title: Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.
abstract: BACKGROUND
  Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms.
  
  
  METHODS
  Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated.
  
  
  RESULTS
  Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively.
  
  
  CONCLUSIONS
  We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.
authors: Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, 10461, United States of America and Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, 10461, United States of America.
authors: Susan C
authors: SC
authors: Irvin
authors: Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, 10461, United States of America and Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, 10461, United States of America.
authors: Betsy C
authors: BC
authors: Herold
mesh_terms: D002460:Cell Line; D049109:Cell Proliferation / Q000187:drug effects; D003271:Contraceptive Agents, Female / Q000009:adverse effects* / Q000494:pharmacology; D016207:Cytokines / Q000276:immunology; D004847:Epithelial Cells / Q000187:drug effects* / Q000821:virology; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D016655:HIV Core Protein p24 / Q000378:metabolism; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D019169:Jurkat Cells; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects* / Q000494:pharmacology; D012307:Risk Factors; D015854:Up-Regulation; D014621:Vagina / Q000166:cytology
chemical_list: D003271:Contraceptive Agents, Female; D016207:Cytokines; D016655:HIV Core Protein p24; D017258:Medroxyprogesterone Acetate