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Oral contraceptives modify DNA methylation and monocyte-derived macrophage function

Campesi, Ilaria and Sanna, Manuela and Zinellu, Angelo and Carru, Ciriaco and Rubattu, Laura and Bulzomi, Pamela and Seghieri, Giuseppe and Tonolo, Giancarlo and Palermo, Mario and Rosano, Giuseppe and Marino, Maria and Franconi, Flavia (2012) Oral contraceptives modify DNA methylation and monocyte-derived macrophage function. Biology of Sex Differences, Vol. 3 (4). eISSN 2042-6410. Article.

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DOI: 10.1186/2042-6410-3-4

Abstract

Background: Fertile women may be encouraged to use contraception during clinical trials to avoid potential drug effects on fetuses. However, hormonal contraception interferes with pharmacokinetics and pharmacodynamics and modifies internal milieus. Macrophages depend on the milieu to which they are exposed. Therefore, we assessed whether macrophage function would be affected by the use of combined oral contraceptives (OCs) and if this influence depended on the androgenic or nonandrogenic properties of progestin.
Methods: Healthy adult women were enrolled and stratified into two groups: women who did not use OCs (Fs) and women treated with OCs (FOCs). FOCs were further stratified as a function of androgenic (FOCA+) and non-androgenic (FOCA-) properties of progestins. Routine hematological, biochemical, inflammatory and endothelial dysfunction parameters were measured. Monocyte-derived macrophages (MDMs) were evaluated for the expression and activity of estrogen receptors and androgen receptors, and release of tumor necrosis factor α (TNFα) was measured from unstimulated and lipopolysaccharide-stimulated cells.
Results: As is already known, the use of OCs changed numerous parameters: the number of lymphocytes, iron levels, total iron-binding capacity of transferrin, triglycerides, high-density lipoprotein, total cholesterol, and C-reactive protein increased, while prothrombin time and alkaline phosphatase decreased. Hormonal levels also varied: cortisol was higher in FOCs, while luteinizing hormone, folliclestimulating hormone, and testosterone were lower in FOCs. Asymmetric dimethylarginine, an index of endothelial function, was lower in FOC than in Fs, as were cysteine and bilirubin. The androgenic properties of progestins affected the activity of OCs: in particular, white blood cell count, hemoglobin, high-density lipoprotein and calcium were higher in FOCA- than in FOCA+, whereas percentage oxygen saturation and γ-glutamyl transpeptidase were lower in FOCA- than in FOCA+. Importantly, FOCs had a lower global DNA methylation, indicating that OC may have epigenetic effects on gene expression. OC did not modify the expression of androgen receptor but increased estrogen receptor α expression, more considerably in FOCA+, and decreased estrogen receptor β, more considerably in FOCA-. Importantly, the activation state of estrogen receptor β in FOCs was decreased, while estrogen receptor α was not active in either Fs or FOCs. Unstimulated MDMs obtained from FOCs showed higher release of TNFα in comparison with Fs. After lipopolysaccharide stimulation, the release of TNFα was significantly higher in Fs than in FOCs.
Conclusions: OC use induced many changes in hematological and plasmatic markers, modifying hormonal levels, endothelial function, inflammation index and some redox state parameters, producing a perturbation of the internal milieu that impacted macrophagic function. In fact, different levels of estrogen receptor expression and release of TNFα were observed in macrophages derived from OC users. Some of the above activities were linked to the androgenic properties of progestin. Even though it is not known whether these effects are reversible, the results indicate that to avoid potential skewing of results only a single type of OC should be used during a single clinical trial.

Item Type:Article
ID Code:7046
Status:Published
Refereed:Yes
Uncontrolled Keywords:Androgenic and non-androgenic progestin, combined oral contraceptive, estrogen receptors, global DNA methylation, monocyte-derived macrophages, TNFα
Subjects:Area 05 - Scienze biologiche > BIO/12 Biochimica clinica e biologia molecolare clinica
Divisions:001 Università di Sassari > 02 Centri > Centro di eccellenza interdisc. sviluppo ricerca biotecnologica e studio biodiversità della Sardegna e dell'area mediterranea
002 Altri enti e centri di ricerca del Nord Sardegna > Porto Conte Ricerche, Alghero
002 Altri enti e centri di ricerca del Nord Sardegna > National laboratory of the national institute of biostructures and biosystems, Osilo
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
002 Altri enti e centri di ricerca del Nord Sardegna > Azienda ASL2, Olbia > Servizio aziendale di diabetologia e malattie metaboliche
Publisher:BioMed Central
eISSN:2042-6410
Copyright Holders:© 2012 Campesi et al.; licensee BioMed Central Ltd.
Deposited On:31 Jan 2012 17:23

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