Review Finds Medical Male Circumcision Yields Health Benefits For Women

BY ANN LOLORDO

JOHNS HOPKINS

In a review of 60 publications, researchers found consistent evidence that male circumcision is associated with decreased risk in women for cervical cancer and sexually transmitted infections. Image Via Johns Hopkins University/JHPIEGO

Expanding access to voluntary medical male circumcision in sub-Saharan Africa may help protect women against not only HIV but other sexually transmitted infections, a literature review published Monday in The Lancet Global Health shows.

Researchers from the U.S. Centers for Disease Control and Prevention, the Johns Hopkins Bloomberg School of Public Health, and global health nonprofit and Hopkins affiliate Jhpiegoanalyzed 60 publications and found consistent evidence that male circumcision is associated with decreased risk in women for cervical cancer, cervical dysplasia, herpes simplex virus type 2 (the main cause of genital herpes), chlamydia, and syphilis. They also found additional evidence that male circumcision is associated with decreased risk for human papillomavirus, or HPV, which causes cervical cancer and genital warts.

"Increasing access to high quality medical male circumcision services has been one of our most profound contributions to preventing the spread of HIV," said Kelly Curran, a study co-author from Jhpiego. "This study reminds us that those efforts can contribute to positive health outcomes for others well beyond our immediate beneficiaries."

Cervical cancer is the second most common cancer among women living in developing countries and a leading cause of death among women living with HIV, while some sexually transmitted infections can cause stillbirth.

Voluntary medical male circumcision, or VMMC—an effective HIV prevention approach being scaled up across Eastern and Southern Africa in accordance with guidance from the World Health Organization and UNAIDS—has been shown to reduce men's risk of heterosexually-acquiring HIV and some other sexually transmitted infections. Nearly 15 million adult and adolescent males chose to have the procedure between 2007 and 2016, with the majority of these procedures supported by the U.S. President's Emergency Plan for AIDS Relief and local ministries of health and defense.

While past studies have shown that the intervention helps decrease women's risk for HIV and cervical cancer, it has not been clear how this male-focused strategy impacts women's health. This new consolidation of evidence suggests that VMMC may have beneficial effects for women beyond HIV in some of the highest-priority diseases in global women's health.

"These findings confirm that voluntary medical male circumcision is associated with protection for female partners from diseases that severely impact their health," said the study's first author, Jonathan Grund, from the CDC's Division of Global HIV & TB. "Existing prenatal care services and cervical cancer screening programs already counsel women about staying healthy. If that counseling includes encouraging male partners to get circumcised and referring interested men to these services, it can improve women's health programs and HIV prevention programs simultaneously."

A next step would be confirming that these findings are also seen in the existing international circumcision program over time, and monitoring their impact. The article's authors recommend that strengthening linkages and cooperation between VMMC and women's health programs be explored, to ensure that the benefits of male circumcision for women's health are fully optimized.

Scientists at Children's Hospital Los Angeles Identify Mechanism Critical to Lung Formation and Regeneration

PRESS RELEASE

Eya1 phosphatase acts to maintain barrier integrity in the lung

(LOS ANGELES, Jul 02, 2012 BUSINESS WIRE) -- Scientists have provided the first evidence that an enzyme called Eya1 protein phosphatase is a critical regulator of lung function and that this may have broad implications for sufferers of a variety of pulmonary diseases. "Identification of the role of Eya1 in establishing pulmonary tight junction and barrier integrity could have a significant impact on asthma, chronic obstructive pulmonary disease, and acute respiratory distress syndrome, all diseases characterized with disruptions in permeability," said Ahmed El-Hashash, PhD, investigator at The Saban Research Institute of Children's Hospital Los Angeles and assistant professor at the Keck School of Medicine.

Proper formation of lung epithelium is essential to life. The normal growth and functioning of the lung depends on the formation of tight junctions between adjacent cells making up the alveolar epithelial sheet, a thin layer of tissue separating neighboring alveoli. Alveoli are the site of gas exchange between the lung and blood vessels. Loss of these tight junctions alters the exchange of oxygen and carbon dioxide. Permeability dysfunction has been implicated in both acute lung injury and acute respiratory distress syndrome, a life-threatening lung condition that prevents adequate oxygen from getting from the lungs and into the blood.

Until now, very little has been known about the basic regulatory mechanisms underlying permeability barrier formation and integrity of the lung epithelium. David Warburton, MD, director of Developmental Biology and Regenerative Medicine at The Saban Research Institute, and El-Hashash provided the first evidence that the enzyme Eya1 protein phosphatase controls tight junction and permeability barrier formation in the lung epithelium. They have also provided the first evidence that Eya1 enzyme coordinates a complex network of other cellular proteins and molecules that are essential for epithelial barrier integrity, and are therefore critical to optimal lung function. Both in vivo and in vitro experiments showed that interfering with Eya1 phosphatase function resulted in defective formation of tight junctions and the permeability barrier.

"These findings identify a novel therapeutic option for lung diseases like COPD and ARDS," said Warburton. "Our discovery of Eya1 enzyme control of pulmonary barrier integrity suggests that influencing alveolar epithelial junction formation by manipulating the activity of enzymes has the potential to identify future targets for the treatment of lung injury and may provide solutions to the problems concerning regeneration of lung tissue for restoration of functional alveoli."

Results of the study will be published in the Journal of Cell Science.

About Children's Hospital Los Angeles

Children's Hospital Los Angeles has been named the best children's hospital in California and among the top five in the nation for clinical excellence with its selection to the prestigious US News & World Report Honor Roll. Children's Hospital is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the United States, is one of America's premier teaching hospitals and has been affiliated with the Keck School of Medicine of the University of Southern California since 1932.

SOURCE: Children's Hospital of Los Angeles.