“…There is uncertainty as to the origin of so called “natural antibodies.” Conflicting data exist regarding the potential role of plant materials, microbes, genetic elements, and even transient blood group A and B expression, in the development of naturally occurring antibody formation, in general, and formation of anti-ABO(H) antibodies, in particular ( Bernstein, F., 1925 , F S, 1934 ; Furuhata, 1969 ; Hayakawa et al., 1999 ; New et al., 2020 ; Springer, 1956 ; Springer et al., 1961 ; Storry and Olsson, 2009 ; Wagner, 1955 ; Watkins, 2001 ). Innate immune factors appear to specifically target microbes decorated in blood group carbohydrate antigens ( Arthur et al., 2015b ; Blenda et al., 2022 ; Ho et al., 2022 ; Stowell et al., 2010 , 2014 , 2014 ; Wu et al., 2021b , 2022 , 2022 ), suggesting that a unique interplay may exist between blood group positive microbes, innate immunity, and the development of naturally occurring anti-blood group antibodies. However, studies using germ-free mice suggest that exogenous antigen stimulation is not required for naturally occurring antibody formation ( Bos et al., 1989 ; Bunker et al., 2017 ; Haury et al., 1997 ; Hooijkaas et al., 1984 , 1985 ).…”