Blood Group, Immunity, and Risk of Infection with Vibrio cholerae in an Area of Endemicity

Abstract

Individuals with blood group O are more susceptible than other individuals to severe cholera, although the mechanism underlying this association is unknown. To assess the respective roles of both intrinsic host factors and adaptive immune responses that might influence susceptibility to infection with Vibrio cholerae, we prospectively followed a cohort of household contacts of patients with cholera in Bangladesh. In this study, we made the novel observation that persons with blood group O were less likely than those with other blood groups to become infected with V. cholerae O1 (odds ratio Vibrio cholerae is a gram-negative bacterium that causes a spectrum of infection ranging from asymptomatic colonization to rapidly fatal secretory diarrhea known as cholera gravis. V. cholerae is differentiated serologically by the O side chain of its lipopolysaccharide; the vast majority of human cholera is caused by the O1 and O139 serogroups. The O1 serogroup of V. cholerae is subclassified into two biotypes (classical and El Tor) and two major serotypes (Inaba and Ogawa) (11). Due to variations in the predominating serogroup, biotype, and serotype in circulation, the epidemiology of cholera is in constant flux. In the 1960s, the V. cholerae O1 El Tor biotype emerged as a major cause of cholera, ultimately replacing the classical biotype. In 1992, the V. cholerae O139 serogroup first appeared; after briefly predominating in South Asia, it now persists in this region, but at much lower levels than V. cholerae O1 El Tor.[Susceptibility to infection with V. cholerae is dependent on both adaptive immune responses induced by previous infection and innate host factors. The best-studied correlate of adaptive immunity to V. cholerae is the serum vibriocidal antibody, a complement-fixing bactericidal antibody. Seroepidemiologic studies in areas of endemicity have shown that vibriocidal antibody titers increase with age and that risk of disease is inversely proportional to the vibriocidal antibody titer (9,16,17). However, there is no threshold vibriocidal antibody titer above which complete protection from infection is achieved, and it is hypothesized that the vibriocidal antibody is a surrogate marker for a protective mucosal immune response (24). Systemic antibodies to cholera toxin have not been found to correlate with protection from cholera (9). Furthermore, infection with V. cholerae O1 does not confer protection from V. cholerae O139, even though both serogroups produce identical cholera toxins (1,22).Among the intrinsic host factors that influence susceptibility to cholera, the ABH histo-blood group antigens are the most studied. Multiple case-control studies in areas of cholera endemicity have demonstrated that individuals with blood group O (the blood group phenotype associated with the H antigen) are at increased risk of hospitalization due to classical and El Tor V. cholerae O1 as well as V. cholerae O139 (3, 4, 5, 7, 26). A study of North American volunteers also demonstrated increased purging in blood group O subjects ...

Blood group does not appear to affect longevity a pilot study in centenarians from Western Sicily

“…There are other examples of infectious diseases in which the severity of infection can be directly linked to ABO phenotype. Patients of group O were more susceptible to severe infections by Vibrio cholerae than non-O patients (Harris et al 2005) and in an outbreak of gastrointestinal infections caused by Escherichia coli O157 in Scotland in 1996, 87.5% of patients who died were group O (Blackwell et al 2002).…”

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

“…HBGA phenotype also appears to influence susceptibility to bacterial enteropathogens [86,87], including V. cholerae [88,89]. Nonsecretors are more likely to suffer from severe cholera than secretors [90].…”

“…Causes of impaired oral vaccine efficacy in developing countries Review colonized by V. cholerae [89], but are more likely, upon colonization, to develop severe symptoms [88,89]. The extent to which HBGA phenotype influences cholera vaccine response remains uncertain.…”

“…Nonsecretors are more likely to suffer from severe cholera than secretors [90]. Somewhat paradoxically, individuals with blood group O are less likely to be (1) future science groupCauses of impaired oral vaccine efficacy in developing countries Review colonized by V. cholerae [89], but are more likely, upon colonization, to develop severe symptoms [88,89]. The extent to which HBGA phenotype influences cholera vaccine response remains uncertain.…”

Is blood group associated with mortality in Crimean-Congo Hemorrhagic Fever?

“…15 In studies conducted on patients with Vibrio cholera infection, mortality was shown to be significantly increased in patients with 0 blood groups, as compared to non-0 groups. 18,19 In a study performed on children infected with Plasmodium falciparum, rosette formation in erythrocytes was decreased in children with 0 blood groups, as compared to children with non-0 blood groups; in addition, vaso-occlusion and severe disease were found to be associated with blood groups. 20,21 The presence of valid information on the distribution of blood groups among patients and in this region, which is an endemic area for CCHF, and available data on specific blood groups in the patient population, is of critical importance.…”