The hormonal milieu of mammals is in constant fluctuation throughout the life cycle, with progesterone (P4) and its metabolites serving as a primary constituent. In many species, P4 is believed to be highly anti-inflammatory, while a variety of synthetic progestins have been found to alter the immune response in comparison with that of progesterone. 1 Medroxyprogesterone acetate (MPA), levonorgestrel (LNG), noresthisterone acetate, and d-norgestrel have been shown to bind selectively to either the progesterone (PR) or glucocorticoid receptor (GR) on a variety of immune cell types, including macrophages, dendritic cells, natural killer cells, and eosinophils
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