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Despite decades of research efforts, no vaccine is available against this common cause of disease and death in foals. The purpose of this narrative review is to summarise the current understanding of interactions between\n                    <jats:italic>R. equi<\/jats:italic>\n                    and the host innate immune system, to describe features of the immune response that are associated with resistance or susceptibility to\n                    <jats:italic>R. equi<\/jats:italic>\n                    infection, and help guide strategies for developing novel approaches for preventing\n                    <jats:italic>R. equi<\/jats:italic>\n                    infections. Virulence of\n                    <jats:italic>R. equi<\/jats:italic>\n                    in foals has been attributed to the virulence associated protein A which allows intracellular survival in macrophages by preventing acidification of\n                    <jats:italic>R. equi<\/jats:italic>\n                    \u2010containing vacuole. Additionally, foal susceptibility to\n                    <jats:italic>R. equi<\/jats:italic>\n                    infection is associated with immaturity and naivety of innate and adaptive immune systems, while adult horses with fully functional immune system are resistant to pneumonia. Specific interaction between\n                    <jats:italic>R. equi<\/jats:italic>\n                    and innate immune cells can result in bacterial survival or death; learning how to manipulate these responses to control infection is critical to prevent pneumonia in foals. Administration of live vaccines and stimulation of innate immune responses appears to improve foals' immune response and has the potential to overcome the challenges of foal active vaccination and elicit protection against pneumonia.\n                  <\/jats:p>","DOI":"10.1111\/evj.14214","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T08:58:11Z","timestamp":1726045091000},"page":"563-586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Protective immune response against\n                    <i>Rhodococcus equi<\/i>\n                    : An innate immunity\u2010focused review"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5588-2851","authenticated-orcid":false,"given":"Bibiana Petri","family":"da Silveira","sequence":"first","affiliation":[{"name":"Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences Texas 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