Genetic variants in the development of autoimmune complaints and capsular contracture in women with breast implants: A systematic review.

[INTRODUCTION] Breast implants were introduced in 1963 by Cronin and Gerow and are widely used for reconstructive and aesthetic purposes. However, their use has been controversial due to the potential risk of developing autoimmune diseases and surgical complications such as capsular contracture. Currently, no genetic markers have been identified that are definitively associated with these complications. Therefore, we conducted a systematic review to check for the presence of genetic variants that are related to complications such as capsular contracture and autoimmune diseases in women with breast implants.

[MATERIALS AND METHODS] A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. The search included databases such as Web of Science, PubMed, and Scopus, using terms such as "breast implants," "breast prostheses," "genes," "genetic markers," and "autoimmunity." The selected studies were cross-sectional, cohort, and case-control studies that assessed specific genetic variants in women with breast implants and their association with autoimmune diseases or capsular contracture.

[RESULTS] A total of 6 cross-sectional studies and 1 case-control study were included. The findings related to autoimmune diseases showed a high prevalence of the HLA-DQ10102 variant among women with myositis associated with breast implants compared to women with myositis without implants (81.8% vs. 31.6%; OR 9.8, 95% CI 1.77-96.79). Other studies identified genetic variants associated with capsular contracture, highlighting the expression of MMP, TIMP, TNF-α, and IL-8 genes in severe contractures.

[CONCLUSION] Prolonged inflammation and specific genetic variants play a crucial role in the development of capsular contracture and autoimmune diseases in women with breast implants. Identifying these genetic markers could help improve the prediction and management of these complications. However, more longitudinal studies are needed to better understand the mechanisms and validate these findings.