Changes

This hypothesis attempts to identify the change in bacterial environment that results in the penis as a result of circumcision, as the mechanism whereby circumcision reduces the spread of HIV transmission. A desparate desperate ad-hoc hypothesis, the explanation is rather farfetched. The argument is that the change in bacterial environment after circumcision makes it difficult for bacteria that cause diseases to live; there are less chances for penile inflamationinflammation, a condition that facilitates the transmission of viruses. The chances for penile inflamation inflammation are reduced, thereby reducing the chances of sexually transmitted viruses, such as HIV.<ref>{{REFjournal

Presenting this hypothesis presents a two-fold problem. First, it presents an irrelevant conclusion; the randomized control trials were measuring frequency in HIV transmission, not for frequency in penile bacterial inflamation, and whether said inflamation facilitated sexually transmitted HIV. And secondly, circumcision advocates give themselves the new burden of proving the newly introduced hypothesis, that change in bacterial infection does indeed result in a significant reduction of HIV transmission. A new study is needed to measure HIV transmission in men who have been circumcised, intact men with constant penile inflamations, and intact men who don't suffer constant penile inflamationinflammation. Unless the randomized controlled studies were limited to only intact men who suffered constant penile inflamationinflammation. == The immunological function of the foreskin == The foreskin's inner fold and the glans of the penis are comprised of [[Preputial mucosa| 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]],<ref>{{REFjournal |last=Weiss |init=GN |last2=Sanders |init2=M |last3=Westbrook |init3=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? |journal=Isr J Med Sci |date=1993-01 |volume=29 |issue=1 |pages=42-43 |accessdate=2019-10-20}}</ref> plasma cells,<ref name="flower1983">{{REFjournal |last=Flower |init=PJ |last2=Ladds |init2=PW |last3=Thomas |init3=AD |last4=Watson |init4=DL |url=https://journals.sagepub.com/doi/abs/10.1177/030098588302000206 |title=An immunopathologic study on the bovine prepuce |journal=Vet Pathol |date=1983-03 |volume=20 |issue=2 |pages=189-201 |accessdate=2019-10-20}}</ref> apocrine glands,<ref>{{REFjournal |last=Ahmed |init=A |last2=Jones |init2=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 |journal=Br J Dermatol |date=1969-12 |volume=81 |issue=12 |pages=899-901 |accessdate=2019-10-20}}</ref> and sebaceous glands,<ref>{{REFjournal |last=Hyman |init=AB |last2=Brownstein |init2=MH |title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis |journal=Arch Dermatol |date=1969-01 |volume=99 |issue=1 |pages=31-36 |accessdate=2019-10-20}}</ref><ref>{{REFjournal |last=Delbanco |init=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 |language=German |journal=Monatshefte für praktische Dermatologie |date=1904 |volume=38 |pages=536-538 |accessdate=2019-10-20}}</ref><ref>{{REFjournal |last=Piccinno |init=R |last2=Carrel |first2=Ch.-F. |init2=CF |last3=Menni |init3=S |etal=yes |title=sebacous glands mimicking molluscum contagiosum |journal=Acta Derm Venerol |date=1990 |volume=70 |pages=344-345}}</ref><ref>{{REFjournal |last=Krompecher |first=St. |init=S |title=Die Histologie der Absonderung des Smegma praeputii |trans-title=Histology of allocation of a smegma praeputii |language=German |journal=Anatomischer Anzeiger |date=1932 |volume=75 |pages=170-176}}</ref>, collectively secrete emollient lubricants.<ref name="parkash-jeykumar1973">{{REFjournal |last=Parkash |init=S |last2=Jeykumar |init2=S |last3=Subramanyan |init3=K |last4=Chaudhuri |init4=S |url=http://www.cirp.org/library/anatomy/parkash/ |title=Human subpreputial collection: its nature and formation |journal=J Urol |date=1973-08 |volume=110 |issue=2 |pages=211-212 |accessdate=2019-10-20}}</ref> Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>{{REFjournal |last=Frohlich |init=E |last2=Shamburg-Lever |init2=G |last3=Klesses |init3=C |title=Immunelectron microscopic localization of cathepsin B in human apocrine glands |journal=J Cutan Pathol |date=1993-02 |volume=20 |issue=1 |pages=54-60}}</ref>  There is also some research to suggest that lysozyme may protect against HIV infection.<ref>{{REFweb |first=George |last=Hill |author-link=George Hill |url=http://www.cirp.org/library/disease/HIV/hill1/ |title=Summary of evidence that the foreskin and lysozyme may protect against HIV infection |date=2003-09-07 |accessdate=2019-10-20}}</ref> <ref name="fleiss-hodges-vanhowe1998" /> Apocrine glands also produce cytokine,<ref>{{REFjournal |last=Ahmed |init=AA |last2=Nordlind |init2=K |last3=Schultzberd |init3=M |last4=Liden |init4=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 |journal=Arch Dermatol Res |date=1995 |volume=287 |issue=8 |pages=764-766 |accessdate=2019-10-20}}</ref> 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.<ref name="flower1983"/>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 |init=L |last2=Nabatov |init2=A |last3=Pion |init3=M |etal=yes |url=http://www.cirp.org/news/healthday2007-03-05/ |title=Langerin is a natural barrier to HIV-1 transmission by Langerhans cells |journal=Nat Med |date=2007-03 |volume=13 |issue=3 |pages=367-371 |accessdate=2019-10-20}}</ref> 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.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal |last=Fleiss |init=PM |author-link=Paul M. Fleiss |last2=Hodges |init2=FM |author2-link=Frederick M. Hodges |last3=Van Howe |init3=RS |author3-link=Robert S. Van Howe |title=Immunological functions of the human prepuce |journal=Sex Trans Infect |date=1998-10 |volume=74 |issue=5 |pages=364-67 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf |quote= |pubmedID=10195034 |pubmedCID= |DOI= |accessdate=2021-10-27}}</ref> Circumcision destroys the natural immunological protections of the foreskin and results in increased risk of contracting infection.