SILICON AND MATRIX MACROMOLECULES - NEW RESEARCH OPPORTUNITIES FOR OLD DISEASES FROM ANALYSIS OF POTENTIAL MECHANISMS OF BREAST IMPLANT TOXICITY

An understanding of the normal and essential integration of the elemen t silicon in biosystems, as well as knowledge of its fundamental chemi stry, are crucial to understanding its role in health and disease. Mod ern organosilicon chemistry, based in part on the artificial silicon-c arbon bond, coincided with the emergence of the biomaterials and bioen gineering fields fifty years ago, and was thought to be a fortunate co incidence according to conventional wisdom that high-molecular-weight polymeric siloxanes were chemically and biologically inert. These conc epts have been challenged by reports of silicone migration and degrada tion following insertion of gel-filled breast implants, claims of a no vel systemic illness appearing in many breast implant recipients, and investigations implicating varied and permeating immunotoxic mechanism s of disease causation by breast devices. The present study develops a dditional potential pathogenetic ideas based on alterations of cell bi ochemistry by silicon-containing compounds, and offers correlation of the patients' diverse clinical features with plausable disruption of b asic biological processes. This in turn raises new questions concernin g everyday environmental exposure, has broad implications for multiple other diseases, can provide alternative directions for future investi gative research, and may contribute to the ongoing redefinition of imm une dysfunction and inflammation.