A comparison of autoantibody production in asymptomatic and symptomatic women with silicone breast implants

Objective. We previously reported an increased preponderance of a broad ran ge of autoantibodies in symptomatic women with silicone breast implants. Th e objective of this study was to investigate the frequency of autoantibody production in asymptomatic compared to symptomatic women with sill cone imp lants. One hundred twenty-two asymptomatic women were recruited to our cent er for autoantibody detection through an advocate dealing with breast impla nt liabilities. Methods. Autoantibody detection in 86 asymptomatic women was done blindly o n a panel of 15 different antibodies (dsDNA, ssDNA, histones, SSA/Ro, SSB/L a, RNP, cardiolipin, phos phatidylserine, pyruvate dehydrogenase, Scl-70, N C-I, silicone, collagen I, II, and IV). Clinical variables, specific questi oning about related silicone implant symptoms, and a rheumatological examin ation were performed blindly by a certified rheumatologist. The findings we re recorded and at a later stage compared with positive autoantibody detect ion. The normal control group consisted of age and sex matched Israeli wome n without known autoimmune disease. In the positive control group were symp tomatic women previously tested for antibody production. The autoantibodies were assessed by ELISA. Values from individual patients were considered po sitive only when greater than 3 standard deviations above the control mean. Results. The mean ages of 86 asymptomatic and 116 symptomatic women were 46 .2 +/- 11.2 and 45.7 +/- 8.3 years, respectively. Breast implants were in p lace for a mean period of 8.2 +/- 5.0 years in the asymptomatic group and 1 5.0 +/- 5.6 years in the symptomatic group. The incidence of increased tite rs of autoantibodies ranged from 2 to 13% for 13 different autoantibodies a mong asymptomatic women. Among symptomatic women, 20% harbored 4 autoantibo dies and 8% had 6 autoantibodies. The most common antibodies in the asympto matic group were: dsDNA 8%; ssDNA 9%; SSB/La 13%; silicone 9%; collagen II 9%. No autoantibodies were found for NC-1, Scl-70, or RNP. Among the sympto matic group, the most common autoantibodies were histone ribosomal phosphat e, SSA, SSB, Scl-70, cardiolipin, phosphatidylserine, GM2-ganglioside, and NC-I. Comparison of autoantibody incidence in asymptomatic and symptomatic women with silicone boast implants revealed an increased incidence of anti- SSB/La and anticollagen II in both groups. Polyclonality was more prominent in the group of symptomatic women with silicone breast implants, but also evident in 3 asymptomatic women. Conclusion. The mean duration of implant in the asymptomatic group was sign ificantly less compared with the symptomatic,group (p < 0.01). The developm ent of autoantibodies may be related to implant duration.