Type IV hypersensitivity to a textured silicone breast implant

Dargan, Dallan; McGoldrick, Ciara; Khan, Khalid

doi:10.1016/j.bjps.2011.11.051

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…45-51 In a case study of capsule biopsies, Dargan et al reported a similar atypical lymphoid reaction to a removed textured BI demonstrating large lymphoid cell reactions consistent with delayed hypersensitivity reaction; patch testing to samples of the implant were positive. 48…”

Section: Orthopedic Particulate Debrismentioning

confidence: 99%

The Inflammatory Effects of Breast Implant Particulate Shedding: Comparison With Orthopedic Implants

Hallab

Samelko

Hammond³

2019

Aesthetic Surgery Journal

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Currently, there is a dearth of information regarding the degree of particle shedding from breast implants (BIs) and what are the general biological consequences of BI debris. Thus, it is unclear to what degree BI debris compromises the long-term biological performance of BIs. For orthopedic implants, it is well established that the severity of biological reactivity to implant debris governs long-term clinical performance. Orthopedic implant particulate debris is generally in the range of 0.01 to 100 μm in diameter. Implant debris-induced bioreactivity/inflammation is mostly a peri-implant phenomenon caused by local innate immune cells (eg, macrophages) that produce proinflammatory cytokines such as tumor necrosis factor-α, interleukin-1β, interleukin-6, and prostaglandin 2 (PGE2). In orthopedics, there have been few systemic concerns associated with polymeric implant debris (like silicone) other than documented dissemination to remote organs (eg, liver, spleen, etc.) with no known associated pathogenicity. This is not true of metal implant debris where normal (well-functioning) implants can induce systemic reactions such as delayed type hypersensitivity. Diagnostic analysis of orthopedic tissues has focused on innate (macrophage mediated) and adaptive (lymphocyte-mediated hypersensitivity) immune responses. Orthopedic implant debris-associated lymphocyte cancers have not been reported in over 40 years of orthopedic literature. Adaptive immune responses such as hypersensitivity reactions to orthopedic implant debris have been dominated by certain implant types that produce specific kinds of debris (eg, metal-on-metal total joint prostheses). Orthopedic hypersensitivity responses and atypical BI bioreactivity such as BI-associated anaplastic large cell lymphoma share crossover markers for diagnosis. Differentiating normal innate immune reactivity to particles from anaplastic large cell lymphoma reactions from delayed type hypersensitivity reactions to BI-associated implant debris remains unclear but vital to patients and surgeons.

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Section: Orthopedic Particulate Debrismentioning

confidence: 99%

The Inflammatory Effects of Breast Implant Particulate Shedding: Comparison With Orthopedic Implants

Hallab

Samelko

Hammond³

2019

Aesthetic Surgery Journal

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“…They are widely used in medical devices such as pacemakers, cochlear and breast implants, as well as in various industries, cosmetology, and household products. [1][2][3] Although silicone coating is used to avoid hypersensitivity reactions to the metal parts of pacemakers and cochlear implants, there are a few reports of hypersensitivity to the silicone coating, mimicking recurrent infections at the site of implantation. 1,2,[4][5][6] A few cases with a similar clinical presentation have been described with silicone breast implant capsules and their fillings.…”

Section: Discussionmentioning

confidence: 99%

Contact dermatitis to silicone toe separators, an underdiagnosed entity?

Gil‐Pallares¹,

Sotés

Usero-Bárcena³

et al. 2021

Contact Dermatitis

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“…Previous research showed that silicone is a chemically stable compound but also, that they are capable of inducing an antigen-specific lymphocyte-medicated response to the silicone gel like a type IV hypersensitivity reaction [7,9]. When a patient has had a prior history of reactions to adhesives the possibility of a type IV hypersensitivity reaction to a silicone implant increases.…”

Section: Discussionmentioning

confidence: 99%