Hormonal contraception alters vaginal microbiota and cytokines in South African adolescents in a randomized trial.
Hormonal contraception alters vaginal microbiota and cytokines in South African adolescents in a randomized trial.
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激素避孕改变南非青少年阴道微生物群和细胞因子的随机试验
DOI：
10.1038/s41467-020-19382-9
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发表时间：
2020-11-04
影响因子：
16.6
通讯作者：
Jaspan HB
中科院分区：
文献类型：
--
作者：
Balle C;Konstantinus IN;Jaumdally SZ;Havyarimana E;Lennard K;Esra R;Barnabas SL;Happel AU;Moodie Z;Gill K;Pidwell T;Karaoz U;Brodie E;Maseko V;Gamieldien H;Bosinger SE;Myer L;Bekker LG;Passmore JS;Jaspan HB
撒哈拉以南非洲的年轻妇女受到艾滋病毒感染和意外怀孕的严重影响。然而，激素避孕药（HC）的使用可能会通过生殖道微生物群和炎症细胞因子的变化影响艾滋病毒的风险。为了调查这一点，130名15-19岁的HIV阴性青少年女性被纳入UChoose的子研究，这是一项开放标签随机交叉研究（NCT 02404038），比较可接受性和避孕产品偏好作为HIV预防分娩方法的代表。参与者被随机分配到注射型炔诺酮庚酸酯（Net-En），联合口服避孕药（COC）或依托孕甾醇/炔雌醇联合避孕阴道环（CCVR）16周，然后交叉到另一个HC 16周。在基线、交叉和退出时收集宫颈阴道样品，用于表征微生物群和测量细胞因子水平;主要终点是宫颈T细胞活化、阴道微生物多样性和细胞因子浓度。与Net-En或CCVR相比，随机分配到COCs的青少年阴道微生物多样性较低，HIV风险相关分类群相对丰富。与COC和Net-En相比，随机分配至CCVR组的青少年宫颈阴道炎性细胞因子浓度显著更高。这表明COC的使用可能通过减少细菌多样性和炎症分类群来诱导最佳的阴道生态系统，而CCVR的使用与生殖器炎症有关。激素避孕可能会改变妇女对艾滋病毒的易感性。在这里，作者报告了一项随机临床试验子研究的结果，评估了注射用Net-En，口服避孕药（COC）和Nuvaring对阴道微生物群和细胞因子的影响，将COC与较低的微生物多样性和Nuvaring与炎症增加联系起来。
Young women in sub-Saharan Africa are disproportionally affected by HIV infection and unintended pregnancies. However, hormonal contraceptive (HC) use may influence HIV risk through changes in genital tract microbiota and inflammatory cytokines. To investigate this, 130 HIV negative adolescent females aged 15–19 years were enrolled into a substudy of UChoose, an open-label randomized crossover study (NCT02404038), comparing acceptability and contraceptive product preference as a proxy for HIV prevention delivery methods. Participants were randomized to injectable norethisterone enanthate (Net-En), combined oral contraceptives (COC) or etonorgesterol/ethinyl estradiol combined contraceptive vaginal ring (CCVR) for 16 weeks, then crossed over to another HC for 16 weeks. Cervicovaginal samples were collected at baseline, crossover and exit for characterization of the microbiota and measurement of cytokine levels; primary endpoints were cervical T cell activation, vaginal microbial diversity and cytokine concentrations. Adolescents randomized to COCs had lower vaginal microbial diversity and relative abundance of HIV risk-associated taxa compared to Net-En or CCVR. Cervicovaginal inflammatory cytokine concentrations were significantly higher in adolescents randomized to CCVR compared to COC and Net-En. This suggests that COC use may induce an optimal vaginal ecosystem by decreasing bacterial diversity and inflammatory taxa, while CCVR use is associated with genital inflammation. Hormonal contraception may alter women’s susceptibility to HIV. Here, the authors report the results of a randomized clinical trial substudy assessing the effects of injectable Net-En, oral contraceptives (COC) and Nuvaring on vaginal microbiota and cytokines, associating COC with lower microbial diversity and Nuvaring with increased inflammation.
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影响因子：
3.7
作者：
Crucitti T;Hardy L;van de Wijgert J;Agaba S;Buyze J;Kestelyn E;Delvaux T;Mwambarangwe L;De Baetselier I;Jespers V;Ring Plus study group
通讯作者：
Ring Plus study group
影响因子：
4.4
作者：
Fettweis JM;Serrano MG;Sheth NU;Mayer CM;Glascock AL;Brooks JP;Jefferson KK;Vaginal Microbiome Consortium (additional members);Buck GA
通讯作者：
Buck GA
影响因子：
2.6
作者：
Farage, Miranda;Maibach, Howard
通讯作者：
Maibach, Howard
影响因子：
17.1
作者：
Gajer P;Brotman RM;Bai G;Sakamoto J;Schütte UM;Zhong X;Koenig SS;Fu L;Ma ZS;Zhou X;Abdo Z;Forney LJ;Ravel J
通讯作者：
Ravel J
影响因子：
168.9
作者：
Baeten, Jared M.;Donnell, Deborah;Stringer, Jeffrey
通讯作者：
Stringer, Jeffrey