Children with the Le(a+b−) Blood Group Have Increased Susceptibility to Diarrhea Caused by Enterotoxigenic Escherichia coli Expressing Colonization Factor I Group Fimbriae

Abstract

Recent studies have shown that children with blood group A have increased susceptibility to enterotoxigenic Escherichia coli (ETEC) diarrhea and that Lewis blood group "a" antigen (Le a ) may be a candidate receptor for ETEC colonization factor (CF) antigen I (CFA/I) fimbriae. Based on these findings, we have attempted to determine if children with the Le(a؉b؊) phenotype may be more susceptible to diarrhea caused by ETEC, in particular ETEC expressing CFA/I and related fimbriae of the CFA/I group, than Le(a؊b؉) children. To test this hypothesis, we have determined the Lewis antigen expression in 179 Bangladeshi children from a prospective birth cohort study in urban Dhaka in which ETEC expressing major CFs such as CFA/I, CS3, CS5, and CS6 was the most commonly isolated diarrhea pathogen during the first 2 years of life. The Lewis blood group phenotypes were determined by a dot blot immunoassay using saliva samples and by a tube agglutination test using fresh red blood cells. The results indicate that Le(a؉b؊) children more often had symptomatic than asymptomatic ETEC infections (P < 0.001), whereas symptomatic and asymptomatic ETEC infections were equally frequent in Le(a؊b؉) children. We also show that children with the Le(a؉b؊) blood type had significantly higher incidences of diarrhea caused by ETEC expressing fimbriae of the CFA/I group than Le(a؊b؉) children (P < 0.001). In contrast, we did not find any association between the Lewis blood group phenotype and diarrhea caused by ETEC expressing CS6 or rotavirus.

Revisiting the role of histo-blood group antigens in rotavirus host-cell invasion

“…However, it is notable that major rotavirus strain variations in HBGA recognition were detected. The relevant human clinical strain Wa did not recognize HBGAs, which is consistent with the observed lack of influence of genetically controlled expression of different HBGAs on pediatric rotavirus gastroenteritis 46,47 . Interestingly, two recent studies suggested that non-secretor individuals (null homozygote fucosyltransferase, FUT2) are not susceptible to infection with the most common rotaviruses 48,49 .…”

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

“…A study in Bangladesh, following ETEC diarrhea of children during their first 2 years of life, noted that ST-expressing ETEC more frequently infected children with blood type A or AB than children with blood group O (698). Further studies determined that children with Lewis antigen Le(aϩbϪ), but not Le(aϪbϩ), were more susceptible to illness caused by ETEC that expresses the CFA/I group of CFs (706). This association was suggested to be because of the ability of CFA/I to adhere to Le a -terminated glycosphingolipids but not Le b -terminated glycosphingolipids on host cells (706,707).…”

Spike Protein VP8* of Human Rotavirus Recognizes Histo-Blood Group Antigens in a Type-Specific Manner

“…RVs of P [1], P [2], P [3], and P [7] genotypes can be found in both humans and animals, and these RVs are mainly sialidase sensitive (9). Three P types (P [4], P [6], and P [8]) have been found to commonly cause gastroenteritis in humans, but none of them are sialidase sensitive (8).…”