Blood group antigen expression on vaginal cells and mucus in women with and without a history of urinary tract infections

Adherence of bacteria to carbohydrate receptors on the surface of vaginal epithelial cells is a critical event that precedes bacterial colonization of the vaginal mucosa and subsequent urinary tract infection. Blood group antigens, carbohydrate structures bound to lipids or proteins, constitute an important component of the uroepithelial cell membrane and may affect susceptibility to urinary tract infections. To determine if the ABH and Lewis antigen expression in women with a history of urinary tract infections differed from that of women without such a history, vaginal specimens from 87 women (42 patients and 45 controls) were analyzed for the detection of these antigenic determinants using monoclonal antibodies in quantitative immunoassays. The profile of ABH antigen expression was generally consistent with the ABO phenotype of the individual and appeared to be influenced by the secretor status. Secretors expressed higher levels of A, B and H determinants than nonsecretors. In addition, Lewis antigens were detected on vaginal cells and in mucus. Samples from nonsecretors expressed higher levels of Le^a and Le(x) antigens, whereas secretors expressed higher levels of Le^b and Le(y) antigens. The levels of antigen expression varied widely among individuals with the same blood type and secretor status. Comparisons between patient and control groups showed no significant differences in ABH or Lewis antigen expression overall, or when controlling for ABO or secretor phenotypes, respectively. These findings confirm our previous observations on healthy women, and document the heterogeneity of blood group antigen expression on vaginal epithelial cells and mucus from women with a history of urinary tract infections.