In persons with a genetic predisposition, IL-6, TGF-β and Th-17 cells may convert an acute reaction into a chronic reaction, which may trigger systemic disease [ 7 ]. Some studies suggest that vitamin D deficiency [ 8 , 9 ] and pre-existing allergies [ 9 ] may be risk factors for the development of autoantibodies in patients with SBI. “Bleeding” of silicone outside the SBI capsule may further increase the risk of an autoimmunological reaction.…”

The ASIA syndrome: basic concepts

“…In a cohort study, vitamin D levels in silicone-implanted breast patients were shown to be inversely related to antibody levels (Relative risk 3.14, 95%CI: 1.24-7.59). 46 This result suggests the possible beneficial role of the immunomodulatory action of vitamin D in preventing the subsequent antibody formation in silicone-implanted patients.…”

Mechanisms of Breast Implant Toxicity: Will the Real Ringmaster Please Stand Up

“…Stated more simply, the vast majority of silicone-induced ailments emanate from multiple and varied toxic disruptions of the body's biochemistry and have virtually nothing to do with autoimmunity (12,12,21) . Another recent publication by Tervaert and colleagues discusses factors that may contribute to the development of autoantibodies in implant recipients (27) . In actuality, the presence or absence of autoantibodies in patients with these devices has no relevance for diagnosing siliconeinduced disease (4,16,20,22) .…”