Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants. In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
アジュバント誘発性自己免疫・自己炎症性症候群（ASIA）は、今まで多くの研究で広く記述されてきた
本症候群は、５つの免疫介在性病状を含むもので、これらはすべて、ワクチン、シリコーン移植、その他の種々の薬剤への暴露に関連している
ASIA症候群の発症は、遺伝的素因、例えばHLA-DRB1*01 または HLA-DRB4を保持していることなどと関連しており、自己免疫性を引き起こす外部あるいは内在する因子への暴露に起因する
そのような因子は、提案された様々な機序により動物モデルおよび人において自己免疫性を誘導することが可能であることが示されている
近年、医師の間でもASIA症候群の存在は知られてきており、多くの症例が報告されつつある
従って、我々は、種々のアジュバントにより誘発された様々な自己免疫症状を記述する、世界各国の医師により報告された３００を超えるASIA症候群の症例を含むレジストリーを作成した
本レビューでは、種々のアジュバントへの暴露とその可能性のある臨床的兆候の関連を明らかにするために、２０１３年以降の蓄積された最新のASIA症候群に関する文献と知識を要約した
また、特に、ASIA症候群と全身性エリテマトーデス（SLE）および抗リン脂質症候群（APS）の関連について言及する
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Melinda Messenger
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