ASIA syndrome and endocrine autoimmune disorders Nicola Luigi Bragazzi, MD, PhD, Consultant Epidemiologist a , Ashraf Hejly, MD, Senior Consultant- Internal Medicine b, c , Abdulla Watad, MD, Senior Consultant- Internal Medicine b, c, d , Mohammed Adawi, MD, Senior Consultant- Internal Medicine e , Howard Amital, MD, Senior Consultant- Internal Medicine b, c, d , Yehuda Shoenfeld, FRCP MaACR, Prof (Emeritus), Senior Consultant- Internal Medicine d, e, * a Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), Toronto, Canada b Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel c Department of Internal Medicine 'B', Sheba Medical Center, Ramat Gan, Israel d Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel e Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia article info Article history: Available online xxx Keywords: ASIA syndrome vaccine adjuvants silicone breast implant endocrine autoimmune disorders An adjuvant is an immunological or pharmacological substance or group of substances that can be added to a given agent to enhance its effect in terms of efficacy, effectiveness and potency. Different mechanisms have been hypothesized underlying the action of the adjuvant, including boosting immune (innate and adaptive) response: this generally results in sparing the necessary amount of the agent and can potentially reduce the frequency of the needed number of therapeutic interventions. Adjuvants can be commonly found in vaccines, immunization products, mineral oils, cosmetics, silicone breast implants and other therapeutic/medical devices, being usually safe and effective. However, in a fraction of geneti- cally susceptible and predisposed subjects, the administration of * Corresponding author. Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 5265601, Israel. E-mail address: yehuda.shoenfeld@sheba.health.gov.il (Y. Shoenfeld). Contents lists available at ScienceDirect Best Practice & Research Clinical Endocrinology & Metabolism journal homepage: www.elsevier.com/locate/beem https://doi.org/10.1016/j.beem.2020.101412 1521-690X/© 2020 Elsevier Ltd. All rights reserved. Best Practice & Research Clinical Endocrinology & Metabolism xxx (xxxx) xxx Please cite this article as: Bragazzi NL et al., ASIA syndrome and endocrine autoimmune disorders, Best Practice & Research Clinical Endocrinology & Metabolism, https://doi.org/10.1016/j.beem.2020.101412