The effect upon the human vaginal histology of the long-term use of the injectable contraceptive Depo-Provera®☆

Bahamondes, Luís; Trevisan, Miriam Aparecida da Silva; Andrade, Liliana Aparecida Lucci De Angelo; Marchi, Nádia M.; Castro, Simone Martins de; Dı́az, Juan; Faúndes, Aníbal

doi:10.1016/s0010-7824(00)00132-3

Cited by 73 publications

(53 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The frequency of intraepithelial LCs was significantly decreased in both COC and NuvaRing users compared to either DMPA users or controls ( Figure 4A). However, no significant difference in LC density was detected between DMPA users and controls, consistent with previous studies [19][20][21]41 . A trend toward increased CD3 + cell density in DMPA users compared to controls was detected ( Figure 4C); however, the trend did not reach statistical significance.…”

Section: Resultssupporting

confidence: 91%

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Objective-Epidemiological evidence suggests an association between the use of hormonal contraception and an increased risk of acquiring sexually transmitted diseases including HIV-1. We sought to elucidate the biological mechanisms underlying the effect of hormonal contraception on the immune system.Design-Cross-sectional study.Methods-To delineate the biological mechanisms underlying the effect of hormonal contraceptives on the immune system, we analyzed the functional capacity of circulating plasmacytoid dendritic cells (pDCs), the distribution of vaginal immune cell populations, and the systemic and genital levels of immune mediators in women using depot medroxyprogesterone acetate (DMPA), NuvaRing, or combined oral contraceptives (COC).Results-The use of DMPA or NuvaRing was associated with reduced capacity of circulating pDCs to produce IFNα and TNFα in response to TLR-9 stimulation. Systemic levels of IFNα and cervicovaginal fluid levels of IFNα, CXCL10, MCP-1, and G-CSF were significantly lower in DMPA users compared to control volunteers not using hormonal contraception. The density of CD207 + Langerhans cells in the vaginal epithelium was reduced in NuvaRing and COC users but not in DMPA users.Conclusions-The presented evidence suggests that the use of some types of hormonal contraception is associated with reduced functional capacity of circulating pDCs and altered immune environment in the female reproductive tract.

show abstract

Section: Resultssupporting

confidence: 91%

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…Although studies using a rhesus macaques model have shown that subcutaneous progesterone administration by implants resulted in vaginal epithelial thinning and increased simian immunodeficiency virus vaginal transmission, studies using human vaginal biopsies have generally not shown an association between hormonal contraception and significant changes in vaginal epithelial thickness and the number of cell layers from biopsy, Langerhans' cell count, or maturation index. [63][64][65] Hence, humans may not respond to exogenous progestins with the dramatic vaginal thinning noted in primates, which is a reassuring finding.…”

Section: Contraceptionmentioning

confidence: 95%

Anatomic and Hormonal Changes in the Female Reproductive Tract Immune Environment during the Life Cycle: Implications for HIV/STI Prevention Research

Venkatesh

Cu‐Uvin

2014

American J Rep Immunol

View full text Add to dashboard Cite

show abstract

“…In nonhuman primate models of HIV infection, progesterone and DMPA administration cause a dramatic atrophy of the vaginal epithelium, and DMPA (at 30 mg) is routinely used to enhance the efficiency of vaginal infection by simian immunodeficiency virus (SIV) or a chimeric variant of HIV (SHIV). [16][17][18][19][20][21] However, data regarding the effect of exogenous progestins on epithelial thickness in the human vagina are mixed, ranging from no change to either increased or decreased thickness, 5,[22][23][24] in short-term (3-6 months) 5,22 and long-term (2-3 year) 23 DMPA users. DMPA could also affect mucosal susceptibility to HIV-1 infection through alterations of the cervicovaginal mucosal immune response.…”

mentioning

confidence: 99%

Depot Medroxyprogesterone Acetate Increases Immune Cell Numbers and Activation Markers in Human Vaginal Mucosal Tissues

Chandra

Thurman

Anderson

et al. 2013

AIDS Research and Human Retroviruses

102

View full text Add to dashboard Cite

The relationship between exogenous contraceptive hormones and permissiveness of the female genital tract to human immunodeficiency virus type 1 (HIV-1) is the subject of renewed debate. To better characterize the effect of depot medroxyprogesterone acetate (DMPA) on HIV-1 cellular targets and epithelial integrity in the vagina, we compared leukocyte populations, markers of activation and proliferation, and the density of intercellular junctional proteins in the vaginal epithelium of women during the follicular and luteal phases of the menstrual cycle and approximately 12 weeks after receiving a DMPA injection. This prospective cohort study involved 15 healthy women. Vaginal biopsies were obtained in the follicular and luteal phases of the menstrual cycle, and approximately 12 weeks following a 150-mg intramuscular injection of DMPA. Leukocyte populations, activation phenotype, and epithelial tight junction and adherens proteins were evaluated by immunohistochemistry. After receiving DMPA, the numbers of CD45, CD3, CD8, CD68, HLA-DR, and CCR5 bearing immune cells were significantly ( p < 0.05) increased in vaginal tissues, compared to the follicular and/or luteal phases of untreated cycles. There were no significant differences in immune cell populations between the follicular and luteal phases of the control cycle. There were also no statistically significant differences in epithelial thickness and density of epithelial tight junction and adherens proteins among the follicular, luteal, and post-DMPA treatment sampling points. In this pilot study, vaginal immune cell populations were significantly altered by exogenous progesterone, resulting in increased numbers of T cells, macrophages, and HLA-DR-and CCR5-positive cells.

show abstract

The effect upon the human vaginal histology of the long-term use of the injectable contraceptive Depo-Provera®☆

Cited by 73 publications

References 12 publications

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

Anatomic and Hormonal Changes in the Female Reproductive Tract Immune Environment during the Life Cycle: Implications for HIV/STI Prevention Research

Depot Medroxyprogesterone Acetate Increases Immune Cell Numbers and Activation Markers in Human Vaginal Mucosal Tissues

Contact Info

Product

Resources

About