Effect of contraceptive methods on the vaginal microbiome and host immune factors

作者：Myrna G. Serrano, David Edwards, Khatija Ahmed, Veronique Bailey, Mags Beksinska, Laahirie Edupuganti, Rushil Harryparsad, Florence Lefebvre d’Hellencourt, Bahiah Meyer, Celia Mehou‐Loko, Nina Radzey, Ongeziwe Taku, Anna‐Lise Williamson, Jennifer Smit, Katherine M. Spaine, Bin Zhu, Kimberly K. Jefferson, Kavita Nanda, Jerome F. Strauss, Charles Morrison, Jennifer Deese, Lindi Masson, Gregory A. Buck · 发表于：Contraception · 年份：2025 · DOI：10.1016/j.contraception.2025.110936 · 被引用次数：8 · 研究领域：Reproductive tract infections research、Reproductive Health and Contraception、Urinary Tract Infections Management

OBJECTIVE: The objective of this study was to assess alterations in vaginal microbiota and immune markers over the first 3 months following initiation of copper intrauterine device (copper IUD), levonorgestrel (LNG) implant, and intramuscular depot medroxyprogestone acetate (DMPA-IM). STUDY DESIGN: We included 162 participants from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial, which enrolled healthy, HIV-negative women seeking contraception and randomized them to a copper IUD, LNG implant, or DMPA-IM. Microbiome and immune profiles in vaginal swab samples collected at enrollment, 1 month and 3 months were analyzed. We categorized microbiome profiles as ''optimal'', ''intermediate'', or ''non-optimal'' based on established criteria [1]. We compared microbiome and immune markers across contraceptive groups and evaluated changes to 1 and 3 months. RESULTS: Copper IUD users had a more diverse vaginal microbiome and generally increased inflammatory cytokines and antimicrobial peptides over the 3-month follow-up, compared to LNG-implant and DMPA-IM users [2]. LNG-implant users had less complex vaginal microbiomes with reduced inflammation, while DMPA-IM showed little change in either microbiome composition or inflammatory markers. Copper IUD users exhibited lower microbiome stability and a higher likelihood of transitioning to less optimal profiles. In contrast, LNG-implant users showed greater stability and a higher probability of transition to optimal micr...