Abstract
Histo-blood group antigens, which are present on gut epithelial surfaces, function as receptors or attachment factors and mediate susceptibility to rotavirus infection. The major determinant for susceptibility is a functional FUT2 enzyme which mediates the presence of α-1,2 fucosylated blood group antigens in mucosa and secretions, yielding the secretor-positive phenotype. Secretors are more susceptible to infection with predominant rotavirus genotypes, as well as to the commonly used live rotavirus vaccines. Difference in susceptibility to the vaccines is one proposed factor for the varying degree of efficacy observed between countries. Besides infection susceptibility, secretor status has been found to modulate rotavirus specific antibody levels in adults, as well as composition of breastmilk in mothers and microbiota of the infant, which are other proposed factors affecting rotavirus vaccine take. Here, the known and possible effects of secretor status in both infant and mother on rotavirus vaccine take are reviewed and discussed.
Highlights
Secretor Status and Susceptibility to RotavirusGroup A rotavirus, hereafter called rotavirus in this review, is the most common cause of severely dehydrating gastroenteritis in children worldwide [1]
Studies from Ghana and Pakistan with the Rotarix vaccine observed a difference in microbiota composition between responders and non-responders [69,70]
As secretor status influences both microbiota composition and factors that can be important for rotavirus vaccine take (Figure 1), it can be difficult to rule out confounding factors and ascertain the specific role of microbiota in these studies
Summary
Group A rotavirus, hereafter called rotavirus in this review, is the most common cause of severely dehydrating gastroenteritis in children worldwide [1]. Studies have shown that some children are more resistant to infection and disease for particular rotavirus genotypes [2] This resistance or susceptibility is largely mediated through expression of human histo-blood group antigens (HBGAs), mainly the types controlled by the FUT2 (secretor), FUT3 (Lewis), and ABO genes, in a rotavirus genotype dependent manner. These three predominant rotavirus P-genotypes are the most clinically relevant is terms of susceptibility to natural rotavirus infections Both in vitro and observational studies have provided strong evidence that secretor (FUT2) and Lewis (FUT3) antigens mediate susceptibility to the predominant genotypes in a P-genotype-dependent manner [2,5]. Variations in secretor-specificity has been observed between studies, as well as between and within lineages of P[8]-genotypes, including the Rotarix vaccine [2,7,8]
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