Immunological and protective function of the foreskin

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Although it was once claimed that the human foreskin was filthy and harbored disease and infection, in reality the opposite is true. The foreskin is designed by nature to be self cleaning and to provide significant natural immunological and protective function against all types of infection, including HIV.

The protective and hygienic function of the foreskin

The foreskin, like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the penis and puts the urethra at a distance form its environment, protecting it from foreign contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection.

At birth, the foreskin is usually attached to the glans (head) of the penis by a synechia, akin to how a fingernail is attached to a finger.[1] The preputial cavity is sealed by the synechia so it cannot be infected.

In infancy, the foreskin's tubular neck (prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.[2][3] Together, these properties prevent the entry of contaminants.[4] The foreskin protects the infant glans penis from ammonia in diapers (nappies) and prevents meatal ulcer and meatal stenosis.[5] [6] [7]

Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskin's inner lining, these are not present in the glans penis.[8] They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans penis is meant to be an internal organ covered and protected from the outside world.

In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.[9]

Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.[10]

The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.[4]

In comparison, due to the open wounds and raw bleeding flesh, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion and contaminants.[11] Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions and meatal stenosis.[11]

The immunological function of the foreskin

The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defense for the body's orifices. These mucous membranes perform many immunological and hygienic functions.

Certain components such as Langerhans cells,[12] plasma cells,[13] apocrine glands,[14] and sebaceous glands,[15][16][17][18], collectively secrete emollient lubricants.[9] Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.[19]

There is also some research to suggest that lysozyme may protect against HIV infection.[20] [4]

Apocrine glands also produce cytokine,[21] which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.[13] It is also very important to note that Langerhans cells that are present in the foreskin produce Langerin, a substance that has been proven to kill human immunodefiency viris (HIV) on contact.[22]

All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.[4]

See also

References

  1. REFjournal Deibert, G.A. (November 1993): The separation of the prepuce in the human penis, in: Anatomical Record. 57(4):387-399. Retrieved 20 October 2019.
  2. REFjournal Hunter, R.H. (October 1935): Notes on the development of the prepuce, in: Journal of Anatomy. 70(1):6875. Retrieved 20 October 2019.
  3. REFjournal Glenister, T.W. (September 1956): A consideration of their process involved in the development of the prepuce in man, in: Br J Urol. 28(3):243-249.
  4. a b c d REFjournal Fleiss, P. / F. Hodges / R.S. Van Howe (October 1998): Immunological functions of the human prepuce, in: Sex Trans Infect. 74(5):364-67, PMID. Retrieved 15 October 2019.
  5. REFjournal Gairdner, Douglas (24 December 1949): The fate of the foreskin: a study of circumcision, in: Br Med J. 2:1433-7, PMID, PMC, DOI. Retrieved 10 January 2019.
  6. REFjournal Van Howe, R.S. (January 2006): Incidence of meatal stenosis following neonatal circumcision in a primary care setting, in: Clin Pediatr (Phila). 45(1):49-54, PMID, DOI. Retrieved 9 January 2020.
  7. REFjournal Upadhyay, V / HM Hammodat / PW Pease (27 February 1998): Post circumcision meatal stenosis, in: N Z Med J. 111(1060):57-8, PMID. Retrieved 10 January 2020.
  8. REFjournal Hyman, A.B. / M.H. Brownstein (January 1969): Tyson's "glands": ectopic sebaceous glands and papillomatosis penis, in: Arch Dermatol. 99(1):31-36. Retrieved 20 October 2019.
  9. a b REFjournal Parkash, S. / S. Jeykumar / K. Subramanyan / S. Chaudhuri (August 1973): Human subpreputial collection: its nature and formation, in: J Urol. 110(2):211-212. Retrieved 20 October 2019.
  10. REFjournal Parkash, S. (June 1982): Penis: some facts and fancies, in: Journal of Physician's Association of Madras:1-13.
  11. a b REFjournal Van Howe, R.S. (1997): Variability in penile appearance and penile findings: a prospective study, in: Br J Urol. 80:776-782. Retrieved 20 October 2019.
  12. REFjournal Weiss, G.N. / M. Sanders / K.C. Westbrook (January 1993): The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?, in: Isr J Med Sci. 29(1):42-43. Retrieved 20 October 2019.
  13. a b REFjournal Flower, P.J. / P.W. Ladds / A.D. Thomas / D.L. Watson (March 1983): An immunopathologic study on the bovine prepuce, in: Vet Pathol. 20(2):189-201. Retrieved 20 October 2019.
  14. REFjournal Ahmed, A. / A.W. Jones (December 1969): Apocrine Cystadenoma: a report of two cases occurring on the prepuce, in: Br J Dermatol. 81(12):899-901. Retrieved 20 October 2019.
  15. REFjournal Hyman, A.B. / M.H. Brownstein (January 1969): Tyson's "glands": ectopic sebaceous glands and papillomatosis penis, in: Arch Dermatol. 99(1):31-36. Retrieved 20 October 2019.
  16. REFjournal Delbanco, E. (1904): Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums [About the increased occurrence of free sebaceous glands on the inner surface of the prepuce] (German), in: Monatshefte für praktische Dermatologie. 38:536-538. Retrieved 20 October 2019.
  17. REFjournal Piccinno, R. / C.-F. Carrel / S. Menni, et al. (1990): sebacous glands mimicking molluscum contagiosum, in: Acta Derm Venerol. 70:344-345.
  18. REFjournal Krompecher, St. (1932): Die Histologie der Absonderung des Smegma praeputii [Histology of allocation of a smegma praeputii] (German), in: Anatomischer Anzeiger. 75:170-176.
  19. REFjournal Frohlich, E. / G. Shamburg-Lever / C. Klesses (February 1993): Immunelectron microscopic localization of cathepsin B in human apocrine glands, in: J Cutan Pathol. 20(1):54-60.
  20. REFweb Hill, George (7 September 2003). Summary of evidence that the foreskin and lysozyme may protect against HIV infection. Retrieved 20 October 2019.
  21. REFjournal Ahmed, A.A. / K. Nordlind / M. Schultzberd / S. Liden (1995): Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands, in: Arch Dermatol Res. 287(8):764-766. Retrieved 20 October 2019.
  22. REFjournal de Witte, L. / A. Nabatov / M. Pion, et al. (March 2007): Langerin is a natural barrier to HIV-1 transmission by Langerhans cells, in: Nat Med. 13(3):367-371. Retrieved 20 October 2019.