Reactive molecules and microorganisms and copper intrauterine devices

Abstract

Copper in the intrauterine device (IUD) has been shown to have bactericidal activity in addition to enhancing contraceptive activity. However the exact mechanism of antimicrobial action of copper IUD is not known. The increase in the number of polymorphonuclear leukocytes in the endometrium following IUD insertion has been documented. These inflammatory cells get activated and release reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI). However metals like iron and copper act as catalyst in augmenting the toxicity of reactive oxygen intermediates. Gupta et al. observed that the copper levels in the uterine flushings were significantly higher one-week post insertion along with increased ROI levels. For control of infection interaction of nitric oxide with microbial enzymes containing iron—sulphydryl proteins and a balance between ROI and RNI could account for antimicrobial action. (excerpt)