EFFECT OF DEPOT MEDOXYPROGESTERONE ACETATE ON IMMUNE FUNCTIONS AND INFLAMMATORY MARKERS OF HIV-INFECTED WOMEN
Identifieur interne : 001101 ( Main/Curation ); précédent : 001100; suivant : 001102EFFECT OF DEPOT MEDOXYPROGESTERONE ACETATE ON IMMUNE FUNCTIONS AND INFLAMMATORY MARKERS OF HIV-INFECTED WOMEN
Auteurs : Adriana Weinberg [États-Unis] ; Jeong-Gun Park [États-Unis] ; Ronald Bosch [États-Unis] ; Alice Cho [États-Unis] ; Elizabeth Livingston [États-Unis] ; Fran Aweeka [États-Unis] ; Yoninah Cramer [États-Unis] ; D. Heather Watts [États-Unis] ; Amneris E. Luque [États-Unis] ; Susan E. Cohn [États-Unis]Source :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2016.
Abstract
Depot medroxyprogesterone acetate (DMPA) was associated with increased HIV transmission and accelerated disease progression in untreated women. The potential underlying mechanisms include immune-modulation. We evaluated the effect of a single DMPA injection on cell-mediated immunity (CMI), T cell activation (Tact), regulation (Treg) and inflammation in HIV-infected women on cART.
Women with HIV plasma RNA ≤400 c/mL on stable cART received DMPA and had immunologic and MPA measurements at baseline, 4 weeks [peak MPA concentration (Cmax)] and 12 weeks [highest MPA area under the concentration curve (AUC)].
At baseline, among 24 women with median 32 years of age and 622 CD4+ cells/μL, ≥68% had HIV, VZV, PHA and CD3/CD28 CMI measured by lymphocyte proliferation and/or IFNγ/IL2 dual-color fluorospot. CMI did not significantly change after DMPA administration except for a 1.4-fold increase in IL2/IFNγ VZV fluorospot at week 12. Tact decreased after DMPA administration, reaching statistical significance at week 12 for CD4+CD25+%. Treg behaved heterogeneously with an increase in CD8+FOXP3+% at week 4 and a decrease in CD4+IL35+% at week 12. There was a decrease in TGFβ at week 12 and no other changes in plasma biomarkers. Correlation analyses showed that high MPA Cmax and/or AUC were significantly associated with increases of IFNγ HIV ELISPOT, CD4+IL35+% and CD4+TGFβ+% Treg and decreases of plasma IL10 from baseline to weeks 4 and/or 12.
A single dose of DMPA did not have immune-suppressive or pro-inflammatory effects in HIV-infected women on cART. Additional studies need to assess the effect of multiple doses.
Url:
DOI: 10.1097/QAI.0000000000000850
PubMed: 26413850
PubMed Central: 4712075
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type="state">Colorado</region></placeName><wicri:cityArea>University of Colorado Denver Anschutz Medical Center, Aurora</wicri:cityArea></affiliation></author><author><name sortKey="Park, Jeong Gun" sort="Park, Jeong Gun" uniqKey="Park J" first="Jeong-Gun" last="Park">Jeong-Gun Park</name><affiliation wicri:level="2"><nlm:aff id="A2">Statistical and Data Analysis Center, Harvard School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Statistical and Data Analysis Center, Harvard School of Public Health, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Bosch, Ronald" sort="Bosch, Ronald" uniqKey="Bosch R" first="Ronald" last="Bosch">Ronald Bosch</name><affiliation wicri:level="2"><nlm:aff id="A2">Statistical and Data Analysis Center, Harvard School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Statistical and Data Analysis Center, Harvard School of Public Health, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Cho, Alice" sort="Cho, Alice" uniqKey="Cho A" first="Alice" last="Cho">Alice Cho</name><affiliation wicri:level="2"><nlm:aff id="A1">University of Colorado Denver Anschutz Medical Center, Aurora, CO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Colorado</region></placeName><wicri:cityArea>University of Colorado Denver Anschutz Medical Center, Aurora</wicri:cityArea></affiliation></author><author><name sortKey="Livingston, Elizabeth" sort="Livingston, Elizabeth" uniqKey="Livingston E" first="Elizabeth" last="Livingston">Elizabeth Livingston</name><affiliation wicri:level="2"><nlm:aff id="A3">Duke University Medical Center, Durham, NC</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke University Medical Center, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Aweeka, Fran" sort="Aweeka, Fran" uniqKey="Aweeka F" first="Fran" last="Aweeka">Fran Aweeka</name><affiliation wicri:level="2"><nlm:aff id="A4">University of California, San Francisco, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Cramer, Yoninah" sort="Cramer, Yoninah" uniqKey="Cramer Y" first="Yoninah" last="Cramer">Yoninah Cramer</name><affiliation wicri:level="2"><nlm:aff id="A2">Statistical and Data Analysis Center, Harvard School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Statistical and Data Analysis Center, Harvard School of Public Health, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Watts, D Heather" sort="Watts, D Heather" uniqKey="Watts D" first="D. Heather" last="Watts">D. Heather Watts</name><affiliation wicri:level="2"><nlm:aff id="A5">Office of the Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>Office of the Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Luque, Amneris E" sort="Luque, Amneris E" uniqKey="Luque A" first="Amneris E." last="Luque">Amneris E. Luque</name><affiliation wicri:level="2"><nlm:aff id="A6">University of Rochester School of Medicine and Dentistry, Rochester, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Cohn, Susan E" sort="Cohn, Susan E" uniqKey="Cohn S" first="Susan E." last="Cohn">Susan E. Cohn</name><affiliation wicri:level="2"><nlm:aff id="A7">Northwestern University Feinberg School of Medicine, Chicago, IL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">Depot medroxyprogesterone acetate (DMPA) was associated with increased HIV transmission and accelerated disease progression in untreated women. The potential underlying mechanisms include immune-modulation. We evaluated the effect of a single DMPA injection on cell-mediated immunity (CMI), T cell activation (Tact), regulation (Treg) and inflammation in HIV-infected women on cART.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Women with HIV plasma RNA ≤400 c/mL on stable cART received DMPA and had immunologic and MPA measurements at baseline, 4 weeks [peak MPA concentration (Cmax)] and 12 weeks [highest MPA area under the concentration curve (AUC)].</p></sec><sec id="S3"><title>Results</title><p id="P3">At baseline, among 24 women with median 32 years of age and 622 CD4+ cells/μL, ≥68% had HIV, VZV, PHA and CD3/CD28 CMI measured by lymphocyte proliferation and/or IFNγ/IL2 dual-color fluorospot. CMI did not significantly change after DMPA administration except for a 1.4-fold increase in IL2/IFNγ VZV fluorospot at week 12. Tact decreased after DMPA administration, reaching statistical significance at week 12 for CD4+CD25+%. Treg behaved heterogeneously with an increase in CD8+FOXP3+% at week 4 and a decrease in CD4+IL35+% at week 12. There was a decrease in TGFβ at week 12 and no other changes in plasma biomarkers. Correlation analyses showed that high MPA Cmax and/or AUC were significantly associated with increases of IFNγ HIV ELISPOT, CD4+IL35+% and CD4+TGFβ+% Treg and decreases of plasma IL10 from baseline to weeks 4 and/or 12.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">A single dose of DMPA did not have immune-suppressive or pro-inflammatory effects in HIV-infected women on cART. Additional studies need to assess the effect of multiple doses.</p></sec></div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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