Effects of the levonorgestrel-releasing intrauterine device on the immune microenvironment of the human cervix and endometrium

Am J Reprod Immunol. 2016 Aug;76(2):137-48. doi: 10.1111/aji.12535.

Abstract

Problem: There is little information regarding the impact of the intrauterine device on immune parameters of the upper female reproductive tract related to risk of HIV acquisition.

Method of study: We collected cervical and endometrial samples from women using the hormonal intrauterine device to study its effects on endocervical cytokines/chemokine concentrations, phenotypic markers of T cells, responses of endometrial T cells to activation, and alterations of endometrial cellular infiltrates.

Results: Hormonal intrauterine device use was associated with: increased concentrations of inflammatory cytokines/chemokines (endocervix); increased coexpression of CXCR4 and CCR5 (endocervix and endometrium); increased coexpression of CD38 and HLADR (endocervix and endometrium); increased intracellular IL-10 production after T-cell stimulation (endometrium); and increased density of T cells, most notably regulatory T cells (endometrium).

Conclusion: Hormonal intrauterine device use resulted in both inflammatory and immunosuppressive alterations. Further research is needed to determine the significance of these changes for HIV risk.

Keywords: HIV; IUD; T-cell; chemokine; cytokine; progestin.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cervix Uteri / immunology*
  • Cross-Sectional Studies
  • Drug Delivery Systems / adverse effects*
  • Endometrium / immunology*
  • Female
  • HIV Infections / immunology
  • HLA-DR Antigens / immunology
  • Humans
  • Interleukin-10 / immunology
  • Levonorgestrel / administration & dosage*
  • Levonorgestrel / adverse effects
  • Middle Aged
  • Receptors, CCR4 / immunology
  • Receptors, CCR5 / immunology
  • Risk Factors
  • T-Lymphocytes / immunology

Substances

  • CCR4 protein, human
  • CCR5 protein, human
  • HLA-DR Antigens
  • IL10 protein, human
  • Receptors, CCR4
  • Receptors, CCR5
  • Interleukin-10
  • Levonorgestrel