Influence of silicone mammoplasty on the immunoendocrine status of female recipients

V. G. Zolotykh, A. Gvozdetsky, A. Y. Kim, S. Lapin, L. Mikhailova, E. M. Starovoitova, T. Fedotkina, L. Churilov, Y. Schoenfeld, P. Yablonsky
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Abstract

The article concerns a study of early influence of silicone breast implants on the development of autoimmune reactions and dynamics of prolactin and thyroid hormone levels in women after mammoplasty. At the present time, this issue remains relevant for several reasons: more than 20 million pairs of implants have been installed in the world and the number of their implantations is constantly growing. Despite relative safety of the silicone implants, some of them are periodically banned by regulatory bodies in various countries. At the same time, there is a growing number of controversial publications in the scientific literature, about potential adverse consequences of their use. Some authors suggest an association between the silicone implants and risk of developing autoimmune conditions, connective tissue disorders, and occasional malignancies. On the other hand, the journals are full of publications about the overall safe tolerance of such medical devices by the patients. These considerations served as a pre-requisite to our research. As part of this project, we have assayed serum levels of autoantibodies to ten antigens, as well as contents of prolactin and thyroid hormones by means of ELISA technique in 27 patients before, 3 and 6 months after aesthetic and reconstructive mammoplastics performed within a period of September 2018 to November 2019. As a result, it was found that 5 out of 27 patients exhibited changes in the autoimmunity spectrum and intensity after mammoplasty. In particular, the concentrations of autoantibodies to modified citrullinated vimentin and IgM autoantibodies to cardiolipin exceeded the normal level at 3 and 6 months. In addition, the initially high prolactin concentration in mammoplasty recipients dropped to normal ranges by 3 months after breast surgery, even after several-fold increased initial levels. As for thyroid hormones, there were no statistically significant changes in their dynamics. The increase of autoantibodies to various target antigens after mammoplasty was statistically significant and positively correlated with each other. This can be explained, for example, by dependence on the adjuvant effect of silicone, which is not associated with antigen specificity. However, it may generally stimulate the immune responses.
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硅胶乳房成形术对女性接受者免疫内分泌状况的影响
本文研究了硅胶乳房植入物对女性乳房成形术后自身免疫反应的发展以及泌乳素和甲状腺激素水平的动态的早期影响。目前,这个问题仍然存在,原因有几个:世界上已经安装了2000多万对植入物,植入数量不断增长。尽管硅胶植入物相对安全,但其中一些植入物定期被各国监管机构禁止。与此同时,科学文献中越来越多有争议的出版物,关于使用它们的潜在不利后果。一些作者认为硅胶植入物与自身免疫性疾病、结缔组织疾病和偶尔的恶性肿瘤的风险之间存在关联。另一方面,这些期刊上充斥着关于患者对此类医疗器械的总体安全耐受性的出版物。这些考虑是我们进行研究的先决条件。作为该项目的一部分,我们通过ELISA技术,在2018年9月至2019年11月期间进行美容和重建乳房肿瘤术之前、3个月和6个月,对27名患者的血清中10种抗原的自身抗体水平以及催乳素和甲状腺激素的含量进行了测定。结果发现,27名患者中有5名在乳房成形术后表现出自身免疫谱和强度的变化。特别是,在3个月和6个月时,修饰瓜氨酸波形蛋白的自身抗体和心磷脂的IgM自身抗体的浓度超过了正常水平。此外,在乳房手术后3个月,乳房成形术受试者最初的高泌乳素浓度降至正常范围,即使在初始水平增加了几倍之后也是如此。至于甲状腺激素,其动力学没有统计学上的显著变化。乳房成形术后各种靶抗原自身抗体的增加具有统计学意义,并且相互呈正相关。例如,这可以通过依赖于与抗原特异性无关的硅酮的佐剂作用来解释。然而,它通常会刺激免疫反应。
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