In a recent study, researchers found that O-glycosylation played a novel role in disease development. For COVID-19, it was predicted that O-glycoproteome being a critical component of the infection, similar activities may occur. Though the human ACE2 receptor appears to be the primary receptor of the virus in host cells, the virus likely binds via the formation of an intermediate O-glycan. It is dominated by the amino acid serine of the virus. In humans, the resulting intermediate structure, which is independent of the blood group, may be replaced by carbohydrates specific to the ABO (H) blood groups.
After the virus attaches itself to a human cell via the ACE2 protein, it was noticed that the amino acid serine of the virus is critical during the host-virus fusion process. That being said about serine from previous studies, is it highly probable that binding to the host cells occurs via O-glycosylation. Disease symptoms seem to occur more in patients with non-O blood groups, suggesting that viral serine targets the saccharides of blood groups A, B, and AB in the glycosylation process. Thus, the innate immune system and its connection to the ABO (H) blood groups may play a key role in the SARS-CoV-2 infection. SARS-CoV-2 escapes the human immune system by hybridization of the ABO (H) blood groups or by mimicking the glycosylation metabolic pathways.
In the blood group O, it was found that it has the least contact with the virus, only being bound to the virus by the formation of the H-type antigen. It is the most protected group as it loses only the anti-H isoagglutinin but retains the secondary IgG responses. In other blood groups (A, B, AB) anti-A/ anti-B and anti-H formations are blocked, anti-A/ anti-B levels are low, and IgG is not produced. Blood group AB is least protected from the pathogen and has the strongest contact with the virus.
The lack of anti-A and anti-B antibodies in the A, B, and AB blood groups cannot prevent the formation of hybrid structures in later steps of the infection process. It is likely that in SARS-CoV-2 infection, the autoimmune processes, particularly in non-O blood groups, may contribute to severe symptoms. However, the researchers state that the individual risk of becoming infected with SARS-CoV-2 or becoming seriously ill cannot be predicted depending on a person’s ABO(H) blood group affiliation alone because of other risks.
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