title: 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.
authors.affiliation: Laboratory Sciences Division, ICDDR, B, GPO Box 128, Dhaka 1000, Bangladesh. dr_tanvir@icddrb.org
authors.forename: Tanvir
authors.initials: T
authors.lastname: Ahmed
authors.forename: Anna
authors.initials: A
authors.lastname: Lundgren
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arifuzzaman
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
authors.forename: Susann
authors.initials: S
authors.lastname: Teneberg
authors.forename: Ann-Mari
authors.initials: AM
authors.lastname: Svennerholm
mesh_terms: D000328:Adult; D001459:Bangladesh; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004198:Disease Susceptibility; D054307:Enterotoxigenic Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D036781:Fimbriae Proteins / Q000096:biosynthesis*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007983:Lewis Blood Group Antigens; D055815:Young Adult
chemical_list: D007983:Lewis Blood Group Antigens; C022924:colonization factor antigens; D036781:Fimbriae Proteins