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Genital colonization by Actinomyces israelii and serologic immune response to the bacterium after five years use of the same copper intra-uterine device.

An increased risk of developing genital actinomycosis has been found with long-term use of IUDs. In this study a group of women who had used their IUDs for 60 +/- 6 months was compared with a group having worn their IUDs for 36 +/- 6 months. None of the women examined had symptoms of genital infection. No significant differences could be found in colonization frequency of A. israelii on the IUDs or in humoral antibody response to the bacterium.

Actinomycosis↗

Hormonal contraception for human males: prospects.

Development of an ideal hormonal contraceptive for man has been the goal of several research workers during the past few decades. Suppression of pituitary gonadotropic hormones, which in turn would inhibit spermatogenesis while maintaining normal libido and potential has been the approach for a contraceptive agent. Intramuscularly administered and orally active testosterone or testosterone in combination with progesterone have been shown to cause inhibition of spermatogenesis resulting in azoospermia in normal men. Similarly testosterone has been used in combination with gonadotropin releasing hormone antagonists and agonists to inhibit pituitary gonadotropic hormone release. Immunological approach to neutralize the circulating levels of follicle stimulating hormone has also been shown to cause inhibition of spermatogenesis. The available literature shows that testosterone causes reversible azoospermia without any significant side effects in Asian population effectively and appears to be a promising chemical for control of fertility in man.

Contraception↗

Injectable polymer microspheres enhance immunogenicity of a contraceptive peptide vaccine.

Advanced contraceptive peptide vaccines suffer from the unavailability of adjuvants capable of enhancing the antibody response with acceptable safety. We sought to overcome this limitation by employing two novel poly(lactic-co-glycolic acid) (PLGA) microsphere formulations to deliver a synthetic human chorionic gonadotropin (hCG) peptide antigen co-synthesized with a T-cell epitope from tetanus toxoid (TT), C-TT2-CTP35: surface-conjugated immunogen to induce phagocytosis; and encapsulated peptide to provide a depot effect, with MgCO(3) co-encapsulated in the polymer to neutralize acidity from the biodegrading PLGA polyester. A single immunization of encapsulated peptide in rabbits elicited a stronger antibody response with equivalent duration relative to a positive control--three injections of the peptide administered in a squalene-based water-in-oil emulsion. Surface-conjugated peptide was less effective but enhanced antibody levels at 1/5 the dose, relative to soluble antigen. Most remarkable and unexpected was the finding that co-encapsulation of base was essential to attain the powerful adjuvant effect of the PLGA-MgCO(3) system, as the MgCO(3)-free microspheres were completely ineffective. A promising contraceptive hCG peptide vaccine with acceptable side effects (i.e., local tissue reactions) was achieved by minimizing PLGA and MgCO(3) doses, without significantly affecting antibody response.

Adjuvants, Immunologic↗

Molecular, immunological, enzymatic and biochemical studies of coproporphyrinogen oxidase deficiency in a family with hereditary coproporphyria.

A 27-year-old woman who had recurrent pain in renal bed since 1998 with increasing character, was stationary admitted. The patient showed dark urine, complained of hair loss and took since 1994 a hormonal oral contraceptive. No photosensitivity was observed. Determinations of urinary porphyrin metabolites in 1998 revealed a porphyria cutanea tarda like excretion pattern with elevations of uro- (1767 nmol/24 hr, normal <29 nmol/24 hr) and heptacarboxyporphyrin (568 nmol/24 hr; normal <4 nmol/24 hr). Follow-up studies in feces showed the characteristics of a hereditary coproporphyria with dominance of coproporphyrin isomer III (total= 1470 nmol/g, isomer III= 93%), (normal: <37 nmol/g, isomer III = 25-35%). The excretion of porphyrin precursors (delta-aminolevulinic acid and porphobilinogen) was increased by taking an ethinylestradiol-cyproteronacetate-preparation, but acute and/or chronic manifestations were not observed. Coproporphyrinogen oxidase activity was decreased to 35% in the patient (normal=138+/-21 pkat/g protein; x+/-s), whereas the activity of red cell uroporphyrinogen decarboxylase was normal. Her mother and both sisters could be verified as heterozygous gene carriers of hereditary coproporphyria by their urinary and fecal excretion parameters and because of reduced coproporphyrinogen oxidase activity up to 50%. The father was normal with respect to his genotype. Molecular analysis revealed a hitherto unknown mutation with the transversion of a cytosine to thymine at nucleotide position 854 in exon 4 of the coproporphyrinogen oxidase gene. The gene defect was confirmed by DGGE in the mother and her three daughters. The investigation of the immunological nature of the defective coproporphyrinogen oxidase gene from the whole family revealed decreased concentrations of coproporphyrinogen oxidase protein in the patient, her mother and her two sisters.

Adult↗

IgG subclass distribution of anti-hCG and anti-diphtheria toxoid antibodies in women immunized with a beta-hCG based immunocontraceptive vaccine.

IgG subclass distribution of antibodies against human chorionic gonadotropin (hCG) and diphtheria toxoid (DT) was determined in the sera of women recruited into Phase II clinical trials of a beta-hCG based immunocontraceptive vaccine. Serum samples from 30 different individuals were analyzed. Anti-hCG antibody response was predominantly of IgG1 subclass, with a mean titer of 537.94 +/- 560 antibody units (AU). The other 3 subclasses showed considerably lower mean levels (IgG2, 16.46 +/- 8.33; IgG3, 3.22 +/- 8.48; IgG4, 56.65 +/- 82.60 AU). A good correlation was observed between the anti-hCG IgG1 antibody titers (r = 0.57, P < 0.01) and the bioneutralization capacity of sera. However, bioneutralization capacity of the sera from subjects capable of inducing IgG4 response was not significantly different from subjects not showing IgG4 antibodies. Similarly, a dominant IgG1 response was observed against diphtheria toxoid (DT) which has been used as one of the carrier proteins in the vaccine.

Chorionic Gonadotropin↗

Identification of novel endometrial targets for contraception.

Successful embryo implantation is a critical step in establishing pregnancy and requires appropriate preparation of the endometrium to provide a transient state of "uterine receptivity." The most essential of the molecular events determining receptivity may therefore provide potential targets for postcoital contraception. Using the mouse as a model, we identified molecules specifically regulated in the endometrium at very early implantation: these were monoclonal nonspecific suppressor factor beta (MNSFbeta), splicing factor SC35, a novel protease of the HtrA family, termed HtrA3, calcium-binding protein (CaBP)-d9k (calbindin d9k) and proprotein convertase 6 (PC6). All of these molecules were also expressed in human endometrium, with the exception of CaBP-d9k, which was represented by the functionally similar CaBP-d28k. Appropriate spatial and temporal expressions of mRNA and protein were demonstrated for all five candidate molecules in mouse and primate (human and rhesus monkey) endometrium during the menstrual cycle and early pregnancy. Functional studies in mice established that blocking production of the CaBPs and PC6 within the endometrium completely prevented implantation and thus provided proof of principle that these molecules are potential contraceptive targets.

Animals↗

Natural family planning.

It is now well accepted that a woman can conceive from an act of intercourse for a maximum of only about 7 days of her menstrual cycle. The reliability of natural family planning depends on identifying this window of fertility without ambiguity. Several symptomatic markers, cervical mucus and basal body temperature, have been used extensively and with considerable success in most women but failures occur. Ovarian and pituitary hormone production show characteristic patterns during the cycle. Urinary estrogen and pregnanediol measurements yield reliable information concerning the beginning, peak, and end of the fertile period, provided that the assays are accurate and performed on timed specimens of urine. We have developed such enzyme immunoassays for urinary estrogen and pregnanediol glucuronides that can be performed at home. In the early versions of the assays, enzyme reaction rates were measured by eye, but more recently, a simple photoelectronic rate meter has been used. The final problem to be solved is not technologic but whether women are sufficiently motivated to expend the same time and effort each day for 10 days a month, with less cost, on fertility awareness as they spend on making a cup of tea.

Adult↗

A 15-year followup of a nonmicrosurgical technique for vasovasostomy.

A 15-year followup was summarized for patients who had nonmicrosurgical vasectomy reversal. Over-all pregnancy rates were 45 per cent (43 per cent for the first 8 years and 49 per cent for the next 7 years) and 73 per cent of the pregnancies occurred within 1 year after vasectomy reversal. Patients who achieved pregnancy compared to those who did not had significantly better sperm motility and a lower incidence of antisperm antibodies. The data indicate that nonmicrosurgical techniques can be used successfully to reverse vasectomy more economically and more rapidly than the microsurgical approach, while contributing to a reasonable pregnancy rate.

Female↗

[A new immunochemical tube test for pregnancy, using the principle of the latex-agglutination inhibition reaction. I. Basic studies (author's transl)].

In a joint study of five laboratories the immunochemical tube test for pregnancy 'Roche', which uses the principle of the latex-agglutination inhibition test, was examined. A total of 1117 samples, complemented by a number of laboratory studies, proved that the test is specific, reproducible and low in interference with a sensitivity of 900-1000 U/l HCG. It is a simple test, the results can be easily read after 90 minutes. pH of the urine sample, protein, urea or calcium content, presence of oral contraceptives, detergents, disinfectants or organic solvents cause no or very little interference.

Calcium↗

Palmar eczema: a pathogenetic role for acetylsalicylic acid, contraceptives and smoking?

A statistical study of the relationship between vesicular palmar eczema and various clinical variables was carried out. Vesicular palmar eczema was found in 153 cases (38%), thereof 113 females (76%). Ninety-two percent of all found cases could be regarded as pompholyx. Three new pathogenetic factors were suggested in the vesicular palmar eczema: use of acetylsalicylic acid (Aspirin), contraceptives and smoking. Furthermore, the relationship between pompholyx and contact allergy to nickel was confirmed. No correlation to atopy was found. However, both atopy and sex were found to constitute certain risk factors. The study was based on information from 425 consecutively patch tested patients (74% females) from our local database DALUK.

Adult↗

[Sex steroids and the immune system].

Endocrine and immune system are strongly correlated. Hormonal contraceptive drugs influence humoral, cellular and mucosal immunity in different kind and in dependency of the relationships between estrogens and gestagens. At present most authors support the opinion that estrogens are responsible for immunosuppressive features. This review summarizes experimental and clinical reports.

Antibody Formation↗

Fertilizing capacity and sperm antibodies in vasovasostomized men.

In order to explain the discrepancy between the patency rate (80%) and the pregnancy rate (46%) in a series of vasovasostomies, attention was focused on a group of patients who became normospermic. The mean age at vasectomy, the duration of vasobstruction, and the parameters of semen analysis were not different for those couples who achieved a pregnancy (n = 8), compared with those couples without pregnancy (n = 7). In the group with pregnancy, six of the eight patients had low titers of serum agglutinins (absent to 1:32), and the fertilizing capacity of their spermatozoa was normal. None had immobilizing antibodies. In the group without pregnancy, six of the seven patients had elevated serum agglutinins (greater than 1:256), and four had agglutinating antibodies in their seminal plasma as well as serum immobilizing antibodies. The spermatozoa of seven patients failed to fertilize zona-free hamster ova. It is concluded that a loss of fertilizing ability of the spermatozoa due to sperm antibodies is an important cause of infertility in vasovasostomized men.

Adult↗

Pregnancy and hormonal influences on malignant melanoma.

Halo cutaneous melanoma developed in a 30-year-old woman. Following wide excision of the melanoma, she remained clinically free of tumor for 5 years. In a subsequent pregnancy, she developed metastases to the liver which became evident in the immediate postpartum period. Long-term survival associated with cutaneous hypopigmentation has been reported and occurred in our patient. The interaction between hormonal and immunologic factors and melanoma is explored.

Adult↗