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In humans and mice, members of the type II transmembrane protease family (TTSP), e.g., TMPRSS2, TMPRSS4, and TMPRSS11d (HAT), have been shown to cleave influenza virus HA for viral activation and infectivity\n            <jats:italic>in vitro<\/jats:italic>\n            . Recently, we reported that inactivation of a single HA-activating protease gene,\n            <jats:italic>Tmprss2<\/jats:italic>\n            , in knockout mice inhibits the spread of H1N1 influenza viruses. However, after infection of\n            <jats:italic>Tmprss2<\/jats:italic>\n            knockout mice with an H3N2 influenza virus, only a slight increase in survival was observed, and mice still lost body weight. In this study, we investigated an additional trypsin-like protease, TMPRSS4. Both TMPRSS2 and TMPRSS4 are expressed in the same cell types of the mouse lung. Deletion of\n            <jats:italic>Tmprss4<\/jats:italic>\n            alone in knockout mice does not protect them from body weight loss and death upon infection with H3N2 influenza virus. In contrast,\n            <jats:italic>Tmprss2<\/jats:italic>\n            <jats:sup>\u2212\/\u2212<\/jats:sup>\n            <jats:italic>Tmprss4<\/jats:italic>\n            <jats:sup>\u2212\/\u2212<\/jats:sup>\n            double-knockout mice showed a remarkably reduced virus spread and lung pathology, in addition to reduced body weight loss and mortality. Thus, our results identified TMPRSS4 as a second host cell protease that, in addition to TMPRSS2, is able to activate the HA of H3N2 influenza virus\n            <jats:italic>in vivo<\/jats:italic>\n            .\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>IMPORTANCE<\/jats:bold>\n            Influenza epidemics and recurring pandemics are responsible for significant global morbidity and mortality. Due to high variability of the virus genome, resistance to available antiviral drugs is frequently observed, and new targets for treatment of influenza are needed. Host cell factors essential for processing of the virus hemagglutinin represent very suitable drug targets because the virus is dependent on these host factors for replication. We reported previously that\n            <jats:italic>Tmprss2<\/jats:italic>\n            -deficient mice are protected against H1N1 virus infections, but only marginal protection against H3N2 virus infections was observed. Here we show that deletion of two host protease genes,\n            <jats:italic>Tmprss2<\/jats:italic>\n            and\n            <jats:italic>Tmprss4<\/jats:italic>\n            , strongly reduced viral spread as well as lung pathology and resulted in increased survival after H3N2 virus infection. Thus, TMPRSS4 represents another host cell factor that is involved in cleavage activation of H3N2 influenza viruses\n            <jats:italic>in vivo<\/jats:italic>\n            .\n          <\/jats:p>","DOI":"10.1128\/jvi.02693-15","type":"journal-article","created":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T15:07:04Z","timestamp":1455808024000},"page":"4298-4307","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":52,"title":["The Proteolytic Activation of (H3N2) Influenza A Virus Hemagglutinin Is Facilitated by Different Type II Transmembrane Serine Proteases"],"prefix":"10.1128","volume":"90","author":[{"given":"Nora","family":"K\u00fchn","sequence":"first","affiliation":[{"name":"Department of Infection Genetics, Helmholtz Centre for Infection Research, and University of Veterinary Medicine Hannover, Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"K\u00f6sterke","sequence":"additional","affiliation":[{"name":"Department of Molecular Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth L. 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