Emory National Primate Research Center (ENPRC) Genomics Core Laboratory, Division of Microbiology & Immunology, Emory University, Atlanta, GA, USA.
Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
Clin Immunol. 2023 Oct;255:109750. doi: 10.1016/j.clim.2023.109750. Epub 2023 Sep 3.
Although effective contraceptives are crucial for preventing unintended pregnancies, evidence suggests that their use may perturb the female genital tract (FGT). A comparative analysis of the effects of the most common contraceptives on the FGT have not been evaluated in a randomized clinical trial setting. Here, we evaluated the effect of three long-acting contraceptive methods: depot medroxyprogesterone acetate(DMPA-IM), levonorgestrel(LNG) implant, and a copper intrauterine device (Cu-IUD), on the endocervical host transcriptome in 188 women from the Evidence for Contraceptive Options and HIV Outcomes Trial (ECHO) trial. Cu-IUD usage showed the most extensive transcriptomic changes, and was associated with inflammatory and anti-viral host responses. DMPA-IM usage was enriched for pathways associated with T cell responses. LNG implant had the mildest effect on endocervical gene expression, and was associated with growth factor signaling. These data provide a mechanistic basis for the diverse influence that varying contraceptives have on the FGT.
尽管有效的避孕措施对于预防意外怀孕至关重要，但有证据表明，它们的使用可能会扰乱女性生殖器官（FGT）。在随机临床试验中，尚未评估最常见的避孕方法对 FGT 的影响。在这里，我们评估了三种长效避孕方法：长效醋酸甲羟孕酮（DMPA-IM）、左炔诺孕酮（LNG）植入物和铜宫内节育器（Cu-IUD）对来自避孕选择和艾滋病毒结局试验（ECHO）试验的 188 名女性的宫颈内转录组的影响。Cu-IUD 使用率显示出最广泛的转录组变化，并与炎症和抗病毒宿主反应有关。DMPA-IM 的使用与 T 细胞反应相关的途径有关。LNG 植入物对宫颈内基因表达的影响最小，与生长因子信号有关。这些数据为不同避孕方法对 FGT 产生不同影响提供了机制基础。
