| Abstract [eng] |
Autoimmunity is a condition in which the body’s immune system begins to attack its own tissues, leading to autoimmune diseases. Recently increasing attention has been given to the factors that may trigger autoimmune responses, among which adjuvants play a significant role. Adjuvants are substances used to enhance immune responses in different medical fields: vaccines, aesthetic fillers and other medical products. However, these substances may also provoke undesirable autoimmune reactions. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses a group of immune-mediated disorders that may develop following exposure to adjuvants. This work analyzes the scientific literature on ASIA and presents two clinical cases in which ASIA symptoms developed after aesthetic medical procedures. Objective. To analyze the scientific literature on the autoimmune/inflammatory syndrome induced by adjuvants (ASIA), with attention to the diversity of adjuvants and their potential role in immune system activation, and to explore the diagnostic challenges, which arise from nonspecific clinical manifestations and the limited applicability of current criteria, illustrated through two clinical cases following aesthetic procedures. Tasks. To review scientific literature on the pathogenesis and clinical features of ASIA, identify potential adjuvants, and present two clinical cases illustrating diagnostic dilemmas of ASIA after aesthetic interventions. Methods. A literature search was conducted using international databases PubMed and Google Scholar, employing keywords such as "Autoimmune/inflammatory syndrome induced by adjuvants", "ASIA", "adjuvants", "autoimmunity". Included sources were literature reviews, clinical case reports, systematic reviews, and meta-analyses published in English between 2011 and 2025. 57 relevant publications were selected and analyzed. Clinical case descriptions and analysis were performed. Results. The findings revealed that the broad range of ASIA symptoms often presents diagnostic challenges in clinical practice. The first patient exhibited mucosal dryness syndrome, while the second experienced paresthesias and symptoms characteristic of autoimmune disease, initially suggesting systemic lupus erythematosus. Both cases underscore the difficulties in diagnosis when symptoms are mild and the causal link to adjuvant exposure is not immediately apparent. Therefore, differential diagnosis is crucial to rule out other potential autoimmune or infectious conditions. Conclusions. ASIA syndrome is an important and increasingly recognized clinical issue that demands heightened awareness from healthcare professionals, especially when encountering atypical or mild symptoms. The diagnosis of ASIA is more subjective than objective, necessitating a detailed medical history, laboratory investigations, and long-term monitoring to determine the true origin of the symptoms. The clinical cases presented in this paper highlight the importance of critically evaluating the use of adjuvants in aesthetic medicine, particularly in relation to the potential risk of autoimmune reactions. Given the growing popularity of aesthetic injections, a deeper understanding of their long-term impact on the immune system is essential. It is important to ensure that patients receive comprehensive information regarding possible complications and long-term consequences of such procedures. |
