Adjuvant-induced autoimmune syndrome: Systematic analysis of symptoms and management

Abstract

Introduction: Adjuvant-Induced Autoimmune Syndrome (ASIA) is a complex and controversial condition that arises after exposure to adjuvants present in vaccines, medications, or prostheses. It is characterized by an abnormal immune response in genetically predisposed individuals, leading to the development of various autoimmune symptoms. Although some associations between adjuvants and autoimmune manifestations have been suggested, the scientific evidence is still limited and requires further investigation. Materials and Methods: A systematic review of the literature was conducted in the PubMed, Scielo and Scopus databases, using search terms such as "adjuvant-induced autoimmune syndrome", "vaccine adjuvants" and "adverse reactions to adjuvants". Clinical trials, cohort studies, case-control studies, systematic reviews, and case reports published between 2000 and 2024 were included. The selection of studies was made by two independent reviewers, using the GRADE system to assess the methodological quality of the articles. Results: The results indicate that ASIA is associated with a variety of symptoms, such as chronic fatigue, fever, rashes, arthralgias, myalgias, and neurological symptoms. Cases of myocarditis, pericarditis, and interstitial nephritis have also been reported, suggesting possible associations between adjuvants and cardiovascular and renal changes. However, the available evidence is predominantly based on case reports and observational studies, which limits the ability to establish a definitive causal relationship. Conclusion: Although some studies point to a possible association between ASIA and various clinical manifestations, current evidence remains controversial and inconclusive. More research is needed to elucidate the immunological mechanisms involved and develop more effective diagnostic and therapeutic strategies. The continuous dissemination of reliable information to healthcare professionals is critical for informed clinical decision-making and the promotion of safe care.