Copper intrauterine device increases vaginal concentrations of inflammatory anaerobes and depletes lactobacilli compared to hormonal options in a randomized trial.

Autor: Brown BP; Seattle Children's Research Institute, Seattle, USA. bryan.brown@seattlechildrens.org.; University of Washington, Seattle, USA. bryan.brown@seattlechildrens.org., Feng C; Seattle Children's Research Institute, Seattle, USA., Tanko RF; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.; The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon., Jaumdally SZ; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Bunjun R; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Dabee S; Seattle Children's Research Institute, Seattle, USA.; University of Washington, Seattle, USA.; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Happel AU; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Gasper M; Seattle Children's Research Institute, Seattle, USA.; University of Washington, Seattle, USA., Nyangahu DD; Seattle Children's Research Institute, Seattle, USA.; University of Washington, Seattle, USA., Onono M; Kenya Medical Research Institute, Kisumu, Kenya., Nair G; Desmond Tutu HIV Centre, Cape Town, South Africa., Palanee-Phillips T; Wits Reproductive Health and HIV Institute, Johannesburg, South Africa., Scoville CW; University of Washington, Seattle, USA., Heller K; University of Washington, Seattle, USA., Baeten JM; University of Washington, Seattle, USA.; Gilead Sciences, Inc, Seattle, USA., Bosinger SE; Yerkes National Primate Research Center, Atlanta, USA.; Emory University, Atlanta, USA., Burgener A; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA.; University of Manitoba, Winnipeg, Canada.; Karolinska Institute, Stockholm, Sweden., Passmore JS; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.; National Health Laboratory Service, Cape Town, South Africa., Heffron R; University of Washington, Seattle, USA.; University of Alabama, Birmingham, USA., Jaspan HB; Seattle Children's Research Institute, Seattle, USA. hbjaspan@gmail.com.; University of Washington, Seattle, USA. hbjaspan@gmail.com.; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. hbjaspan@gmail.com.
Jazyk: angličtina
Zdroj: Nature communications [Nat Commun] 2023 Jan 30; Vol. 14 (1), pp. 499. Date of Electronic Publication: 2023 Jan 30.
DOI: 10.1038/s41467-023-36002-4
Abstrakt: Effective contraceptives are a global health imperative for reproductive-aged women. However, there remains a lack of rigorous data regarding the effects of contraceptive options on vaginal bacteria and inflammation. Among 218 women enrolled into a substudy of the ECHO Trial (NCT02550067), we evaluate the effect of injectable intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG), and a copper intrauterine device (Cu-IUD) on the vaginal environment after one and six consecutive months of use, using 16S rRNA gene sequencing and multiplex cytokine assays. Primary endpoints include incident BV occurrence, bacterial diversity, and bacterial and cytokine concentrations. Secondary endpoints are bacterial and cytokine concentrations associated with later HIV seroconversion. Participants randomized to Cu-IUD exhibit elevated bacterial diversity, increased cytokine concentrations, and decreased relative abundance of lactobacilli after one and six months of use, relative to enrollment and other contraceptive options. Total bacterial loads of women using Cu-IUD increase 5.5 fold after six months, predominantly driven by increases in the concentrations of several inflammatory anaerobes. Furthermore, growth of L. crispatus (MV-1A-US) is inhibited by Cu 2+ ions below biologically relevant concentrations, in vitro. Our work illustrates deleterious effects on the vaginal environment induced by Cu-IUD initiation, which may adversely impact sexual and reproductive health.
(© 2023. The Author(s).)
Databáze: MEDLINE
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