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Injectable Contraceptives: Good or Bad?

Explore the effects of Medroxyprogesterone Acetate (MPA) and Norethisterone enanthate (NET) in relation to immune function, HIV susceptibility, and TB infection. Research conducted by SUN Immunology Research Group at Stellenbosch University reveals potential implications of injectable contraceptives. MPA alters immune cell functioning, increases HIV risk, and correlates with TB infection rates. Mouse studies indicate higher bacterial loads in the lungs of MPA-treated subjects. Contrarily, NET shows no significant immune function impact. Are injectable contraceptives beneficial or harmful? Findings shed light on immune responses to contraceptive usage.

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Injectable Contraceptives: Good or Bad?

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  1. Injectable contraceptives: Good or Bad? SUN Immunology Research Group SUN Immunology Research Group LéanieKleynhans Supervisor: Dr Katharina Ronacher Department of Biomedical Sciences University of Stellenbosch

  2. MPA (Medroxyprogesterone Acetate) R6,03 • 3 months injectable contraceptive SUN Immunology Research Group (Medroxyprogesterone Acetate)

  3. Medroxyprogesterone Acetate NET • 2 months injectable contraceptive R12,91 SUN Immunology Research Group (Norethisteroneenanthate)

  4. What do we know about MPA? • Makes women more prone to HIV • Increased number of HIV viruses in vagina • Increases risk of spreading HIV to male partners • Functions in similar way as the stress hormone cortisol SUN Immunology Research Group

  5. MPA most commonly used contraceptive in areas with high TB infection rates SUN Immunology Research Group Contraceptives used in TB household contacts Ravensmead/Uitsig, Cape Town

  6. Our study • MPA and TB-causing bacteria added to blood in artificial system. • Extracted blood from MPA users and non-contraceptive users. Added TB-causing bacteria. • 3 Injected MPA and TB-causing bacteria into mice to investigated the development disease. MPA SUN Immunology Research Group vs MPA

  7. 1. MPA alters the functioning of immune cells HUMAN STUDY: MPA Levels of immune “messengers” SUN Immunology Research Group Expression level (Kleynhanset al. 2011 PLoS ONE 6:e24639)

  8. 2. MPA-use alters functioning of immune cells in women using this contraceptive Levels of immune “messengers” Expression level SUN Immunology Research Group MPA vs (Kleynhanset al. 2011 PLoS ONE 6:e24639)

  9. Monocytes Group: p = 0.0033 Time: p = 0.1638 0.83 0.82 0.81 0.80 0.79 0.78 0.77 0.76 0.75 0.74 MPAusers 0.73 Controls R F6 F18 Time point 3. MPA users have lower levels of immune cells called monocytes log10 Monocytes Immune cells: monocytes SUN Immunology Research Group MPA Cell numbers vs Time (Kleynhanset al. 2011 PLoS ONE 6:e24639)

  10. MOUSE STUDY: Collect lung tissue 8 weeks 3 weeks 16 weeks SUN Immunology Research Group Day 8: TB Infection Day 1: MPA

  11. 4. Mice injected with MPA and TB bacteria have more bacteria in their lungs Bacteria in lungs TB TB + MPA SUN Immunology Research Group Bacterial load

  12. Does NET alter the functioning of immune cells? NET Levels of immune “messengers” SUN Immunology Research Group Expression level

  13. Take home message… • MPA limits normal functioning of certain immune cells • MPA users have lower levels of the immune cells called monocytes • Mice injected with MPA have more bacteria in their lungs than untreated mice • NET does not limit immune functions SUN Immunology Research Group Are injectable contraceptives good or bad?

  14. Acknowledgements Collaborators at UCT Prof Muazzam Jacobs DrNasiema Allie DrPetrusSteyn Funding National Research Foundation Harry Crossley South Africa TB AIDS Training Program (SATBAT) KwaZulu-Natal Research Institute for TB-HIV (K-RITH) Bill and Melinda Gates Foundation Dr Katharina Ronacher Prof Gerhard Walzl SUN Immunology Research Group Nelita du Plessis Lizaan Ehlers Prof Martin Kidd

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