The biology of how circumcision reduces HIV susceptibility: broader implications for the prevention field.
AIDS Res Ther
; 14(1): 49, 2017 Sep 12.
Article
in En
| MEDLINE
| ID: mdl-28893286
ABSTRACT
Circumcision reduces heterosexual HIV-1 acquisition in men by at least 60%. However, the biological mechanisms by which circumcision is protective remain incompletely understood. We test the hypothesis that the sub-preputial microenvironment created by the foreskin drives immune activation in adjacent foreskin tissues, facilitating HIV-1 infection through a combination of epithelial barrier disruption, enhanced dendritic cell maturation, and the recruitment/activation of neutrophils and susceptible CD4 T cell subsets such as Th17 cells. Furthermore, we provide evidence that the genital microbiome may be an important driver of this immune activation. This suggests that new modalities to reduce genital immune activation and/or alter the genital microbiome, used alone or in combination with topical microbicides, may be of significant benefit to HIV prevention.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
HIV-1
/
Circumcision, Male
/
Disease Susceptibility
Limits:
Adult
/
Animals
/
Humans
/
Male
Language:
En
Journal:
AIDS Res Ther
Year:
2017
Document type:
Article
Affiliation country: