avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2023-13-6-405-412avk-1689Research ArticleЛЕКЦИИLECTURESАутоиммунный/воспалительный синдром, индуцированный адъювантамиAutoimmune/Inflammatory Syndrome Induced by Adjuvantshttps://orcid.org/0000-0001-9147-8461ЗаяеваА. А.ZayaevaA. A.

Симферополь

Simferopol

https://orcid.org/0000-0002-2361-8730ЮнсиС. И. Р.YounsiS. I. R.

София Ибн Ридха Юнси

Симферополь

Sofia Ibn Ridha Younsi

Simferopol

younsisofia@mail.ruhttps://orcid.org/0000-0003-3197-8055ЗаусалинаА. И.ZausalinaA. I.

Симферополь

Simferopol

https://orcid.org/0000-0002-7467-7191КошуковаГ. Н.КоshukovaG. N.

Симферополь

Simferopol

https://orcid.org/0000-0003-1577-7077КлимчукА. В.КlimchukA. V.

Симферополь

Simferopol

https://orcid.org/0000-0003-2965-4975ЮнсиГ. А.YounsiG. A.

Симферополь

Simferopol

Федеральное государственное автономное образовательное учреждение высшего образования Крымский федеральный университет имени В.И. ВернадскогоРоссияV.I. Vernadsky Crimean Federal UniversityRussian Federation202312012024136405412Copyright © Заяева А.А., Юнси С.И., Заусалина А.И., Кошукова Г.Н., Климчук А.В., Юнси Г.А., 20242024Заяева А.А., Юнси С.И., Заусалина А.И., Кошукова Г.Н., Климчук А.В., Юнси Г.А.Zayaeva A.A., Younsi S.I., Zausalina A.I., Коshukova G.N., Кlimchuk A.V., Younsi G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1689

ASIA-синдром (autoimmune/inflammatory syndrome i nduced by adjuvants –аутоиммунный/воспалительный синдром, обусловленный адъювантами, синдром Шонфельда (Shoenfeld’s syndrome)) представляет собой группу аутоиммунных заболеваний, вызванных адъювантами, обладающими способностью индуцировать иммунные реакции. Синдром включает пять иммуноопосредованных состояний, которые связаны с предшествующим воздействием различных триггерных факторов, такие как силиконоз, синдром макрофагального миофасцита, синдром Персидского залива, синдром «больных» зданий и поствакцинальные аутоиммунные явления. Развитие ASIA-синдрома связано с индивидуальной генетической предрасположенностью и возникает в результате сочетанного воздействия экзогенных и эндогенных факторов, запускающих аутоиммунный ответ. При этом, реакция иммунной системы может быть непредсказуемой. В статье приведены диагностические критерии синдрома, а также его клинико-лабораторные и морфологические проявления. Спектр клинических проявлений аутоиммунного/ воспалительного синдрома, индуцированного адъювантами, обширен и затрагивает практически все системы организма человека. При этом, его характерным признаком является регресс клинических, лабораторных и морфологических проявлений после удаления адъюванта. Нет сомнений в том, что ASIA-синдром прояснил роль адъювантов в развитии аутоиммунных процессов. Это должно учитываться при создании безопасных вакцин, силиконовых имплантов, филлеров и других медицинских изделий с минимальными побочными эффектами. Кроме того, медицинские работники должны повышать уровень осведомленности пациентов о побочных эффектах применения некоторых косметологических процедур и использования силиконовых имплантов, для чего необходимо включить в учебно — методические пособия для студентов, ординаторов и врачей различных специальностей описание этиологии, патогенеза, диагностики и лечения ASIA — синдрома, как отдельной нозологической единицы.

ASIA syndrome (autoimmune/inflammatory syndrome induced by adjuvants) is a group of autoimmune diseases caused by adjuvants that have the ability to induce immune responses. The syndrome includes five immune-mediated conditions that are associated with prior exposure to various trigger factors, such as siliconosis, macrophage myofasciitis syndrome, Persian Gulf syndrome, sick building syndrome, and post-vaccination autoimmune events. The development of ASIA syndrome is associated with an individual genetic predisposition and occurs as a result of the combined effect of exogenous and endogenous factors that trigger an autoimmune response. In this case, the reaction of the immune system can be unpredictable. The article presents the diagnostic criteria for the syndrome, as well as its clinical, laboratory and morphological manifestations. The spectrum of clinical manifestations of the autoimmune/inflammatory syndrome induced by adjuvants is extensive and affects almost all systems of the human body. At the same time, its characteristic feature is the regression of clinical, laboratory and morphological manifestations after removal of the adjuvant. There is no doubt that ASIA syndrome has clarified the role of adjuvants in the development of autoimmune processes. This should be taken into account when creating safe vaccines, silicone implants, fillers and other medical devices with minimal side effects. In addition, medical professionals should raise patients’ awareness of the side effects of using certain cosmetic procedures and the use of silicone implants, for which it is necessary to include a description of the etiology, pathogenesis, diagnosis and treatment of ASIA syndrome in teaching aids for students, residents and doctors of various specialties as a separate nosological unit.

аутоиммунный/воспалительный синдроминдуцированный адъювантамиASIA — синдромсиндром Шонфельдаадьювантautoimmune/inflammatory syndrome induced by adjuvantsASIA syndromeSchoenfeld’s syndromeadjuvantReferencesGuimarães L.E., Baker B., Perricone C. et. al. Vaccines, adjuvants and autoimmunity. Pharmacol Res. 2015; 100: 190-209. doi: 10.1016/j.phrs.2015.08.003.Guimarães L.E., Baker B., Perricone C. et. al. Vaccines, adjuvants and autoimmunity. Pharmacol Res. 2015; 100: 190-209. doi: 10.1016/j.phrs.2015.08.003.Tregoning J.S., Russell R.F., Kinnear E. Adjuvanted influenza vaccines. Hum Vaccin Immunother. 2018; 14(3): 550-564. doi: 10.1080/21645515.2017.1415684.Tregoning J.S., Russell R.F., Kinnear E. Adjuvanted influenza vaccines. Hum Vaccin Immunother. 2018; 14(3): 550-564. doi: 10.1080/21645515.2017.1415684.Segal Y., Dahan S., Sharif K. et. al. The value of Autoimmune Syndrome Induced by Adjuvant (ASIA) — Shedding light on orphan diseases in autoimmunity. Autoimmun Rev. 2018; 17(5): 440-448. doi: 10.1016/j.autrev.2017.11.037.Segal Y., Dahan S., Sharif K. et. al. The value of Autoimmune Syndrome Induced by Adjuvant (ASIA) — Shedding light on orphan diseases in autoimmunity. Autoimmun Rev. 2018; 17(5): 440-448. doi: 10.1016/j.autrev.2017.11.037.Watad A., Sharif K., Shoenfeld Y. The ASIA syndrome: basic concepts. Mediterr J Rheumatol. 2017; 28(2): 64-69. doi: 10.31138/mjr.28.2.64.Watad A., Sharif K., Shoenfeld Y. The ASIA syndrome: basic concepts. Mediterr J Rheumatol. 2017; 28(2): 64-69. doi: 10.31138/mjr.28.2.64.Sisti A., Huayllani M.T., Restrepo D.J. et. al. Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature. Acta Biomed. 2020; 91(3): e2020082. doi: 10.23750/abm.v91i3.8533.Sisti A., Huayllani M.T., Restrepo D.J. et. al. Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature. Acta Biomed. 2020; 91(3): e2020082. doi: 10.23750/abm.v91i3.8533.Seida I., Seida R., Elsalti A. et. al. Vaccines and Autoimmunity-From Side Effects to ASIA Syndrome. Medicina (Kaunas). 2023; 59(2): 364. doi: 10.3390/medicina59020364.Seida I., Seida R., Elsalti A. et. al. Vaccines and Autoimmunity-From Side Effects to ASIA Syndrome. Medicina (Kaunas). 2023; 59(2): 364. doi: 10.3390/medicina59020364.Jara L.J., García-Collinot G., Medina G., et. al. Severe manifestations of autoimmune syndrome induced by adjuvants (Shoenfeld’s syndrome). Immunol Res. 2017; 65(1): 8-16. doi: 10.1007/s12026-016-8811-0.Jara L.J., García-Collinot G., Medina G., et. al. Severe manifestations of autoimmune syndrome induced by adjuvants (Shoenfeld’s syndrome). Immunol Res. 2017; 65(1): 8-16. doi: 10.1007/s12026-016-8811-0.Blomberg J., Gottfries C.G., Elfaitouri A. et. al. Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model. Front Immunol. 2018; 9: 229. doi: 10.3389/fimmu.2018.00229.Blomberg J., Gottfries C.G., Elfaitouri A. et. al. Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model. Front Immunol. 2018; 9: 229. doi: 10.3389/fimmu.2018.00229.Guo M., Liu X., Chen X., et. al. Insights into new-onset autoimmune diseases after COVID-19 vaccination. Autoimmun Rev. 2023; 22(7): 103340. doi: 10.1016/j.autrev.2023.103340.Guo M., Liu X., Chen X., et. al. Insights into new-onset autoimmune diseases after COVID-19 vaccination. Autoimmun Rev. 2023; 22(7): 103340. doi: 10.1016/j.autrev.2023.103340.Golomb B.A., Nguyen E., Dinkeloo E. Radiation Exposure Predicts Reported Vaccine Adverse Effects in Veterans with Gulf War Illness. Int J Environ Res Public Health. 2020; 17(19): 7136. doi: 11.3390/ijerph17197136. PMID: 33003502;Golomb B.A., Nguyen E., Dinkeloo E. Radiation Exposure Predicts Reported Vaccine Adverse Effects in Veterans with Gulf War Illness. Int J Environ Res Public Health. 2020; 17(19): 7136. doi: 11.3390/ijerph17197136. PMID: 33003502;Nkiliza A., Joshi U., Evans J.E. et. al. Adaptive Immune Responses Associated with the Central Nervous System Pathology of Gulf War Illness. Neurosci Insights. 2021; 16: 26331055211018458. doi: 10.1177/26331055211018458.Nkiliza A., Joshi U., Evans J.E. et. al. Adaptive Immune Responses Associated with the Central Nervous System Pathology of Gulf War Illness. Neurosci Insights. 2021; 16: 26331055211018458. doi: 10.1177/26331055211018458.Muñoz-Ortiz J., Gómez-López M.T., Echeverry-Hernández P. et. al. Dermatological and Ophthalmological Inflammatory, Infectious, and Tumoral Tattoo-Related Reactions: A Systematic Review. Perm J. 2021; 25: 20.225. doi: 10.7812/TPP/20.225.Muñoz-Ortiz J., Gómez-López M.T., Echeverry-Hernández P. et. al. Dermatological and Ophthalmological Inflammatory, Infectious, and Tumoral Tattoo-Related Reactions: A Systematic Review. Perm J. 2021; 25: 20.225. doi: 10.7812/TPP/20.225.Beutler B.D., Cohen P.R. Sarcoidosis in Melanoma Patients: Case Report and Literature Review. Cancers (Basel). 2015; 7(2): 1005-21. doi: 10.3390/cancers7020821.Beutler B.D., Cohen P.R. Sarcoidosis in Melanoma Patients: Case Report and Literature Review. Cancers (Basel). 2015; 7(2): 1005-21. doi: 10.3390/cancers7020821.Scanzi F., Andreoli L., Martinelli M., et. al. Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures. Immunol Res. 2017; 65(1): 150-156. doi: 10.1007/s12026-017-8912-4.Scanzi F., Andreoli L., Martinelli M., et. al. Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures. Immunol Res. 2017; 65(1): 150-156. doi: 10.1007/s12026-017-8912-4.Borba V., Malkova A., Basantsova N. et. al. Classical Examples of the Concept of the ASIA Syndrome. Biomolecules. 2020; 10(10): 1436. doi: 10.3390/biom10101436.Borba V., Malkova A., Basantsova N. et. al. Classical Examples of the Concept of the ASIA Syndrome. Biomolecules. 2020; 10(10): 1436. doi: 10.3390/biom10101436.Perricone C., Colafrancesco S., Mazor R.D. et. al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun. 2013; 47: 1-16. doi: 10.1016/j.jaut.2013.10.004.Perricone C., Colafrancesco S., Mazor R.D. et. al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun. 2013; 47: 1-16. doi: 10.1016/j.jaut.2013.10.004.Halpert G., Amital H., Shoenfeld Y. Silicone Breast Illness as a Classical Example of Autoimmune/Inflammatory Syndrome Induced by Adjuvant (ASIA). Isr Med Assoc J. 2022; 24(6): 357-359.Halpert G., Amital H., Shoenfeld Y. Silicone Breast Illness as a Classical Example of Autoimmune/Inflammatory Syndrome Induced by Adjuvant (ASIA). Isr Med Assoc J. 2022; 24(6): 357-359.Mahroum N., Elsalti A., Alwani A. et. al. The mosaic of autoimmunity — Finally discussing in person. The 13th international congress on autoimmunity 2022 (AUTO13) Athens. Autoimmun Rev. 2022; 21(10): 103166. doi: 10.1016/j.autrev.2022.103166.Mahroum N., Elsalti A., Alwani A. et. al. The mosaic of autoimmunity — Finally discussing in person. The 13th international congress on autoimmunity 2022 (AUTO13) Athens. Autoimmun Rev. 2022; 21(10): 103166. doi: 10.1016/j.autrev.2022.103166.Cohen Tervaert J.W., Kappel R.M. Silicone implant incompatibility syndrome (SIIS): a frequent cause of ASIA (Shoenfeld’s syndrome). Immunol Res. 2013; 56(2-3): 293-8. doi: 10.1007/s12026-013-8401-3.Cohen Tervaert J.W., Kappel R.M. Silicone implant incompatibility syndrome (SIIS): a frequent cause of ASIA (Shoenfeld’s syndrome). Immunol Res. 2013; 56(2-3): 293-8. doi: 10.1007/s12026-013-8401-3.Oh J.H., Song S.Y., Lew D.H. et. al. Distant Migration of Multiple Siliconomas in Lower Extremities following Breast Implant Rupture: Case Report. Plast Reconstr Surg Glob Open. 2016; 4(10): e1011. doi: 10.1097/GOX.0000000000001011.Oh J.H., Song S.Y., Lew D.H. et. al. Distant Migration of Multiple Siliconomas in Lower Extremities following Breast Implant Rupture: Case Report. Plast Reconstr Surg Glob Open. 2016; 4(10): e1011. doi: 10.1097/GOX.0000000000001011.Watad A., Bragazzi N.L., Amital H., et. al. Hyperstimulation of Adaptive Immunity as the Common Pathway for Silicone Breast Implants, Autoimmunity, and Lymphoma of the Breast. Isr Med Assoc J. 2019; 21(8): 517-519.Watad A., Bragazzi N.L., Amital H., et. al. Hyperstimulation of Adaptive Immunity as the Common Pathway for Silicone Breast Implants, Autoimmunity, and Lymphoma of the Breast. Isr Med Assoc J. 2019; 21(8): 517-519.Watad A., Quaresma M., Bragazzi N.L. et. al. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld’s syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry. Clin Rheumatol. 2018; 37(2): 483-493. doi: 10.1007/s10067-017-3748-9.Watad A., Quaresma M., Bragazzi N.L. et. al. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld’s syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry. Clin Rheumatol. 2018; 37(2): 483-493. doi: 10.1007/s10067-017-3748-9.Trowsdale J., Knight J.C. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013; 14: 301-23. doi: 10.1146/annurevgenom-091212-153455.Trowsdale J., Knight J.C. Major histocompatibility complex genomics and human disease. Annu Rev Genomics Hum Genet. 2013; 14: 301-23. doi: 10.1146/annurevgenom-091212-153455.Cohen Tervaert J.W., Martinez-Lavin M., Jara L.J. et. al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023. Autoimmun Rev. 2023; 22(5):103287. doi: 10.1016/j.autrev.2023.103287.Cohen Tervaert J.W., Martinez-Lavin M., Jara L.J. et. al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023. Autoimmun Rev. 2023; 22(5):103287. doi: 10.1016/j.autrev.2023.103287.Pepmueller P.H. Undifferentiated Connective Tissue Disease, Mixed Connective Tissue Disease, and Overlap Syndromes in Rheumatology. Mo Med. 2016; 113(2): 136-40.Pepmueller P.H. Undifferentiated Connective Tissue Disease, Mixed Connective Tissue Disease, and Overlap Syndromes in Rheumatology. Mo Med. 2016; 113(2): 136-40.Xiao Z.X., Miller J.S., Zheng S.G. An updated advance of autoantibodies in autoimmune diseases. Autoimmun Rev. 2021; 20(2): 102743. doi: 10.1016/j.autrev.2020.102743.Xiao Z.X., Miller J.S., Zheng S.G. An updated advance of autoantibodies in autoimmune diseases. Autoimmun Rev. 2021; 20(2): 102743. doi: 10.1016/j.autrev.2020.102743.Chen P.M., Tsokos G.C. Mitochondria in the Pathogenesis of Systemic Lupus Erythematosus. Curr Rheumatol Rep. 2022; 24(4): 88-95. doi: 10.1007/s11926-022-01063-9.Chen P.M., Tsokos G.C. Mitochondria in the Pathogenesis of Systemic Lupus Erythematosus. Curr Rheumatol Rep. 2022; 24(4): 88-95. doi: 10.1007/s11926-022-01063-9.Wang B., Shao X., Wang D. et. al. Vaccinations and risk of systemic lupus erythematosus and rheumatoid arthritis: A systematic review and meta-analysis. Autoimmun Rev. 2017; 16(7): 756-765. doi: 10.1016/j.autrev.2017.05.012.Wang B., Shao X., Wang D. et. al. Vaccinations and risk of systemic lupus erythematosus and rheumatoid arthritis: A systematic review and meta-analysis. Autoimmun Rev. 2017; 16(7): 756-765. doi: 10.1016/j.autrev.2017.05.012.Ruhrman-Shahar N., Torres-Ruiz J., Rotman-Pikielny P. Autoimmune reaction after anti-tetanus vaccination-description of four cases and review of the literature. Immunol Res. 2017; 65(1): 157-163. doi: 10.1007/s12026-016-8822-x.Ruhrman-Shahar N., Torres-Ruiz J., Rotman-Pikielny P. Autoimmune reaction after anti-tetanus vaccination-description of four cases and review of the literature. Immunol Res. 2017; 65(1): 157-163. doi: 10.1007/s12026-016-8822-x.Denton C.P., Khanna D. Systemic sclerosis. Lancet. 2017; 390(10103): 1685-1699. doi: 10.1016/S0140-6736(17)30933-9.Denton C.P., Khanna D. Systemic sclerosis. Lancet. 2017; 390(10103): 1685-1699. doi: 10.1016/S0140-6736(17)30933-9.Rubio-Rivas M., Moreno R., Corbella X. et. al. Occupational and environmental scleroderma. Systematic review and meta-analysis. Clin Rheumatol. 2017; 36(3): 569-582. doi: 10.1007/s10067-016-3533-1.Rubio-Rivas M., Moreno R., Corbella X. et. al. Occupational and environmental scleroderma. Systematic review and meta-analysis. Clin Rheumatol. 2017; 36(3): 569-582. doi: 10.1007/s10067-016-3533-1.Silva I.S., Ferreira B.H., Almeida C.R. Molecular Mechanisms Behind the Role of Plasmacytoid Dendritic Cells in Systemic Sclerosis. Biology (Basel). 2023; 12(2): 285. doi: 10.3390/biology12020285.Silva I.S., Ferreira B.H., Almeida C.R. Molecular Mechanisms Behind the Role of Plasmacytoid Dendritic Cells in Systemic Sclerosis. Biology (Basel). 2023; 12(2): 285. doi: 10.3390/biology12020285.Barthel A., Benker G., Berens K., An Update on Addison’s Disease. Exp Clin Endocrinol Diabetes. 2019; 127(2-03): 165-175. doi: 10.1055/a-0804-2715.Barthel A., Benker G., Berens K., An Update on Addison’s Disease. Exp Clin Endocrinol Diabetes. 2019; 127(2-03): 165-175. doi: 10.1055/a-0804-2715.Betterle C., Presotto F., Furmaniak J. Epidemiology, pathogenesis, and diagnosis of Addison’s disease in adults. J Endocrinol Invest. 2019; 42(12): 1407-1433. doi: 10.1007/s40618-019-01079-6.Betterle C., Presotto F., Furmaniak J. Epidemiology, pathogenesis, and diagnosis of Addison’s disease in adults. J Endocrinol Invest. 2019; 42(12): 1407-1433. doi: 10.1007/s40618-019-01079-6.Saverino S., Falorni A. Autoimmune Addison’s disease. Best Pract Res Clin Endocrinol Metab. 2020; 34(1): 101379. doi: 10.1016/j.beem.2020.101379.Saverino S., Falorni A. Autoimmune Addison’s disease. Best Pract Res Clin Endocrinol Metab. 2020; 34(1): 101379. doi: 10.1016/j.beem.2020.101379.Kamath S., Khabra J.K., Desai P. et. al. Adrenal Crisis Secondary to Influenza and Tetanus Vaccination in an Adult Without Known Adrenal Insufficiency: A Case of Autoimmune Adrenalitis. Cureus. 2021; 13(7): e16312. doi: 10.7759/cureus.16312.Kamath S., Khabra J.K., Desai P. et. al. Adrenal Crisis Secondary to Influenza and Tetanus Vaccination in an Adult Without Known Adrenal Insufficiency: A Case of Autoimmune Adrenalitis. Cureus. 2021; 13(7): e16312. doi: 10.7759/cureus.16312.Liu J., Zhang B., Zhu G. et. al. Discovering genetic linkage between periodontitis and type 1 diabetes: A bioinformatics study. Front Genet. 2023; 14: 1147819. doi: 10.3389/fgene.2023.1147819.Liu J., Zhang B., Zhu G. et. al. Discovering genetic linkage between periodontitis and type 1 diabetes: A bioinformatics study. Front Genet. 2023; 14: 1147819. doi: 10.3389/fgene.2023.1147819.Rai U., Senapati D., Arora M.K. Insights on the role of anti-inflammatory and immunosuppressive agents in the amelioration of diabetes. Diabetol Int. 2022; 14(2): 134-144. doi: 10.1007/s13340-022-00607-9.Rai U., Senapati D., Arora M.K. Insights on the role of anti-inflammatory and immunosuppressive agents in the amelioration of diabetes. Diabetol Int. 2022; 14(2): 134-144. doi: 10.1007/s13340-022-00607-9.Tschopp R., König R.S., Rejmer P. et. al. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A preliminary survey among patients in Switzerland. Heliyon. 2023; 9(5): e15595. doi: 10.1016/j.heliyon.2023.e15595.Tschopp R., König R.S., Rejmer P. et. al. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A preliminary survey among patients in Switzerland. Heliyon. 2023; 9(5): e15595. doi: 10.1016/j.heliyon.2023.e15595.Gherardi R.K., Crépeaux G., Authier F.J. Myalgia and chronic fatigue syndrome following immunization: macrophagic myofasciitis and animal studies support linkage to aluminum adjuvant persistency and diffusion in the immune system. Autoimmun Rev. 2019; 18(7): 691-705. doi: 10.1016/j.autrev.2019.05.006.Gherardi R.K., Crépeaux G., Authier F.J. Myalgia and chronic fatigue syndrome following immunization: macrophagic myofasciitis and animal studies support linkage to aluminum adjuvant persistency and diffusion in the immune system. Autoimmun Rev. 2019; 18(7): 691-705. doi: 10.1016/j.autrev.2019.05.006.Rigolet M., Aouizerate J., Couette M., et. al. Clinical features in patients with long-lasting macrophagic myofasciitis. Front Neurol. 2014; 5: 230. doi: 10.3389/fneur.2014.00230.Rigolet M., Aouizerate J., Couette M., et. al. Clinical features in patients with long-lasting macrophagic myofasciitis. Front Neurol. 2014; 5: 230. doi: 10.3389/fneur.2014.00230.Dobson R., Giovannoni G. Multiple sclerosis — a review. Eur J Neurol. 2019;26(1):27-40. doi: 10.1111/ene.13819.Dobson R., Giovannoni G. Multiple sclerosis — a review. Eur J Neurol. 2019;26(1):27-40. doi: 10.1111/ene.13819.Stowe J., Andrews N., Miller E. Do Vaccines Trigger Neurological Diseases? Epidemiological Evaluation of Vaccination and Neurological Diseases Using Examples of Multiple Sclerosis, Guillain-Barré Syndrome and Narcolepsy. CNS Drugs. 2020; 34(1): 1-8. doi: 10.1007/s40263-019-00670-y.Stowe J., Andrews N., Miller E. Do Vaccines Trigger Neurological Diseases? Epidemiological Evaluation of Vaccination and Neurological Diseases Using Examples of Multiple Sclerosis, Guillain-Barré Syndrome and Narcolepsy. CNS Drugs. 2020; 34(1): 1-8. doi: 10.1007/s40263-019-00670-y.Alluqmani M. New Onset Multiple Sclerosis Post– COVID-19 Vaccination and Correlation With Possible Predictors in a Case-Control Study. Cureus. 2023;15(3):e36323. doi:10.7759/cureus.36323.Alluqmani M. New Onset Multiple Sclerosis Post– COVID-19 Vaccination and Correlation With Possible Predictors in a Case-Control Study. Cureus. 2023;15(3):e36323. doi:10.7759/cureus.36323.Butnaru D., Shoenfeld Y. Adjuvants and lymphoma risk as part of the ASIA spectrum. Immunol Res. 2015; 61(1-2): 79-89. doi: 10.1007/s12026-014-8622-0.Butnaru D., Shoenfeld Y. Adjuvants and lymphoma risk as part of the ASIA spectrum. Immunol Res. 2015; 61(1-2): 79-89. doi: 10.1007/s12026-014-8622-0.Colafrancesco S, Perricone C, Shoenfeld Y. Autoimmune/Inflammatory Syndrome Induced by Adjuvants and Sjögren’s Syndrome. Isr Med Assoc J. 2016; 18(3-4): 150-3.Colafrancesco S, Perricone C, Shoenfeld Y. Autoimmune/Inflammatory Syndrome Induced by Adjuvants and Sjögren’s Syndrome. Isr Med Assoc J. 2016; 18(3-4): 150-3.

The authors declare that there are no conflicts of interest present.