ANTIBODY TO SILICONE AND NATIVE MACROMOLECULES IN WOMEN WITH SILICONEBREAST IMPLANTS

Silicone implants have been associated with the development of multipl e organ system abnormalities, including rheumatic disorders, nervous s ystem, pulmonary dysfunction associated with autoantibodies and abnorm alities of cellular immunity. In this regards a number of case reports and series of articles have been described. We hypothesized that an i mmune reaction to silicone breast implants would include the host reac tivity against silicone and the macromolecules within the microenviron ment of the implant, and these autoantibodies may react with other tis sue antigens far from the site of the implant. To test this hypothesis 520 Symptomatic women with Silicone Implants which have developed Sil icone related Immunological disorders and have typically complained of breast pain, Myalgia-Arthralgia, fatigue, or generalized pain, were e xamined by their physician. Blood samples were obtained and examined f or the presence of Silicone antibodies, Myelin Basic Protein and human serum albumin antibodies. These samples were then compared to 520 mat ched controls without implants. At least at the level of two standard deviation silicone specific antibodies, IgG, IgA IgM, IgE and IgG+IgAIgM antibodies were detected above the mean of normal controls. When t hese antibodies were classified based on the specialty of the examinin g physician, the % of patients with Silicone Antibodies were varied; g eneral practice 51.6, Rheumatology 58.7, and Plastic Surgery 83.3, whi ch may relate to the severeness of the disease. Being that a large % o f patients demonstrated very high levels of Myelin Basic Protein Antib odies, possible cross reactive antibodies were sought. However, absorp tion of highly positive sera for Silicone Antibodies with MBP did not change the levels of Silicone Antibodies. On the other hand, Silicone- HSA was able to reduce the antibody values significantly. This reducti on in antibody levels by Silicone is the best indication for the speci ficity of these antibodies. Moreover when data for silicone antibodies and MBP antibodies was analyzed in patients some with high and others with medium or low levels of silicone antibodies, MBP antibodies did not correspond to the silicone antibody levels. Similarly human serum albumin antibodies which was significantly higher in patients with sil icone implants did not correlate with levels of silicone antibodies. T hese results indicate that immune reaction to silicone and different t issue antigens do occur and they are initiated through different mecha nisms. And since predominant antibody class against silicone, MBP and HSA was IgM, clonal activation of IgM is possible which certainly warr ants further investigation.