Apr 22 2011

Enterotypes and blood types

My mailbox got choked up the other morning with emails from friends and strangers wondering about my thoughts on the recent study published in Nature on the mapping of gut bacterial (microbiome) patterns to basically three general groups. The findings were extensively reported in the media, including Wired Magazine which managed to start the article off with the bizarre claim that humans can belong to any one of eight blood groups. Although I suspect that the writer was alluding to ABO and Rhesus (4*2=8) that is not a very accurate way of putting things, since there are a large number of determinants, and in fact the secretor status (FUT2) that controls ABO presence in bodily secretions is much more significant ‘blood group’ on a phenotypic level that Rhesus (Rh), which is a true erythrocyte antigen and not found in the gut or body secretions.

The authors found three distinctive “enterotypes,” or bacterial communities dominated by a distinct genus — Bacteroides, Prevotella or Ruminococcus — each of which is found with a particular community of bacteria.

The abstract describes the study as follows:

By combining 22 newly sequenced fecal metagenomes of individuals from four countries with previously published data sets, here we identify three robust clusters (referred to as enterotypes hereafter) that are not nation or continent specific. We also confirmed the enterotypes in two published, larger cohorts, indicating that intestinal microbiota variation is generally stratified, not continuous. This indicates further the existence of a limited number of well-balanced host-microbial symbiotic states that might respond differently to diet and drug intake.

There is much being made out of the apparent similarities between these enterotypes and the human blood groups. And well there should be. Except the link between blood groups and the microbiome is already well-known. I first wrote about it in my book Live Right For Your Type over ten years ago. (1)


The distal human intestine represents an anaerobic bioreactor programmed with an enormous population of bacteria, dominated by relatively few divisions that are highly diverse at the strain/subspecies level. This microbiota and its collective genomes (microbiome) provide us with genetic and metabolic attributes we have not been required to evolve on our own, including the ability to harvest otherwise inaccessible nutrients. New studies are revealing how the gut microbiota has coevolved with us and how it manipulates and complements our biology in ways that are mutually beneficial.

We are also starting to understand how certain keystone members of the microbiota operate to maintain the stability and functional adaptability of this microbial organ. It is estimated that the human digestive tract may contain up to 100 trillion microorganisms (2) and the human gut may host up to 500-1000 different species of bacteria, of which as little as 7% have been successfully cultured in the laboratory. (3)

What's your type?

The human GI tract is predominantly a bacterial ecosystem. Cell densities in the colon (1011-1012/ml contents) are the highest recorded for any known ecosystem. The vast majority of phylotypes belong to two divisions (superkingdoms) of Bacteria: the Bacteroidetes (48%) and the Firmicutes (51%). The remaining phylotypes are distributed among the Proteobacteria, Verrucomicrobia, Fusobacteria, Cyanobacteria, Spirochaetes, and the candidate phylum VadinBE97.

Gut bacteria can have direct effects on gene activation that may be essential for proper gut development. Bacteria induced expression of mammalian genes has been known since the 1980’s when Japanese researchers were able to show that a fucosyltransferase enzyme (fucosyl-asialo GM1) was induced by bacteria but was absent from germ-free strains. (4)

This is especially interesting in light of the fact that many of the fucosyltransferase enzymes convey blood group and/or secretor status. (5) Human feces contain enzymes produced by enteric bacteria that degrade the A, B, and H blood group antigens of gut mucin glycoproteins.

The autosomal dominant ABH secretor gene together with the ABO blood group gene controls the presence and specificity of A, B, and H blood group antigens in human gut mucin glycoproteins. There is evidence that the host’s ABO blood group and secretor status affects the specificity of blood group-degrading enzymes produced by his fecal bacteria in vitro. (6)

In essence, bacteria ‘eat right for their type’ even if we sometimes don’t.

Comparatively small populations of fecal bacteria produce blood group-degrading enzymes but their presence is highly correlated with the ABO /secretor phenotype of the host: Fecal populations of B-degrading bacteria were stable over time, and their population density averaged 50,000-fold greater in blood group B secretors than in other subjects. In fact, the large populations of fecal anaerobes may be an additional source of blood group antigen substrate for blood group antigen degrading bacteria: antigens crossreacting with blood group antigens were detected on cell walls of anaerobic bacteria from three of 10 cultures inoculated. (7,8)

Another example of “eco-phenotypic cooperation” between a host’s polymorphism and gut bacteria may be seen in the development of the early vascular networks. In this case a mechanism of postnatal animal development, where microbes colonizing a mucosal surface are assigned responsibility for regulating elaboration of the underlying microvasculature by signaling through a bacteria-sensing epithelial cell and its possible relation to a polymorphic phenotype on the part of the host.

  1. D’Adamo P, Whitney C. Live Right For Your Type. 2001. GP Putnam and Sons, NYC
  2. Bäckhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. Mar 25; 307(5717):1915-20. (2005)
  3. http://www.genome.gov/25521743
  4. Eckburg, P. B., Bik, E. M., Bernstein, C. N., Purdom, E., Dethlefsen, L., Sargent, M., Gill, S. R., Nelson, K. E. & Relman, D. A. Diversity of the human intestinal microbial flora. Science 308, 1635-38. (2005)
  5. Umesaki Y. Immunohistochemical and biochemical demonstration of the change in glycolipid composition of the intestinal epithelial cell surface in mice in relation to epithelial cell differentiation and bacterial association. J Histochem Cytochem. 1984 Mar; 32(3):299-304.
  6. D’Adamo PJ, Kelly GS. Metabolic and immunologic consequences of ABH secretor and Lewis subtype status. Altern Med Rev. Aug;6(4):390-405; 2001
  7. Hoskins LC, Boulding ET. Degradation of blood group antigens in human colon ecosystems. I. In vitro production of ABH blood group-degrading enzymes by enteric bacteria. J Clin Invest Jan;57(1):63-73;1976
  8. Hoskins LC, Boulding ET. Degradation of blood group antigens in human colon ecosystems. II. A gene interaction in man that affects the fecal population density of certain enteric bacteria. J Clin Invest Jan;57(1):74-82; 1976

6 responses so far

6 Responses to “Enterotypes and blood types”

  1. Nancy S says:

    Would this also explain why some people have great dental health while others are riddled with major dental problems. I’m blood type O and have horrible teeth with many crowns. Prior to that many amalgam fillings. My husband is AB and only has about 4 fillings and the rest of his teeth are in great shape. I have recently adopted the blood type diet and feeling much better (less tired, more stable mentally). On the other hand my husband seems to eat pretty much what he wants, has a steady supply of energy and goes about his merry way.

    • Mr.Lasse says:

      Hi Nancy.

      Im not Peter (obviously), but one of the enterotypes has an increased intrinsic production of K2 vitamin. That would provide better bone health. But other factors might very well overshadow this effect, so I dont think you should look for simple explanations for the difference between individuals.

  2. Mr.Lasse says:

    Very very interesting news about these socalled enterotypical divisions.

    But I would like to complement your interesting comment here, wiht some views and thoughts that unfortunately is overlooked both here and in the information-stream of news regarding these new findings. I would love to here your (or anyone elses comments on these views). Here goes, what I think is missing in the news and debate if we want to level-up our knowledge and intellectual benchmark:

    First of all, we have to investigate or try to understand, wether we are just studying the current microbiological cultures, that currently prevails in the human guts or wether we are studying stable and permanent cultures that are not linked to external factors at all. And we also needs to know, if these cultures – even if they happen to be permanent and stable – are linked 1:1 to our genetic makeup at all. Maybe they are just the prevailing survivors of the environment, that stems from our diet and lifestyle and how we accidentally happen to let our genes express themselves, at the current time (or over a whole lifetime, as humans are a highly habitual specie). As a firstorder analysis I would say that investigating microbial cultures is not the same as investigating ‘types’ of humans (call it genotype, enterotype or what ever), as these cultures are not intrinsic to the human genetic makeup and we happen to identify ‘human type’ with the genetic makeup and regard eveything else as external noise or consesquences of how that makeup happens to express itself at the current time.

    There is a profound difference between these scenarios, and it would be of utmost importance to the whole idea of socalled ‘enterotypes’, to unveil all this in future research.

    Secondly. We need to understand wether the prevailing culture can be changed in the specific person. A natural way to experiment with would of course be through diet and lifestyle changes. If it happens to be so, it would not nescessarily smash the maybe link between types and cultures; as we know that the genetic expression of a person can be changed, even though the genetic type of that same person does not change. But it would nevertheless prove be very rewarding to understand, wether the dominant culture (enterotype) can be changed in a person in some way.

    Ok thank you. Feel free to comment in an intelligent and constructive way please…

  3. MetaHIT says:

    The enterotypes discovery is the result of a fruitful scientific collaboration called MetaHIT (metagenomics of the human intestinal tract), funded by the European Commission. It takes many researchers, labs, fields of expertise to come up with such a major finding and we want to thank and acknowledge all those who contributed to these exciting results!

  4. [...] significant influence on the digestive tract, from stomach acid levels to intestinal enzymes to the particular strains of bacteria that grow inside of us. Much of the immunologic reactivity of many foods varies by blood type. Virtually every sceptic [...]

  5. [...] “There is a big difference between an absence of evidence and evidence of absence.”  There are many research studies that demonstrate fascinating connections between blood type and digestive and immune health that form the basis for the development of the Blood Type Diet system.  For example, “ABO blood type is a significant influence on the digestive tract, from stomach acid levels to intestinal enzymes to the particular strains of bacteria that grow inside of us.” [...]

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