Cellular immunodeficiency and autoimmunity in long-term mineral oil administration

Rapidly progressive diffuse systemic sclerosis after local vitamins A, D and E complex injections: literature review and report of two cases

The term autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) or Shoenfeld's syndrome refers to a wide group of immune-mediated diseases triggered by external agents. Several substances, such as vaccine adjuvants, squalene and silicone implants, are implied in the pathogenesis of ASIA syndrome. Treatment and prognosis of this complex condition are not completely known due to lack of good quality evidence. After a brief introductory literature review on ASIA, we report here two cases of patients that developed rapidly progressive systemic sclerosis clinical features after multiple intramuscular local injections of a substance recommended by a non-medical professional called ADE. ADE is an oily vitamin complex for veterinary use, and it was used in these cases for cosmetic muscular definition and enhancement purpose. To our knowledge, this is the first paper to describe the relation between injections of ADE and the development of ASIA with severe systemic sclerosis phenotype. Further investigation is needed to better understand the pathophysiology and to provide the basis for the treatment of this condition.

Modulation of P2X7 receptor expression in macrophages from mineral oil-injected mice

P2X7 receptor activation is involved in a number of pro-inflammatory responses in macrophages and other immune cells. Their expression can be positively modulated with lipopolysaccharide (LPS) and TNFalpha, reinforcing their role during inflammation. We investigated the effect of substances capable of recruiting macrophages into the peritoneal cavity of mice (mineral oil and thioglycolate) on P2X7 receptor expression and function, addressing whether these stimuli can interfere with multinucleated giant cell (MGC) formation, ATP-induced apoptosis, plasma membrane permeabilization and nitric oxide production. It was demonstrated that mineral oil treatment reduces P2X7-dependent MGC formation, whereas thioglycolate treatment does not. Mineral oil treatment reduced P2X7 receptor expression, down-modulating ATP-induced apoptosis, permeabilization and nitric oxide production. In conclusion, mineral oil down modulated P2X7 expression and consequently P2X7-associated phenomena, but thioglycolate did not. These effects might be associated with the unpleasant side effects already described during long-term administration of mineral oil for cosmetic purposes or as a laxative and could be useful in understanding the mechanism of recycling and modulation of P2 receptors present in other situations of immunopathological interest.