Limits...
The Contribution of Cervicovaginal Infections to the Immunomodulatory Effects of Hormonal Contraception.

Fichorova RN, Chen PL, Morrison CS, Doncel GF, Mendonca K, Kwok C, Chipato T, Salata R, Mauck C - MBio (2015)

Bottom Line: In women with a normal Nugent score and no genital infection, compared to the no-HC group, COC users showed higher levels of IL-1β, IL-6, IL-8, and IL-1RA, while DMPA users showed higher levels of RANTES and lower levels of BD2, both associated with HIV seroconversion.The effect of DMPA was exacerbated by lower levels of IL-1RA in gonorrhea, chlamydia, or herpes, SLPI in gonorrhea, and IL-1β, MIP-3α, and IL-1RA/IL1β ratio in trichomoniasis.A high prevalence of asymptomatic infections among HC users that remain undiagnosed and untreated raises even more concerns in light of their combined effects on biomarkers of HIV risk.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA rfichorova@rics.bwh.harvard.edu.

No MeSH data available.


Related in: MedlinePlus

Combined effects of cervicovaginal infections (CVIs) and hormonal contraception (HC) on markers of cervical immunity. Women were stratified by CVI status and HC use within each CVI stratum, and levels of immune biomarkers were compared by multivariable analysis via generalized linear models and Wilcoxon tests after adjustment for other individual CVIs. Bars represent the differences between the average concentrations calculated for each of the combined CVI-plus-HC category listed on the left and the average concentration calculated for the physiologic CVI-free no-HC baseline (15 women who were infection free, had a normal Nugent score, and who did not use any HC). Consequently, the CVI-free, no-HC baseline average was set to 0 in each bar plot. P values with asterisks (*, P < 0.05; **, P < 0.01; and ***, P < 0.001) signify differences between no-HC and combined oral contraceptive (COC) or DMPA users within each CVI stratum. P values with plus signs (+,P < 0.05; ++, P < 0.01; and +++, P < 0.001) signify differences between each CVI-positive group and the CVI-free group matched by HC (e.g., no-HC, COC, and DMPA). The P values for the two comparisons and the number of women in each group are shown in Tables S1 and S2 in the supplemental material.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4556810&req=5

fig2: Combined effects of cervicovaginal infections (CVIs) and hormonal contraception (HC) on markers of cervical immunity. Women were stratified by CVI status and HC use within each CVI stratum, and levels of immune biomarkers were compared by multivariable analysis via generalized linear models and Wilcoxon tests after adjustment for other individual CVIs. Bars represent the differences between the average concentrations calculated for each of the combined CVI-plus-HC category listed on the left and the average concentration calculated for the physiologic CVI-free no-HC baseline (15 women who were infection free, had a normal Nugent score, and who did not use any HC). Consequently, the CVI-free, no-HC baseline average was set to 0 in each bar plot. P values with asterisks (*, P < 0.05; **, P < 0.01; and ***, P < 0.001) signify differences between no-HC and combined oral contraceptive (COC) or DMPA users within each CVI stratum. P values with plus signs (+,P < 0.05; ++, P < 0.01; and +++, P < 0.001) signify differences between each CVI-positive group and the CVI-free group matched by HC (e.g., no-HC, COC, and DMPA). The P values for the two comparisons and the number of women in each group are shown in Tables S1 and S2 in the supplemental material.

Mentions: The concentrations of each biomarker in no-HC users stratified by CVI are shown in Table S2 in the supplemental material. To illustrate the combined effect of CVIs and HCs, we used the average of the CVI-free no-HC group as a baseline and calculated differences between this baseline and each combination of CVI with no-HC, DMPA, or COC (Fig. 2).


The Contribution of Cervicovaginal Infections to the Immunomodulatory Effects of Hormonal Contraception.

Fichorova RN, Chen PL, Morrison CS, Doncel GF, Mendonca K, Kwok C, Chipato T, Salata R, Mauck C - MBio (2015)

Combined effects of cervicovaginal infections (CVIs) and hormonal contraception (HC) on markers of cervical immunity. Women were stratified by CVI status and HC use within each CVI stratum, and levels of immune biomarkers were compared by multivariable analysis via generalized linear models and Wilcoxon tests after adjustment for other individual CVIs. Bars represent the differences between the average concentrations calculated for each of the combined CVI-plus-HC category listed on the left and the average concentration calculated for the physiologic CVI-free no-HC baseline (15 women who were infection free, had a normal Nugent score, and who did not use any HC). Consequently, the CVI-free, no-HC baseline average was set to 0 in each bar plot. P values with asterisks (*, P < 0.05; **, P < 0.01; and ***, P < 0.001) signify differences between no-HC and combined oral contraceptive (COC) or DMPA users within each CVI stratum. P values with plus signs (+,P < 0.05; ++, P < 0.01; and +++, P < 0.001) signify differences between each CVI-positive group and the CVI-free group matched by HC (e.g., no-HC, COC, and DMPA). The P values for the two comparisons and the number of women in each group are shown in Tables S1 and S2 in the supplemental material.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556810&req=5

fig2: Combined effects of cervicovaginal infections (CVIs) and hormonal contraception (HC) on markers of cervical immunity. Women were stratified by CVI status and HC use within each CVI stratum, and levels of immune biomarkers were compared by multivariable analysis via generalized linear models and Wilcoxon tests after adjustment for other individual CVIs. Bars represent the differences between the average concentrations calculated for each of the combined CVI-plus-HC category listed on the left and the average concentration calculated for the physiologic CVI-free no-HC baseline (15 women who were infection free, had a normal Nugent score, and who did not use any HC). Consequently, the CVI-free, no-HC baseline average was set to 0 in each bar plot. P values with asterisks (*, P < 0.05; **, P < 0.01; and ***, P < 0.001) signify differences between no-HC and combined oral contraceptive (COC) or DMPA users within each CVI stratum. P values with plus signs (+,P < 0.05; ++, P < 0.01; and +++, P < 0.001) signify differences between each CVI-positive group and the CVI-free group matched by HC (e.g., no-HC, COC, and DMPA). The P values for the two comparisons and the number of women in each group are shown in Tables S1 and S2 in the supplemental material.
Mentions: The concentrations of each biomarker in no-HC users stratified by CVI are shown in Table S2 in the supplemental material. To illustrate the combined effect of CVIs and HCs, we used the average of the CVI-free no-HC group as a baseline and calculated differences between this baseline and each combination of CVI with no-HC, DMPA, or COC (Fig. 2).

Bottom Line: In women with a normal Nugent score and no genital infection, compared to the no-HC group, COC users showed higher levels of IL-1β, IL-6, IL-8, and IL-1RA, while DMPA users showed higher levels of RANTES and lower levels of BD2, both associated with HIV seroconversion.The effect of DMPA was exacerbated by lower levels of IL-1RA in gonorrhea, chlamydia, or herpes, SLPI in gonorrhea, and IL-1β, MIP-3α, and IL-1RA/IL1β ratio in trichomoniasis.A high prevalence of asymptomatic infections among HC users that remain undiagnosed and untreated raises even more concerns in light of their combined effects on biomarkers of HIV risk.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA rfichorova@rics.bwh.harvard.edu.

No MeSH data available.


Related in: MedlinePlus