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[Detection of pill-induced antiethinylestradiol antibodies (author's transl)].

The synthetic hormones contained in contraceptive pills were shown to induce antiethinylestradiol (EE) antibodies in some women. These antibodies can be detected by the presence of circulating immune complexes (CIC) which are precipitated from serum in 25 p. cent saturated ammonium sulphate. A method of analysis of the anti-EE antibodies is described, in which binding of tritiated EE is measured with and without addition of unlabeled EE in excess. This method allows to identify specific reversible binding on saturable sites. Because of the large excess of non specific sites, the whole serum was enriched in antibodies before the binding measurement, either by previous separation of CIC, or by an affinity chromatography on a EE column. Results of this method confirmed the presence in a number of women on oral contraceptives, of immunoglobulins which were able to bind EE reversibly. The antibodies were found in CIC. in the absence of CIC, they were occasionally found in serum after an affinity chromatography on a EE column. This method is felt to allow a more accurate detection of women immunoreactive to the pill.

Antibodies↗

Contraceptive vaccine assessment based on a murine ZP3 mini-autoantigen.

A summary is presented of published and some unpublished observations from studies on the immunological response of mice to a 13-mer peptide of the murine ovarian zona pellucida glycoprotein ZP3. The findings have the following implications for the design of immunocontraceptive vaccines. To be reversible, a ZP3 vaccine must not contain pathogenic T cell epitopes of ZP3, but contraception without autoimmune oophoritis may be feasible. The immune response to the ZP3 mini-autoantigen is highly variable among inbred mouse strains, suggesting that a single oophoritogenic peptide would not achieve irreversible contraception in an outbred population. The discovery of antigen mimicry at the level of T cell peptide has thrown doubt on the validity of current strategy in detecting relevant self-antigens that might cross react with vaccine immunogens and on the feasibility of fully predicting the cross-reactive autoimmunogenic potential of a peptide or polypeptide vaccine antigen. Autoantibodies directed against epitopes outside the ZP3 mini-autoantigen, produced by immunization with the pure T cell epitope, react with high affinity, with native zona pellucida, and may be useful in identifying B cell epitopes in ZP3.

Amino Acid Sequence↗

Effect of oral contraceptive containing a new progestin (ORG 2969) on plasma renin activity, growth hormone and immunoreactive insulin.

Plasma renin activity (PRA), Growth hormone (GH) and immunoreactive insulin (IRI) were studied in seven healthy subjects during the ovulatory menstrual cycle and during the first and third cycles of oral contraception with 0.05 mg of ethinylestradiol and 0.100 mg or 0.125 mg of a new progestogen, 17 alpha-ethinyl-18-methylene-4-estren-17 beta-ol. The PRA level in the second half of the control cycle was significantly higher than in the beginning of the cycle. At the end of the treated cycles it was significantly higher than at the end of the control cycle. Neither GH nor IRI showed significant changes during the control cycle. GH was significantly higher at the end of the first and third treated cycles than at the end of the control cycle. IRI was significantly higher both in the beginning and at the end of the first treated cycle than the corresponding IRI levels in the control cycle. IRI at the end of the third treatment cycle was not significantly different from corresponding means at the end of the control cycle or the first treated cycle.

Adult↗

[Contraception and pregnancy in systemic lupus erythematosus].

In 1990 conflicting views are still being held concerning oral contraception and risks associated with pregnancy in women with systemic lupus erythematosus. As regards oral contraceptives, all authors agree that oestrogen-progestin combination pills are harmful, but the best alternative hormonal contraception remains to be determined. Protein-based "micropills" seem to be harmless; cyproterone acetate appears to be without side-effects, and its usefulness in preventing recurrences is being evaluated. As regards pregnancy, it would be wise not to contemplate having a child until 6 months have elapsed since the onset of remission. Blood pressure, platelet count and serum creatinine and uric acid levels must be closely monitored. Two types of antibodies may be present in the mother and are known to be responsible for foetal complications. These are antibodies to phospholipids (antiprothrombinase, anticardiolipin, antibodies responsible for dissociated treponema serology), which expose to spontaneous abortion or intrauterine death, and the antibody to SS-A (or anti-Ro), which exposes to foetal cardiomyopathy and congenital atrioventricular block.

Abortion, Spontaneous↗

The heterocytotoxicity of human serum. III. Studies of the serum levels and distribution of activity in human populations.

A metabolic inhibition assay has been employed to investigate the distribution of serum heterocytotoxicity mediated by natural antibody activating the classical complement pathway and by antibody-independent activation of the alternative complement pathway in human serum samples derived from various groups of individuals. Levels in female cancer patients and in women taking oral contraceptives were significantly elevated over normal controls. Newborn infants exhibited approximately half of the average adult levels. Levels were maximally elevated in patients with visceral cancer, particularly in individuals with adenocarcinomas, while patients with sarcomas exhibited reduced levels. These and other data derived from the literature suggest that the metabolic inhibition assay may provide a useful measure of natural antibody and activation of the alternate complement pathway representative of mechanisms of natural immunity vs tumours.

Adult↗

[Effect of estrogen on the blast transformation of lymphocytes and interleukin-2 production in lupus erythematosus].

The mitogenic response of peripheral lymphocytes was investigated in 12 patients with systemic lupus erythematosus and in healthy female volunteers who were on 11 and without 9 contraceptive pills. The effect of estrogen (ethinyl-estradiol 10(-5)-10(-6)-10(-7)M) was studied on Phytohaemagglutinin and Pokeweed mitogen induced blastogenic transformation and interleukin-2 production of peripheral lymphocytes in vitro. We observed a significantly depressed Phytohaemagglutinin induced lymphoblastic transformation both in patients and women taking oral contraceptive in presence of 10(-5)M estrogen as compared to normal controls. However there was no significant alteration neither in the response of lymphocyte nor in the production of interleukin-2 using of Pokeweed mitogen. The stimulataneous inhibition of the interleukin-2 production proved to be moderate. Marked significant correlation (r greater than = 0.8) vas detected between lymphoblastic transformation and interleukin-2 production in healthy females. Correlation coefficient measured in females taking oral contraceptive (r less than = 0.64) and patients with systemic lupus erythematosus (r less than = 0.34) suggest that in these groups the inhibition of lymphoblastic transformation is due to the inhibition effect of estrogen on the interleukin-2 production.

Adolescent↗

Anti-oestrogen antibodies in users of oral contraceptives and in patients with systemic lupus erythematosus.

Recent studies have demonstrated that many patients with SLE have elevated plasma levels of the minor oestrogen metabolite 16 alpha-hydroxyestrone (16 alpha OHE). This oestrogen is unique in its ability to react with lysine residues and form stable, covalent Heyns products with proteins. Increased levels of 16 alpha OHE-modified proteins have been found to occur on the membranes of red cells and lymphocytes in patients with SLE. In the present study, patient and control sera were analysed for the presence of circulating immunoglobulins which react with an oestrogen hapten. Anti-oestrogen antibodies were detected in 26% (9/34) of male and female SLE patients, and were found to correlate both with levels of plasma 16 alpha OHE (P less than 0.001) and with the presence of active disease (P less than 0.005). Surprisingly, this antibody activity was also observed in 25% (13/52) of normal, disease-free women who had a history of oral contraceptive use. No detectable activity was observed in normal men, women who had not taken oral contraceptives, or patients with a variety of other immunological diseases. The possible role of anti-oestrogen antibodies in both the hormonal exacerbation of SLE and in the long-term sequelae of oral contraceptive usage is discussed.

Adult↗

Immune studies in oral contraceptive users.

Some of the parameters of immune status-percentage of B and T lymphocyte subpopulation, PHA-induced lymphocyte transformation measured by 3H-thymidine incorporation (PILT) and levels of total haemolytic complement (CH5O) were studied in Indian women from low income group who were using estrogen-progestogen combination pills. There were no differences in percentage of B and T lymphocyte subpopulation or PILT between OC users and the control group. However, CH5O levels were significantly lower in OC users. The depression in circulating complement levels in OC users is intriguing and suggests the possibility that complement system and circulating immune complexes may be altered in OC users.

Adult↗

Breastfeeding, lactational, infecundity, contraception and the spacing of births: implications of the Bellagio consensus statement.

While the nutritional, immunological and anti-bacterial benefits of breast milk are incontestable, the contraceptive effect of breastfeeding is more apparent in the aggregate than at the level of the individual. Nevertheless, it has recently been recommended that lactating women not consider adopting contraception until the earliest of their first post-partum menstruation, the introduction of supplementary feeding or their child's reaching six months of age. This article employs microsimulation to quantify the implications of this recommendation for the spacing of births and, in particular, for the proportion of birth intervals that are unacceptably short. The findings are not encouraging. The implementation of this protocol would not produce better birth spacing than a simpler strategy of initiating contraception early in the post-partum period and, unless implemented perfectly, the outcomes would be considerably worse. Breastfeeding should be viewed not as a method of birth control but as the best form of infant nourishment. Efficient contraception is the best way to ensure that children in modernizing societies can reap the benefits of breastfeeding, without being endangered by being weaned too early because of a new pregnancy.

Amenorrhea↗

Contraceptive potential of antibodies to the zona pellucida.

The notion of a contraceptive vaccine based on gamete-specific surface antigens was first proposed over a decade ago, as the result of in-vitro and in-vivo studies, and in recent years has been the subject of intensive research. In particular, the zona pellucida has attracted much attention as a potential target for immunological intervention in the fertilization process. Such is the rapidly-expanding nature of research into the biochemical and biological characterization of this structure, that a review of the implications for the development of a contraceptive vaccine seems timely.

Antigens, Surface↗

Rheumatoid factor (antigammaglobulin) in women: effects of oral contraceptives use of its prevalence.

A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease.

Adolescent↗

[Inefficacy of oral contraception during use of minocycline].

A healthy woman aged 21 years who used the oral contraceptive Trigynon became pregnant while being treated with Minocin (minocycline; 100 mg per day) for acne conglobata. While the risk of use of antibiotics such as this one reducing the efficacy of oral contraceptives is small, patients should nevertheless be informed that the risk exists.

Acne Vulgaris↗