Autoimmune/inflammatory syndrome induced by adjuvants, also known as Shoenfeld’s syndrome or ASIA, is a hypothesised autoimmune disorder proposed by Israeli immunologist Yehuda Shoenfeld in 2011.[1][2] According to Shoenfeld, the syndrome includes four conditions: “post-vaccination symptoms,” macrophagic myofasciitis, Gulf war syndrome, sick building syndrome, and siliconosis.[3][4] Shoenfeld alleges that the syndrome is caused by adjuvants such as silicone, tetramethylpentadecane, pristane, and aluminum.[5] However, causality is difficult to prove because ASIA only occurs in a small fraction of patients exposed to these adjuvants.[6] Additionally, proponents of this theory allege that the disorder can manifest anywhere from 2 days to 23 years after exposure.[4] Shoenfeld has also named Sjögren’s syndrome as potentially being another facet of ASIA.[7] In 2013, the authors of a textbook on autoimmune diseases concluded that “there exists persuasive evidence for ASIA,” but noted that several academic and governmental agencies had dismissed the possibility of a link between silicone and autoimmune disease.[8]

However, apart from the theoretical concept of ASIA, there is a lack of reproducible evidence for any causal relationship between adjuvant and autoimmune condition.[9] A study of 18,000 people showed that there is no merit to the theory of autoimmune/inflammatory syndrome induced by adjuvants.[10]


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