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Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is an entity that includes different autoimmune conditions observed after exposure to an adjuvant. Patients with undifferentiated connective tissue disease (UCTD) present many signs and symptoms of ASIA, alluding to the idea that an ex...
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| Published in: | Immunologic research 2017-02, Vol.65 (1), p.150-156 |
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| creator | Scanzi, F. Andreoli, L. Martinelli, M. Taraborelli, M. Cavazzana, I. Carabellese, N. Ottaviani, R. Allegri, F. Franceschini, F. Agmon-Levin, N. Shoenfeld, Y. Tincani, Angela |
| description | The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is an entity that includes different autoimmune conditions observed after exposure to an adjuvant. Patients with undifferentiated connective tissue disease (UCTD) present many signs and symptoms of ASIA, alluding to the idea that an exposure to adjuvants can be a trigger also for UCTD. The aim of this case-control study was to investigate exposure to adjuvants prior to disease onset in patients affected by UCTD. Ninety-two UCTD patients and 92 age- and sex-matched controls with no malignancy, chronic infections, autoimmune disease nor family history of autoimmune diseases were investigated for exposure to adjuvants. An ad hoc-created questionnaire exploring the exposure to vaccinations, foreign materials and environmental and occupational exposures was administered to both cases and controls. Autoantibodies were also analyzed (anti-nuclear, anti-extractable nuclear antigens, anti-double-stranded DNA, anti-cardiolipin, anti-β2 glycoprotein I). UCTD patients displayed a greater exposure to HBV (
p
= 0.018) and tetanus toxoid (
p
|
| doi_str_mv | 10.1007/s12026-017-8912-4 |
| format | article |
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p
= 0.018) and tetanus toxoid (
p
< 0.001) vaccinations, metal implants (
p
< 0.001), cigarette smoking (
p
= 0.006) and pollution due to metallurgic factories and foundries (
p
= 0.048) as compared to controls. UCTD patients exposed to major ASIA triggers (vaccinations, silicone implants) (
n
= 49) presented more frequently with chronic fatigue (
p
< 0.001), general weakness (
p
= 0.011), irritable bowel syndrome (
p
= 0.033) and a family history for autoimmunity (
p
= 0.018) in comparison to non-exposed UCTDs. ASIA and UCTD can be considered as related entities in the “mosaic of autoimmunity”: the genetic predisposition and the environmental exposure to adjuvants elicit a common clinical phenotype characterized by signs and symptoms of systemic autoimmunity.</description><identifier>ISSN: 0257-277X</identifier><identifier>EISSN: 1559-0755</identifier><identifier>DOI: 10.1007/s12026-017-8912-4</identifier><identifier>PMID: 28332072</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvants ; Adjuvants, Immunologic - adverse effects ; Adjuvants, Pharmaceutic - adverse effects ; Adult ; Aged ; Allergology ; Antigens ; Autoantibodies ; Autoimmune diseases ; Autoimmunity ; Biomedical and Life Sciences ; Biomedicine ; Cardiolipin ; Case-Control Studies ; Cigarette smoking ; Connective tissue diseases ; Connective tissues ; Deoxyribonucleic acid ; DNA ; Environment and Autoimmunity ; Environmental Exposure - adverse effects ; Exposure ; Extractive metallurgy ; Family medical history ; Fatigue ; Female ; Foundries ; Genetics ; Glycoprotein I ; Glycoproteins ; Hepatitis B virus ; Humans ; Immunology ; Implants ; Inflammation ; Internal Medicine ; Irritable bowel syndrome ; Italy - epidemiology ; Male ; Malignancy ; Medicine/Public Health ; Middle Aged ; Occupational exposure ; Occupational health ; Papillomavirus Vaccines - adverse effects ; Patients ; Phenotypes ; Prostheses and Implants - adverse effects ; Signs and symptoms ; Silicones ; Silicones - adverse effects ; Smoking - adverse effects ; Syndrome ; Tetanus ; Tetanus Toxoid - adverse effects ; Undifferentiated Connective Tissue Diseases - etiology ; Vaccination - adverse effects ; Vaccines</subject><ispartof>Immunologic research, 2017-02, Vol.65 (1), p.150-156</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Springer Science+Business Media New York 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-8465a74320dc5228b913a1b56cab9235fb70f312a31646bc10d21de9c5e0cf6c3</citedby><cites>FETCH-LOGICAL-c499t-8465a74320dc5228b913a1b56cab9235fb70f312a31646bc10d21de9c5e0cf6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28332072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scanzi, F.</creatorcontrib><creatorcontrib>Andreoli, L.</creatorcontrib><creatorcontrib>Martinelli, M.</creatorcontrib><creatorcontrib>Taraborelli, M.</creatorcontrib><creatorcontrib>Cavazzana, I.</creatorcontrib><creatorcontrib>Carabellese, N.</creatorcontrib><creatorcontrib>Ottaviani, R.</creatorcontrib><creatorcontrib>Allegri, F.</creatorcontrib><creatorcontrib>Franceschini, F.</creatorcontrib><creatorcontrib>Agmon-Levin, N.</creatorcontrib><creatorcontrib>Shoenfeld, Y.</creatorcontrib><creatorcontrib>Tincani, Angela</creatorcontrib><title>Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures</title><title>Immunologic research</title><addtitle>Immunol Res</addtitle><addtitle>Immunol Res</addtitle><description>The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is an entity that includes different autoimmune conditions observed after exposure to an adjuvant. Patients with undifferentiated connective tissue disease (UCTD) present many signs and symptoms of ASIA, alluding to the idea that an exposure to adjuvants can be a trigger also for UCTD. The aim of this case-control study was to investigate exposure to adjuvants prior to disease onset in patients affected by UCTD. Ninety-two UCTD patients and 92 age- and sex-matched controls with no malignancy, chronic infections, autoimmune disease nor family history of autoimmune diseases were investigated for exposure to adjuvants. An ad hoc-created questionnaire exploring the exposure to vaccinations, foreign materials and environmental and occupational exposures was administered to both cases and controls. Autoantibodies were also analyzed (anti-nuclear, anti-extractable nuclear antigens, anti-double-stranded DNA, anti-cardiolipin, anti-β2 glycoprotein I). UCTD patients displayed a greater exposure to HBV (
p
= 0.018) and tetanus toxoid (
p
< 0.001) vaccinations, metal implants (
p
< 0.001), cigarette smoking (
p
= 0.006) and pollution due to metallurgic factories and foundries (
p
= 0.048) as compared to controls. UCTD patients exposed to major ASIA triggers (vaccinations, silicone implants) (
n
= 49) presented more frequently with chronic fatigue (
p
< 0.001), general weakness (
p
= 0.011), irritable bowel syndrome (
p
= 0.033) and a family history for autoimmunity (
p
= 0.018) in comparison to non-exposed UCTDs. ASIA and UCTD can be considered as related entities in the “mosaic of autoimmunity”: the genetic predisposition and the environmental exposure to adjuvants elicit a common clinical phenotype characterized by signs and symptoms of systemic autoimmunity.</description><subject>Adjuvants</subject><subject>Adjuvants, Immunologic - adverse effects</subject><subject>Adjuvants, Pharmaceutic - adverse effects</subject><subject>Adult</subject><subject>Aged</subject><subject>Allergology</subject><subject>Antigens</subject><subject>Autoantibodies</subject><subject>Autoimmune diseases</subject><subject>Autoimmunity</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cardiolipin</subject><subject>Case-Control Studies</subject><subject>Cigarette smoking</subject><subject>Connective tissue diseases</subject><subject>Connective tissues</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>Environment and Autoimmunity</subject><subject>Environmental Exposure - adverse effects</subject><subject>Exposure</subject><subject>Extractive metallurgy</subject><subject>Family medical history</subject><subject>Fatigue</subject><subject>Female</subject><subject>Foundries</subject><subject>Genetics</subject><subject>Glycoprotein I</subject><subject>Glycoproteins</subject><subject>Hepatitis B virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Implants</subject><subject>Inflammation</subject><subject>Internal Medicine</subject><subject>Irritable bowel syndrome</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medicine/Public Health</subject><subject>Middle Aged</subject><subject>Occupational exposure</subject><subject>Occupational health</subject><subject>Papillomavirus Vaccines - adverse effects</subject><subject>Patients</subject><subject>Phenotypes</subject><subject>Prostheses and Implants - adverse effects</subject><subject>Signs and symptoms</subject><subject>Silicones</subject><subject>Silicones - adverse effects</subject><subject>Smoking - adverse effects</subject><subject>Syndrome</subject><subject>Tetanus</subject><subject>Tetanus Toxoid - adverse effects</subject><subject>Undifferentiated Connective Tissue Diseases - etiology</subject><subject>Vaccination - adverse effects</subject><subject>Vaccines</subject><issn>0257-277X</issn><issn>1559-0755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1DAYRSMEotPCA7BBlthMF6G2E8fxCkUDhUqVWNBK7CLH_kI9SuzBP6PmAXkvPJ2CEBKsvPD5zvXPLYpXBL8lGPOLQCimTYkJL1tBaFk_KVaEMVFiztjTYoUp4yXl_OtJcRrCFmPS1HX1vDihbVVRzOmq-NF5QPEOkEzRmXlOFi6MHSc5zzI6v6CwWO3dDMhYnRRoNCxI6m3aSxsDWndfrrpzJK1-kCSrzTiCBxuNjBlWzlpQ0exziAkhAdImgAyA1rebm_fnyMP0AEaHQKo75LLGv0MdUhkq83j0bkIhJr0gNyKwe-OdnXOAnBDc71xIHsKL4tkopwAvH9ez4vbyw83mU3n9-ePVprsuVS1ELNu6YZLX-epaMUrbQZBKkoE1Sg6CVmwcOB4rQmWVH6oZFMGaEg1CMcBqbFR1VqyP3p133xOE2M8mKJgmacGl0JNW8KrFNSMZffMXunXJ23y6njaC8Zbjqv4flV2U1KTFIlPkSCnvQvAw9jtvZumXnuD-0IT-2IQ-N6E_NKE_mF8_mtMwg_498evrM0CPQMhb9hv4P6L_af0JGgHAZQ</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Scanzi, F.</creator><creator>Andreoli, L.</creator><creator>Martinelli, M.</creator><creator>Taraborelli, M.</creator><creator>Cavazzana, I.</creator><creator>Carabellese, N.</creator><creator>Ottaviani, R.</creator><creator>Allegri, F.</creator><creator>Franceschini, F.</creator><creator>Agmon-Levin, N.</creator><creator>Shoenfeld, Y.</creator><creator>Tincani, Angela</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20170201</creationdate><title>Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures</title><author>Scanzi, F. ; Andreoli, L. ; Martinelli, M. ; Taraborelli, M. ; Cavazzana, I. ; Carabellese, N. ; Ottaviani, R. ; Allegri, F. ; Franceschini, F. ; Agmon-Levin, N. ; Shoenfeld, Y. ; Tincani, Angela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-8465a74320dc5228b913a1b56cab9235fb70f312a31646bc10d21de9c5e0cf6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adjuvants</topic><topic>Adjuvants, Immunologic - adverse effects</topic><topic>Adjuvants, Pharmaceutic - adverse effects</topic><topic>Adult</topic><topic>Aged</topic><topic>Allergology</topic><topic>Antigens</topic><topic>Autoantibodies</topic><topic>Autoimmune diseases</topic><topic>Autoimmunity</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cardiolipin</topic><topic>Case-Control Studies</topic><topic>Cigarette smoking</topic><topic>Connective tissue diseases</topic><topic>Connective tissues</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>Environment and Autoimmunity</topic><topic>Environmental Exposure - adverse effects</topic><topic>Exposure</topic><topic>Extractive metallurgy</topic><topic>Family medical history</topic><topic>Fatigue</topic><topic>Female</topic><topic>Foundries</topic><topic>Genetics</topic><topic>Glycoprotein I</topic><topic>Glycoproteins</topic><topic>Hepatitis B virus</topic><topic>Humans</topic><topic>Immunology</topic><topic>Implants</topic><topic>Inflammation</topic><topic>Internal Medicine</topic><topic>Irritable bowel syndrome</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medicine/Public Health</topic><topic>Middle Aged</topic><topic>Occupational exposure</topic><topic>Occupational health</topic><topic>Papillomavirus Vaccines - adverse effects</topic><topic>Patients</topic><topic>Phenotypes</topic><topic>Prostheses and Implants - adverse effects</topic><topic>Signs and symptoms</topic><topic>Silicones</topic><topic>Silicones - adverse effects</topic><topic>Smoking - adverse effects</topic><topic>Syndrome</topic><topic>Tetanus</topic><topic>Tetanus Toxoid - adverse effects</topic><topic>Undifferentiated Connective Tissue Diseases - etiology</topic><topic>Vaccination - adverse effects</topic><topic>Vaccines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scanzi, F.</creatorcontrib><creatorcontrib>Andreoli, L.</creatorcontrib><creatorcontrib>Martinelli, M.</creatorcontrib><creatorcontrib>Taraborelli, M.</creatorcontrib><creatorcontrib>Cavazzana, I.</creatorcontrib><creatorcontrib>Carabellese, N.</creatorcontrib><creatorcontrib>Ottaviani, R.</creatorcontrib><creatorcontrib>Allegri, F.</creatorcontrib><creatorcontrib>Franceschini, F.</creatorcontrib><creatorcontrib>Agmon-Levin, N.</creatorcontrib><creatorcontrib>Shoenfeld, Y.</creatorcontrib><creatorcontrib>Tincani, Angela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Immunologic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scanzi, F.</au><au>Andreoli, L.</au><au>Martinelli, M.</au><au>Taraborelli, M.</au><au>Cavazzana, I.</au><au>Carabellese, N.</au><au>Ottaviani, R.</au><au>Allegri, F.</au><au>Franceschini, F.</au><au>Agmon-Levin, N.</au><au>Shoenfeld, Y.</au><au>Tincani, Angela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures</atitle><jtitle>Immunologic research</jtitle><stitle>Immunol Res</stitle><addtitle>Immunol Res</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>65</volume><issue>1</issue><spage>150</spage><epage>156</epage><pages>150-156</pages><issn>0257-277X</issn><eissn>1559-0755</eissn><abstract>The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is an entity that includes different autoimmune conditions observed after exposure to an adjuvant. Patients with undifferentiated connective tissue disease (UCTD) present many signs and symptoms of ASIA, alluding to the idea that an exposure to adjuvants can be a trigger also for UCTD. The aim of this case-control study was to investigate exposure to adjuvants prior to disease onset in patients affected by UCTD. Ninety-two UCTD patients and 92 age- and sex-matched controls with no malignancy, chronic infections, autoimmune disease nor family history of autoimmune diseases were investigated for exposure to adjuvants. An ad hoc-created questionnaire exploring the exposure to vaccinations, foreign materials and environmental and occupational exposures was administered to both cases and controls. Autoantibodies were also analyzed (anti-nuclear, anti-extractable nuclear antigens, anti-double-stranded DNA, anti-cardiolipin, anti-β2 glycoprotein I). UCTD patients displayed a greater exposure to HBV (
p
= 0.018) and tetanus toxoid (
p
< 0.001) vaccinations, metal implants (
p
< 0.001), cigarette smoking (
p
= 0.006) and pollution due to metallurgic factories and foundries (
p
= 0.048) as compared to controls. UCTD patients exposed to major ASIA triggers (vaccinations, silicone implants) (
n
= 49) presented more frequently with chronic fatigue (
p
< 0.001), general weakness (
p
= 0.011), irritable bowel syndrome (
p
= 0.033) and a family history for autoimmunity (
p
= 0.018) in comparison to non-exposed UCTDs. ASIA and UCTD can be considered as related entities in the “mosaic of autoimmunity”: the genetic predisposition and the environmental exposure to adjuvants elicit a common clinical phenotype characterized by signs and symptoms of systemic autoimmunity.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28332072</pmid><doi>10.1007/s12026-017-8912-4</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0257-277X |
| ispartof | Immunologic research, 2017-02, Vol.65 (1), p.150-156 |
| issn | 0257-277X 1559-0755 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1897380451 |
| source | Springer Link |
| subjects | Adjuvants Adjuvants, Immunologic - adverse effects Adjuvants, Pharmaceutic - adverse effects Adult Aged Allergology Antigens Autoantibodies Autoimmune diseases Autoimmunity Biomedical and Life Sciences Biomedicine Cardiolipin Case-Control Studies Cigarette smoking Connective tissue diseases Connective tissues Deoxyribonucleic acid DNA Environment and Autoimmunity Environmental Exposure - adverse effects Exposure Extractive metallurgy Family medical history Fatigue Female Foundries Genetics Glycoprotein I Glycoproteins Hepatitis B virus Humans Immunology Implants Inflammation Internal Medicine Irritable bowel syndrome Italy - epidemiology Male Malignancy Medicine/Public Health Middle Aged Occupational exposure Occupational health Papillomavirus Vaccines - adverse effects Patients Phenotypes Prostheses and Implants - adverse effects Signs and symptoms Silicones Silicones - adverse effects Smoking - adverse effects Syndrome Tetanus Tetanus Toxoid - adverse effects Undifferentiated Connective Tissue Diseases - etiology Vaccination - adverse effects Vaccines |
| title | Are the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and the undifferentiated connective tissue disease (UCTD) related to each other? A case-control study of environmental exposures |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T13%3A01%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Are%20the%20autoimmune/inflammatory%20syndrome%20induced%20by%20adjuvants%20(ASIA)%20and%20the%20undifferentiated%20connective%20tissue%20disease%20(UCTD)%20related%20to%20each%20other?%20A%20case-control%20study%20of%20environmental%20exposures&rft.jtitle=Immunologic%20research&rft.au=Scanzi,%20F.&rft.date=2017-02-01&rft.volume=65&rft.issue=1&rft.spage=150&rft.epage=156&rft.pages=150-156&rft.issn=0257-277X&rft.eissn=1559-0755&rft_id=info:doi/10.1007/s12026-017-8912-4&rft_dat=%3Cproquest_cross%3E2695787034%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c499t-8465a74320dc5228b913a1b56cab9235fb70f312a31646bc10d21de9c5e0cf6c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1892141809&rft_id=info:pmid/28332072&rfr_iscdi=true |