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Five subtypes (ESX-1 to ESX-5) exist, each with specific roles and well-characterized secretion profiles in various mycobacterial species.\n                    <jats:italic>Mycobacterium abscessus<\/jats:italic>\n                    , encodes only ESX-3 and ESX-4. Here, single and double\n                    <jats:italic>M. abscessus<\/jats:italic>\n                    mutants lacking the main ATPases EccC3 and EccC4 were used to define ESX-3 and ESX-4 contributions to substrate secretion and virulence. Our results demonstrate that EsxG\/H secretion depends entirely on ESX-3, whereas both ESX-3 and ESX-4 secrete EsxU\/T. Furthermore, two newly identified PE\/PPE substrates (MAB_0046\/MAB_0047) require ESX-3 for secretion. Functional complementation restored secretion and revealed subpolar localization of these systems. Macrophage infections showed that ESX-3 and ESX-4 contribute to bacterial internalization, phagosomal escape, and intracellular survival. In mice, infections with\n                    <jats:italic>eccC3-<\/jats:italic>\n                    and\/or\n                    <jats:italic>eccC4<\/jats:italic>\n                    -deletion mutants resulted in complete survival and reduced bacterial loads in the lungs. These findings demonstrate that both ESX systems drive\n                    <jats:italic>M. abscessus<\/jats:italic>\n                    pathogenicity.\n                  <\/jats:p>","DOI":"10.1038\/s42003-025-07572-4","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T15:14:01Z","timestamp":1738595641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Deletion of ESX-3 and ESX-4 secretion systems in Mycobacterium abscessus results in highly impaired pathogenicity"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9026-5333","authenticated-orcid":false,"given":"Wassim","family":"Daher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2012-1750","authenticated-orcid":false,"given":"Vincent","family":"Le Moigne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6110-2614","authenticated-orcid":false,"given":"Yara","family":"Tasrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Parmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L.","family":"Sexton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Jairo","family":"Aguilera-Correa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4162-5363","authenticated-orcid":false,"given":"Valentin","family":"Berdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elitza I.","family":"Tocheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-6418","authenticated-orcid":false,"given":"Jean-Louis","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-4458","authenticated-orcid":false,"given":"Laurent","family":"Kremer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"7572_CR1","doi-asserted-by":"publisher","first-page":"e1000507","DOI":"10.1371\/journal.ppat.1000507","volume":"5","author":"W Bitter","year":"2009","unstructured":"Bitter, W. et al. 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