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Shortly after RSV infection, the epithelial cells and alveolar macrophages produce Gas6. The Gas6/Axl axis polarizes antibacterial (M0-like) macrophages into nonantibacterial (M2-like) macrophages that inhibit the activation of caspase-1/IL-18. The low levels of IL-18/IFN-γ in the macrophages and NK cells result in severe secondary pneumococcal infection.
