Understanding the immunology of silicone breast implants, at present, consists of reconciling an increasingly large body of data with an older, established, but otherwise unsubstantiated theory. Despite the variety of silicone breast implants, there are nevertheless certain phenomena that occur with all silicone gel-filled devices. Recent clinical findings suggest that in some patients, silicone will act as an adjuvant on native macromolecules and render them immunogenic. The purpose of this review is to highlight biophysical and clinical phenomena that warrant further investigation.
Pretty, H.M. , H.H. Fudenberg, H.A. Perkins and F. Gerbode.1968. "Anti Gamma Globulin Antibodies after Open Heart Surgery;' Blood, 32:205-216.
2.
Brody, G.S.1993. "The Breast Implant Controversy;' N. Eng. J. Med., 328:732.
3.
Picha, G.J. and J.A. Goldstein.1991. "Analysis of the Soft-Tissue Response to Components Used in the Manufacture of Breast Implants: Rat Animal Model;' Plastic and ReconstructiveSurgery, 87(3):490-500.
4.
Crisp, A., E. de Juan, Jr., and J. Tiedman.1987. "Effect of Silicone Oil Viscosity on Emulsification," Arch Ophthalmol, 105:546-550.
5.
Israelachvili, J.N.1985. Intermolecular and Surface Forces, New York: Academic Press.
6.
Okamoto, J. and Y. Ohde.1986. "Environmental Stress Failure: An Irreversible Thermodynamics Approach;' in Failure of Plastics, W. Brostow and R. D. Corneliussen , eds., New York: Hanser, pp. 330-344.
7.
Shons, A.R. and W. Schubert.1992. "Silicone Breast Implants and Immune Disease;' Annals ofPlastic Surgery, 28(5):491-501.
8.
Rees, T.D., D.L. Ballantyne, I. Seidman and G.A. Hawthorne.1967. "Visceral Response to Subcutaneous and Intraperitoneal Injections of Silicone in Mice," Plast. Reconstr. Surg., 39:402-410.
9.
Silver, R.M., E.E. Sahn, J.A. Allen, et al. 1993. "Demonstration of Silicon in Sites of Connective-Tissue Disease in Patients with Silicone-Gel Breast Implants;' Archives ofDermatology, 129:63-68.
10.
Travis, W.D., K. Balogh and J.L. Abraham.1985. "Silicone Granulomas: Report of Three Cases and Review of the Literature;' Human Pathology, 16:19-27.
11.
Rudolph, R. and J. Abraham.1980. "Tissue Effects of New Silicone Mammary-Type Implants in Rabbits;' Ann. Plast. Surg., 4:14-20.
12.
Bischoff, F.1972. "Organic Polymer Biocompatibility and Toxicology (Review),"Clinical Chemistry, 18:869-894.
13.
Falb, R.D., G.A. Grode, M.T. Takahashi and R.I. Leininger.1967. "NIH Contract PH-43-64-496, Development of Blood Compatible Polymeric Materials," Report of 30 March 1967.
14.
Chattoraj, D.K. and H. Bull.1959. "Electrophoresis of Adsorbed Proteins," J. Am. Chem. Soc, 81:5128-5133.
15.
Kochwa, S., M. Brownell, R.E. Rosenfield and L.R. Wasserman.1967. "Adsorption of Proteins by Polystyrene Particles. I. Molecular Unfolding and Acquired Immunogenicity of IgG;' J. Immunol, 99:981-986.
16.
Wilkerson, P.1992. Report Presented Before the General and Plastic Surgery Device Evaluation Panel, FDA , Bethesda, MD, 18 February, 1992 .
17.
Stern, I.J., A.A. Kapsalis and B.L. Neil.1969. "Immunogenic Effects of Materials on Plasma Proteins," Proceedings Artificial Heart Program Conference, R. J. Hegyeli, ed., National Institute of Health, pp. 259-267.
18.
Stern, I.J. , A.A. Kapsalis, B.L. DeLuca and W. Pieczynski.1972. "Immunogenic Effects of Foreign Materials on Plasma Proteins," Nature, 238:151-152.
19.
de Camara, D.L., J.M. Sheridan and B.A. Kammer.1993. "Rupture and Aging of Silicone Gel Breast Implants;' Plastic and ReconstructiveSurgery, 91(5):828-834.
20.
Bridges, A.J. , C. Conley, G. Wang, D.E. Burns and F.B. Vaset.1993. "A Clinical and Immunologic Evaluation of Women with Silicone Breast Implants and Symptoms of Rheumatic Disease," Annals of Internal Medicine, 118(12):929-936.
21.
Goldblum, R.M. , R.P. Pelley, A.A. O'Donell, D. Pyron and J.P. Heggers.1992. "Antibodies to Silicone Elastomers and Reactions to Ventriculoperitoneal Shunts," The Lancet, 340:510-513.
22.
Press, R.I. , C. Peebles, Y. Kumagai, R.L. Ochs and E.M. Tan.1992. "Antinuclear Autoantibodies in Women with Silicone Breast Implants," The Lancet, 340:1304-1307.
23.
Kossovsky, N., M. Zeidler, G. Chun, A. Nugyen, S. Rajguru, N. Papasian, A. Gelman and E. Sponsler.1993. "Surface Dependent Antigens Identified by High Binding Avidity of Serum Antibodies in a Subpopulation of Patients with Breast Prostheses," J. of Appl. Biomat., Winter, in press.
24.
Naim, J.O. and R.J. Lanzafame.1993. "The Adjuvant Effect of SiliconeGel on Antibody Formation in Rats," InvestigativeImmunology, 22:151-161.
