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Within host cells, it establishes a replicative niche named Coxiella-containing vacuole (CCV). This is driven by effector proteins secreted by the bacterium into the host cell cytoplasm via a Type 4b Secretion System (T4SS). Advances in axenic culture and mutagenesis allowed the characterization of Coxiella effector proteins, revealing their host targets and strategies of cellular subversion. This review highlights recent insights into Coxiella effector proteins and their manipulation of host processes, from vesicular trafficking to innate immunity.<\/jats:p>","DOI":"10.3390\/pathogens14090896","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T14:53:01Z","timestamp":1757083981000},"page":"896","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Bacterial Puppeteering: How the Stealth Bacterium Coxiella Pulls the Cellular Strings"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1934-2640","authenticated-orcid":false,"given":"Dylan","family":"Ruart","sequence":"first","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Riedinger","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-3931","authenticated-orcid":false,"given":"Sihem","family":"Zitouni","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6341-2278","authenticated-orcid":false,"given":"Arthur","family":"Bienvenu","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-8759","authenticated-orcid":false,"given":"Matteo","family":"Bonazzi","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8568-3725","authenticated-orcid":false,"given":"Eric","family":"Martinez","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Infectiologie de Montpellier (IRIM), Universit\u00e9 de Montpellier, CNRS, CEDEX 5, 34293 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/CMR.00045-16","article-title":"From Q Fever to Coxiella Burnetii Infection: A Paradigm Change","volume":"30","author":"Eldin","year":"2017","journal-title":"Clin. 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