Systems analysis reveals differential expression of endocervical genes in African women randomized to DMPA-IM, LNG implant or cu-IUD
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...
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Published in | Clinical immunology (Orlando, Fla.) Vol. 255; p. 109750 |
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Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.10.2023
Academic Press |
Subjects | |
Online Access | Get full text |
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Summary: | 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.
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•Contraceptives significantly impact the immune system of the female genital tract (FGT)•The impact of DMPA, LNG implant, and Cu-IUD on the FGT was studied in 188 women from the ECHO trial using functional genomics•Cu-IUD led to elevated metallothionein responses associated with increased inflammation•DMPA usage was associated with enhanced T cell recruitment and signaling•LNG implant had the mildest impact on the FGT environment |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 These authors contributed equally to this work. Current address: Heersink School of Medicine, University of Alabama. |
ISSN: | 1521-6616 1521-7035 |
DOI: | 10.1016/j.clim.2023.109750 |