CDC Circumcision HIV Langerin Langerhans Cells

The Centers for Disease Control and Prevention CDC on their page on Male Circumcision (http://www.cdc.gov/hiv/malecircumcision/) gives this explanation to the biological plausibility between circumcision status and HIV:

"Compared with the dry external skin surface of the glans penis and penile shaft, the inner mucosa of the foreskin has less keratinization (deposition of fibrous protein) and a higher density of target cells for HIV infection [2]. Some laboratory studies have shown the foreskin is more susceptible to HIV infection than other penile tissue [3], although others have failed to show any difference in the ability of HIV to penetrate inner compared with outer foreskin surface [4]. The foreskin may also have greater susceptibility to traumatic epithelial disruptions (tears) during intercourse, providing a portal of entry for pathogens, including HIV [5]. In addition, the microenvironment in the preputial sac between the unretracted foreskin and the glans penis may be conducive to viral survival [3]. Finally, the presence of other sexually transmitted diseases (STDs), which independently may be more common in uncircumcised men, increase the risk for HIV acquisition [6-11]. "

What's interesting is that this ignores De witte L et al 2007, "Langerin is a natural barrier to HIV-1 transmission by Langerhans cells" which states that " Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function."







De witte L, Nabatov A, Pion M et-al. Langerin is a natural barrier to HIV-1 transmission by Langerhans cells. Nat. Med. 2007;13 (3): 367-71. <a href="http://dx.doi.org/10.1038/nm1541">doi:10.1038/nm1541</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17334373">Pubmed citation</a><div class="ref_v2"></div>