{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:25:39Z","timestamp":1763058339282,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Problem<\/jats:title><jats:p>Injectable contraceptive use may impact immune cell responsiveness and susceptibility to infection. We measured responsiveness of T\u2010cells from women before and after initiating depot medroxyprogesterone acetate (DMPA) or norethisterone enanthate (Net\u2010En).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>Peripheral blood mononuclear cells collected from women aged 18\u201034\u00a0years prior to, at steady state, and nadir concentrations after initiating DMPA (n\u00a0=\u00a030) or Net\u2010En (n\u00a0=\u00a036) and from women initiating copper intrauterine device (CU\u2010IUD; n\u00a0=\u00a032) were stimulated with phorbol myristate acetate and analyzed using flow cytometry. We evaluated percentage change in T\u2010cells expressing programmed cell death\u20101 (PD\u20101) and cytotoxic T\u2010lymphocyte associated protein\u20104 (CTLA\u20104).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to baseline, there were decreased numbers of CD4+CTLA4+ (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and CD8+CTLA4+ (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01) T\u2010cells following ex vivo stimulation challenge at steady state DMPA concentrations and no differences at nadir concentrations (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.781 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.463, respectively). In Net\u2010En users, no differences in CD4+CTLA4+ T\u2010cells at steady state (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.087) and nadir concentrations (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.217) were observed. DMPA users had fewer CD4+PD\u20101+ (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and CD8+PD\u20101+ (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) T\u2010cells at nadir concentrations. Number of CD4+PD\u20101+ and CD8+PD\u20101+ T\u2010cells decreased at steady state concentration (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001, respectively) and at nadir concentrations after Net\u2010En initiation (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). In CU\u2010IUD users, there were no changes in number of CD4+CTLA4+ (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.426) and CD8+CTLA4+ (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.169) and no changes in CD4+PD\u20101+ (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.083) and CD8+PD\u20101+ (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.936) compared to baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Activation of T\u2010cells in response to ex vivo stimulation is suppressed at steady state DMPA concentration and resolves at nadir concentration, suggesting DMPA immunosuppressive effects may be transient.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13210","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T01:35:18Z","timestamp":1573781718000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Depot medroxyprogesterone acetate and norethisterone enanthate differentially impact T\u2010cell responses and expression of immunosuppressive markers"],"prefix":"10.1111","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5361-7686","authenticated-orcid":false,"given":"Allen","family":"Matubu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Sciences\u2010Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon L.","family":"Hillier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Reproductive Sciences School of Medicine University of Pittsburgh Pittsburgh PA USA"},{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie A.","family":"Meyn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Reproductive Sciences School of Medicine University of Pittsburgh Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin A.","family":"Stoner","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Mhlanga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Sciences\u2010Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Mbizvo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Sciences\u2010Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Maramba","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zvavahera M.","family":"Chirenje","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Sciences\u2010Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-8262","authenticated-orcid":false,"given":"Sharon L.","family":"Achilles","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Reproductive Sciences School of Medicine University of Pittsburgh Pittsburgh PA USA"},{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"UNAIDS.Latest global and regional statistics on the status of the AIDS epidemic\u2010Factsheet 2017;www.unaids.org\/en\/resources\/fact-sheet. 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