title: Effects of the levonorgestrel-releasing intrauterine device on the immune microenvironment of the human cervix and endometrium.
abstract: There is little information regarding the impact of the intrauterine device on immune parameters of the upper female reproductive tract related to risk of HIV acquisition.
  
  
  
  We collected cervical and endometrial samples from women using the hormonal intrauterine device to study its effects on endocervical cytokines/chemokine concentrations, phenotypic markers of T cells, responses of endometrial T cells to activation, and alterations of endometrial cellular infiltrates.
  
  
  
  Hormonal intrauterine device use was associated with: increased concentrations of inflammatory cytokines/chemokines (endocervix); increased coexpression of CXCR4 and CCR5 (endocervix and endometrium); increased coexpression of CD38 and HLADR (endocervix and endometrium); increased intracellular IL-10 production after T-cell stimulation (endometrium); and increased density of T cells, most notably regulatory T cells (endometrium).
  
  
  
  Hormonal intrauterine device use resulted in both inflammatory and immunosuppressive alterations. Further research is needed to determine the significance of these changes for HIV risk.
authors.affiliation: Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA.
authors.forename: Uma
authors.initials: U
authors.lastname: Shanmugasundaram
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: Joan F
authors.initials: JF
authors.lastname: Hilton
authors.affiliation: Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA.
authors.forename: J William
authors.initials: JW
authors.lastname: Critchfield
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.|Departments of Clinical Pharmacy and Medicine, University of California, San Francisco, CA, USA.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Giudice
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Averbach
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Dominika
authors.initials: D
authors.lastname: Seidman
authors.affiliation: Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Shacklett
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Smith-McCune
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000276:immunology*; D003430:Cross-Sectional Studies; D016503:Drug Delivery Systems / Q000009:adverse effects*; D004717:Endometrium / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D016753:Interleukin-10 / Q000276:immunology; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D054398:Receptors, CCR4 / Q000276:immunology; D019713:Receptors, CCR5 / Q000276:immunology; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: C515354:CCR4 protein, human; C584933:CCR5 protein, human; D006684:HLA-DR Antigens; C508609:IL10 protein, human; D054398:Receptors, CCR4; D019713:Receptors, CCR5; D016753:Interleukin-10; D016912:Levonorgestrel
keywords: HIV; IUD; T-cell; chemokine; cytokine; progestin