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Immunological and protective function of the foreskin

63 bytes removed, 23:48, 29 December 2020
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adjusted REFjournal
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.<ref>{{REFjournal
|last=Deibert
|firstinit=G.A.GA
|author-link=
|title=The separation of the prepuce in the human penis
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.<ref>{{REFjournal
|last=Hunter
|firstinit=R.H.RH
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1249280/pdf/janat00534-0090.pdf
|title=Notes on the development of the prepuce
}}</ref><ref>{{REFjournal
|last=Glenister
|firstinit=T.W.TW |titleurl=[https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1956.tb04763.x |title=A consideration of their process involved in the development of the prepuce in man]
|journal=Br J Urol
|date=1956-09
Together, these properties prevent the entry of contaminants.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal
|last=Fleiss
|firstinit=P.PM
|author-link=Paul M. Fleiss
|last2=Hodges
|first2init2=F.FM
|author2-link=Frederick M. Hodges
|last3=Van Howe
|first3init3=R.S.RS
|author3-link=Robert S. Van Howe
|title=Immunological functions of the human prepuce
|last=Gairdner
|first=Douglas
|init=D
|author-link=Douglas Gairdner
|etal=no
}}</ref> <ref name="vanhowe2006">{{REFjournal
|last=Van Howe
|firstinit=R.S.RS
|author-link=
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting
}}</ref> <ref>{{REFjournal
|last=Upadhyay
|firstinit=V
|author-link=
|last2=Hammodat
|first2init2=HM
|author2-link=
|last3=Pease
|first3init3=PW
|author3-link=
|etal=no
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]].<ref name="hyman-brownstein1969">{{REFjournal
|last=Hyman
|firstinit=A.B.AB
|last2=Brownstein
|first2init2=M.H.MH
|url=https://jamanetwork.com/journals/jamadermatology/article-abstract/530842
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
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.<ref name="parkash-jeykumar1973">{{REFjournal
|last=Parkash
|firstinit=S.
|last2=Jeykumar
|first2init2=S.
|last3=Subramanyan
|first3init3=K.
|last4=Chaudhuri
|first4init4=S.
|url=http://www.cirp.org/library/anatomy/parkash/
|title=Human subpreputial collection: its nature and formation
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.<ref>{{REFjournal
|last=Parkash
|firstinit=S.
|title=Penis: some facts and fancies
|journal=Journal of Physician's Association of Madras
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.<ref name="vanhowe1997">{{REFjournal
|last=Van Howe
|firstinit=R.S.RS
|author-link=Robert Van Howe
|url=https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410X.1997.00467.x
Certain components such as [[Langerhans cells]],<ref>{{REFjournal
|last=Weiss
|firstinit=G.N.GN
|last2=Sanders
|first2init2=M.
|last3=Westbrook
|first3init3=K.C.KC
|url=http://www.circumstitions.com/Langerhans.html
|title=The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?
}}</ref> plasma cells,<ref name="flower1983">{{REFjournal
|last=Flower
|firstinit=P.J.PJ
|last2=Ladds
|first2init2=P.W.PW
|last3=Thomas
|first3init3=A.D.AD
|last4=Watson
|first4init4=D.L.DL
|url=https://journals.sagepub.com/doi/abs/10.1177/030098588302000206
|title=An immunopathologic study on the bovine prepuce
}}</ref> apocrine glands,<ref>{{REFjournal
|last=Ahmed
|firstinit=A.
|last2=Jones
|first2init2=A.W.AW
|url=https://www.academia.edu/5687437/APOCRINE_CYSTADENOMA_A_REPORT_OF_TWO_CASES_OCCURRING_ON_THE_PREPUCE
|title=Apocrine Cystadenoma: a report of two cases occurring on the prepuce
}}</ref> and sebaceous glands,<ref>{{REFjournal
|last=Hyman
|firstinit=A.B.AB
|last2=Brownstein
|first2init2=M.H.MH
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
|journal=Arch Dermatol
}}</ref><ref>{{REFjournal
|last=Delbanco
|firstinit=E.
|title=Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums
|trans-title=About the increased occurrence of free sebaceous glands on the inner surface of the prepuce
}}</ref><ref>{{REFjournal
|last=Piccinno
|firstinit=R.
|last2=Carrel
|first2=CCh.-F. |init2=CF
|last3=Menni
|first3init3=S.
|etal=yes
|title=sebacous glands mimicking molluscum contagiosum
|last=Krompecher
|first=St.
|init=S
|title=Die Histologie der Absonderung des Smegma praeputii
|trans-title=Histology of allocation of a smegma praeputii
}}</ref>, collectively secrete emollient lubricants.<ref name="parkash-jeykumar1973"/> Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>{{REFjournal
|last=Frohlich
|firstinit=E.
|last2=Shamburg-Lever
|first2init2=G.
|last3=Klesses
|first3init3=C.
|title=Immunelectron microscopic localization of cathepsin B in human apocrine glands
|journal=J Cutan Pathol
Apocrine glands also produce cytokine,<ref>{{REFjournal
|last=Ahmed
|firstinit=A.A.AA
|last2=Nordlind
|first2init2=K.
|last3=Schultzberd
|first3init3=M.
|last4=Liden
|first4init4=S.
|url=https://link.springer.com/article/10.1007%2FBF01105803
|title=Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands
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 immunodeficency virus (HIV) on contact.<ref>{{REFjournal
|last=de Witte
|firstinit=L.
|last2=Nabatov
|first2init2=A.
|last3=Pion
|first3init3=M.
|etal=yes
|url=http://www.cirp.org/news/healthday2007-03-05/
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