Changes in genital tract immune cell populations after initiation of intrauterine contraception

Sharon L. Achilles, Mitchell D Creinin, Kevin A. Stoner, Beatrice A. Chen, Leslie Meyn, Sharon L. Hillier

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE: The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.

STUDY DESIGN: Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.

RESULTS: Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.

CONCLUSION: Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume211
Issue number5
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Fingerprint

Intrauterine Devices
Contraception
HIV
Population
T-Lymphocytes
Levonorgestrel
Copper Intrauterine Devices
Virus Diseases
Endometrium
Cervix Uteri
Flow Cytometry
Cell Count
Students

Keywords

  • CCR5
  • HIV
  • hormonal contraception
  • IUD
  • T cell

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Changes in genital tract immune cell populations after initiation of intrauterine contraception. / Achilles, Sharon L.; Creinin, Mitchell D; Stoner, Kevin A.; Chen, Beatrice A.; Meyn, Leslie; Hillier, Sharon L.

In: American Journal of Obstetrics and Gynecology, Vol. 211, No. 5, 01.11.2014.

Research output: Contribution to journalArticle

Achilles, Sharon L. ; Creinin, Mitchell D ; Stoner, Kevin A. ; Chen, Beatrice A. ; Meyn, Leslie ; Hillier, Sharon L. / Changes in genital tract immune cell populations after initiation of intrauterine contraception. In: American Journal of Obstetrics and Gynecology. 2014 ; Vol. 211, No. 5.
@article{271a951e4ac54d9fa3c46ec750483bd4,
title = "Changes in genital tract immune cell populations after initiation of intrauterine contraception",
abstract = "OBJECTIVE: The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.STUDY DESIGN: Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.RESULTS: Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.CONCLUSION: Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.",
keywords = "CCR5, HIV, hormonal contraception, IUD, T cell",
author = "Achilles, {Sharon L.} and Creinin, {Mitchell D} and Stoner, {Kevin A.} and Chen, {Beatrice A.} and Leslie Meyn and Hillier, {Sharon L.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1016/j.ajog.2014.05.016",
language = "English (US)",
volume = "211",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Changes in genital tract immune cell populations after initiation of intrauterine contraception

AU - Achilles, Sharon L.

AU - Creinin, Mitchell D

AU - Stoner, Kevin A.

AU - Chen, Beatrice A.

AU - Meyn, Leslie

AU - Hillier, Sharon L.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - OBJECTIVE: The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.STUDY DESIGN: Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.RESULTS: Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.CONCLUSION: Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.

AB - OBJECTIVE: The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.STUDY DESIGN: Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.RESULTS: Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.CONCLUSION: Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.

KW - CCR5

KW - HIV

KW - hormonal contraception

KW - IUD

KW - T cell

UR - http://www.scopus.com/inward/record.url?scp=84964315226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964315226&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2014.05.016

DO - 10.1016/j.ajog.2014.05.016

M3 - Article

C2 - 24834865

AN - SCOPUS:84908349587

VL - 211

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 5

ER -