Lower concentrations of chemotactic cytokines and soluble innate factors in the lower female genital tract associated with the use of injectable hormonal contraceptive. (August 2015)

• Record Type: Journal Article
• Authors: Ngcapu, Sinaye; Masson, Lindi; Sibeko, Sengeziwe; Werner, Lise; McKinnon, Lyle R.; Mlisana, Koleka; Shey, Muki; Samsunder, Natasha; Karim, Salim Abdool; Karim, Quarraisha Abdool; Passmore, Jo-Ann S.
• Is Part Of: Journal of reproductive immunology. Volume 110(2015)
• Page Start: 14
• Page End: 21
• Publication Date: 2015-08
• Subjects: Hormone contraceptives -- DMPA -- Net-EN -- Cytokines -- MMP -- TIMP; Reproduction -- Immunological aspects -- Periodicals; Immunology -- Periodicals; Allergy and Immunology -- Periodicals; Reproduction -- Periodicals; Reproduction -- Immunologie -- Périodiques; Immunologie -- Périodiques; Immunology; Reproduction -- Immunological aspects; Periodicals; Electronic journals; Electronic journals; 615.766
• DOI: 10.1016/j.jri.2015.03.007
• Languages: English
• ISSNs: 0165-0378

Abstract

Highlights: Injectable hormonal contraceptives (HCs) may regulate genital tract innate immunity. Genital tract cytokines were suppressed in women using injectable HCs. Despite lower concentrations of genital tract cytokines, responses to STIs were not compromised in HC users. Abstract: Progesterone-based injectable hormonal contraceptives (HCs) potentially modulate genital barrier integrity and regulate the innate immune environment in the female genital tract, thereby enhancing the risk of STIs or HIV infection. We investigated the effects of injectable HC use on concentrations of inflammatory cytokines and other soluble factors associated with genital epithelial repair and integrity. The concentrations of 42 inflammatory, regulatory, adaptive growth factors and hematopoietic cytokines, five matrix metalloproteinases (MMPs), and four tissue inhibitors of metalloproteinases (TIMPs) were measured in cervicovaginal lavages (CVLs) from 64 HIV-negative women using injectable HCs and 64 control women not using any HCs, in a matched case–control study. There were no differences between groups in the prevalence of bacterial vaginosis (BV; Nugent score ≥7), or common sexually transmitted infections (STIs). In multivariate analyses adjusting for condom use, sex work status, marital status, BV and STIs, median concentrations of chemokines (eotaxin, MCP-1, MDC), adaptive cytokines (IL-15), growth factors (PDGF-AA) and a metalloproteinase (TIMP-2) were significantly lower in CVLs from women using injectable HCs than controls. In addition, the pro-inflammatory cytokine IL-12p40 and the chemokine fractalkine were less likely to have detectable levels in women using injectable HCs compared with those not using HCs. We conclude that injectable HC use was broadly associated with an immunosuppressive female genital tract innate immune profile. While the relationship between injectable HC use and STI or HIV risk is yet to be resolved, our data suggest that the effects of injectable HCs were similar in STI-positive and STI-negative participants.