@misc{khan_minto_kelley-patteson_van natta_neumann_suh_singh_lester_vonderhaar_gordillo_et al._2020, 
  title={Biofilm Derived Oxylipin Mediated Autoimmune Response in Breast Implant Subjects}, 
  DOI={10.1101/2020.11.18.20233510}, 
  abstractNote={<jats:title>Abstract</jats:title><jats:p>Over 10 million women worldwide have breast implants for breast cancer/prophylactic reconstruction or cosmetic augmentation. In recent years, a number of patients have described a constellation of symptoms that are believed to be related to their breast implants. This constellation of symptoms has been named Breast Implant Illness (BII). The symptoms described include chronic fatigue, joint pain, muscle pain and a host of other manifestations often associated with autoimmune illnesses. In this work, we report that bacterial biofilm is associated with BII. We postulate that the pathogenesis of BII is mediated <jats:italic>via</jats:italic> a host-pathogen interaction whereby the biofilm bacteria <jats:italic>Staphylococcus epidermidis</jats:italic> interacts with breast lipids to form the oxylipin 10-HOME. The oxylipin 10-HOME was found to activate CD4<jats:sup>+</jats:sup> T cells to Th1 subtype. An increased abundance of CD4<jats:sup>+</jats:sup>Th1 was observed in the breast tissue of BII subjects. The identification of a mechanism of immune activation associated with BII via a biofilm enabled pathway provides insight into the pathogenesis for implant-associated autoimmune symptoms.</jats:p>}, 
  publisher={Cold Spring Harbor Laboratory}, 
  author={Khan, Imran and Minto, Robert E. and Kelley-Patteson, Christine and Van Natta, Bruce W. and Neumann, Colby R. and Suh, Lily J. and Singh, Kanhaiya and Lester, Mary and VonDerHaar, R Jason and Gordillo, Gayle M. and et al.}, 
  year={2020}, 
  month={Nov}
  }