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Home , Immunocontraception

Immunocontraception

Postgraduate Research Training in Reproductive Health Faculty of Medicine, University of Yaounde Pierre Marie Tebeu (M.D) [email protected]

1 Specific objectives

z Definition z Identify who will be able to use immunocontraception z Justify the development of immunocontraception z Identify the advantages of immunocontraception z Identify the disadvantages of immunocontraception z The target of immunocontraceptive agents z The mechanism of action of immunocontraceptive agents z Identify the actual limits of immunocontraception

2 What is Immunocontraception?

z Immunity = Body defense mechanisms z Contraception = Protection against unplanned pregnancy z Immunocontraception = The use of body defense

mechanisms to provide protection against an unplanned

pregnancy

3 Distinguish anti-disease # Immunocontraception

z Anti-disease vaccine. z Immunocontraception z Protection against disease z Protection for pregnancy z Target is foreign pathogen z Target is self cells/hormon z Immunity often boosted by z Vaccine induced immunity exposure to pathogens z Immunity is not boosted z Long acting vaccine by re-exposure to induced immunity z Long acting vaccine induced immunity Why the Immunocontraception? (1)-Unplanned pregnancies

z New pregnancies/year: 210 millions (Aitken 2002). z 38% are unplanned. z 22% are aborted

5 Why the Immunocontraception? (2)-population overgrowth

z By year 2000: 6 billions z By year 2004: 6.4 billions z By year 2050: 10 billions z 97% worid growth is in developing countries z This overgrowth will worsen the impact of many social, ecologic , economic and medical trends

6 Why the Immunocontraception?(3)

z To provide an additional long acting option to family planning users z Recourse to the self , easily use

7 Why the Immunocontraception? (4)-To diminish whilelife animals

z As wildlife habitat continues to diminish and animals adapt to living near us, we have a practical and perhaps a moral obligation to find new management solutions Why the Immunocontraception? (5)-A mean to control wildlife population Examples of biocontrol approach

z Interfering with z Preventing development of z Preventing the development of the reproductive system z Interfering with lactation Target of immunocontraceptive agents

z GnRH z FSH z Steroids z z hCG

11 Common mechanism of action

z Induction to the body the production of against it's own reproductive z This would block the action of the reproductive proteins or destroy them Various stages of clinical testing (1)-Phase I study

z Safety of the preparation in human z About 50 subjects allocated sequentially to increase the dose. z Lasting 1-2 years Various stages of clinical testing (2)-Phase II study

z The efficacy of selected dose z About 100-200 subjects allocated z Lasting 2-3years Various stages of clinical testing (3)-Phase III study

z The safety and efficacy z About 1000 subjects randomized in groups z Lasting 4-6years GnRH immunocontraception

z Immunological ( Preclinical trials) z Prolong anovulation in postpartum women (Clinical trials ongoing) z Hormonal suppression in man with prostatic (Clinical trial)

16 FSH immunocontraceptives

z Immunogenesis + effect on spermatogenesis (Phase I clinical trial) z Results: .Some reduction in number and motility .No significant effect on parameters .Preparation was weakly immunogenic

17 Steroid immunocontraceptives

z Only preclinical trials are conducted

z No clinical trial conducted to date

18 immunocontraceptives (sponsor-agent)

z Only preclinical trials are conducted z Sponsor: HSUS (Human Society of the United States) z Agent: proteins (PZP)

19 Gamete immunocontraceptives (Mechanism of action)

z Action of PZP:Spay-VacR:form of immunovaccine z After injection of pig PZP to the animal, that animal body produces antibodies to it. These antibodies attach to female ZP , then prevent sperm from attaching z No clinical trial conducted to date

20 hCG immunocontraceptives studies

z Many preclinical trials completed z Many phase I, II clinical trials completed z Phase III clinical trials are ongoing

21 hCG immunocontraceptives sponsors

z National Institute of Immunology, Delhi, . z Population Council, New York, USA. z Word Health Organization, Geneva, Switzerland.

22 hCG immunocontraceptives sponsor and specific agent used: 1-National Institute of Immunology India

z Agent: Heterospecies dimer of Beta-hCG .alpha-oLH, .tetanus toxoid, .dipthteria toxoid, .LPS, .alum z Many phase I, II clinical trials completed z Phase III clinical trials are ongoing

23 hCG immunocontraceptives sponsor and specific agent used: 2-Population Council, New York, USA

z Agent: -beta hCG -tetanus toxoid, -alum. z Many pnase I, clinical trials completed

24 hCG immunocontraceptives sponsor and specific agent used: 3-World Health Organization, Geneva, Switzerland

z Agent: .hCG specific , .diptheria toxoid, .muramyl dipeptide, .slow-release copolymer matrix, .water-in-oil emulsion vehicle z Many phase I, clinical preparation

25 Specific needs for Immunocontraception

z Clarification of mechanisms of action z Reversal of contraceptive effect on demand z Assessment of long term safety z Assess the acceptability z Clarify the social, economic and political issue

26 Conclusion

z Immunocontraception is a long term family planning

option for tomorrow z But we need to keep its development in mind

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