{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:54:30Z","timestamp":1768316070955,"version":"3.49.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":1377,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Bacterial superinfection aggravates the disease of influenza. Streptococcus pneumoniae is the most common bacterial pathogen. Synergistic virulence has been demonstrated between influenza neuraminidase and pneumococcal NanA and NanB. NanC, the other pneumococcal neuraminidase infrequently present in clinical isolates, is not well characterized. In this study, we report that superinfection with a NanC-negative pneumococcus strain suppresses anti-influenza immunity and impairs viral clearance with higher TGF-\u03b2 activation in mice. Bacterial load in the lungs also increases as the host immunity is suppressed. NanC-positive isogenic mutant reverses wild type S. pneumoniae\u2013mediated immune suppression and facilitates virus clearance. However, it causes more severe disease as the augmented inflammation causes collateral damage. Both virus-mediated damage and immune response\u2013mediated inflammation are important for pathogenesis of severe influenza. Inflammation may be more critical than virus-mediated damage in influenza with bacterial superinfection.<\/jats:p>","DOI":"10.4049\/immunohorizons.2100020","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T18:45:41Z","timestamp":1619635541000},"page":"210-218","source":"Crossref","is-referenced-by-count":7,"title":["Role of Pneumococcal NanC in the Severe Disease of <i>Streptococcus pneumoniae<\/i> Superinfection with Influenza"],"prefix":"10.1093","volume":"5","author":[{"given":"Avijit","family":"Dutta","sequence":"first","affiliation":[{"name":"Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Yin","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tse-Ching","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Department of Pathology, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Shiang","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Lin","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting-An","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-5348","authenticated-orcid":false,"given":"Yung-Chang","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Hematology and Oncology, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Yen","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Hepatogastroenterology, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Chia","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, Department of Pediatrics, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Tai","family":"Huang","sequence":"additional","affiliation":[{"name":"Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital , Guishan, Taoyuan City ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, College of Medicine, Chang Gung University , Guishan, Taoyuan City ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"2025010703474211300_r1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1172\/JCI103791","article-title":"Studies on influenza in the pandemic of 1957-1958. 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