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. Author manuscript; available in PMC: 2014 Nov 1.
Published in final edited form as: Influenza Other Respir Viruses. 2013 Nov;7(0 3):10.1111/irv.12174. doi: 10.1111/irv.12174

Table 2.

Pathogenetic mechanisms of viral-bacterial co-infections.

Virus induced alteration in epithelial cells

  • reduced ciliary function

  • cell death/decreased epithelial barrier function

  • upregulation of surface receptors for bacterial adhesion

Enhancement of bacterial colonization and transmission in vivo
Virus-mediated inhibition of innate immune cells (e.g., macrophages, neutrophils)

  • suppressed phagocytosis

  • impaired microbial killing

  • depressed leukocyte migration

Antiviral immune molecules – Type I and II interferons

  • suppressed innate immunity

  • inhibition of IL-17 responses

Dysregulated inflammation

  • enhanced lung injury from increased inflammation (e.g., chemokines)

  • increased susceptibility from induction of anti-inflammatory cytokines (e.g., Il-10)