Definition: In this task, you're given a paragraph from the research paper and your task is to generate a suitable title for the research paper based on the given paper. Under 100 words is a good title length.
Input: Mixed viral and bacterial infections are widely described in community-acquired pneumonia; however, the clinical implications of co-infection on the associated immunopathology remain poorly studied. In this study, microRNA, mRNA and cytokine/chemokine secretion profiling were investigated for human monocyte-derived macrophages infected in-vitro with Influenza virus A/H1N1 and/or Streptococcus pneumoniae. We observed that the in-vitro co-infection synergistically increased interferon-γinduced protein-10 (CXCL10, IP-10) expression compared to the singly-infected cells conditions. We demonstrated that endogenous miRNA-200a-3p, whose expression was synergistically induced following co-infection, indirectly regulates CXCL10 expression by targeting suppressor of cytokine signaling-6 (SOCS-6), a well-known regulator of the JAK-STAT signaling pathway. Additionally, in a subsequent clinical pilot study, immunomodulators levels were evaluated in samples from 74 children (≤5 years-old) hospitalized with viral and/or bacterial community-acquired pneumonia. Clinically, among the 74 cases of pneumonia, patients with identified mixed-detection had significantly higher (3.6-fold) serum IP-10 levels than those with a single detection (P = 0.03), and were significantly associated with severe pneumonia (P < 0.01). This study demonstrates that viral and bacterial coinfection modulates the JAK-STAT signaling pathway and leads to exacerbated IP-10 expression, which could play a major role in the pathogenesis of pneumonia. Community-acquired pneumonia (CAP) is a common inflammatory illness of the lungs that remains the major cause of pediatric mortality in low-and middle-income countries 1 . Streptococcus pneumoniae (SP) is the main causative agent of pneumonia; however, concomitant viral infection occurs in up to 66% of cases of CAP 2,3 . Clinical data suggest mixed infections are related to a higher severity of inflammatory disease 4,5 -especially in secondary pneumococcal infection following influenza virus (IAV) infection 6-8 -and mixed infection represents a relevant risk factor for pediatric intensive care hospitalization 9 . However, the mechanisms underlying the pathogenesis of mixed viral and bacterial infection remain poorly understood. Assessment of induced blood immunomodulators during infection may assist clinical diagnosis and the management of severe CAP. Interferon (IFN)-γ -induced protein 10 (IP-10/CXCL10) appears to contribute to the

Viral and bacterial co-infection in severe pneumonia triggers innate immune responses and specifically enhances IP-10: a translational study OPEN