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T cell responses play an important role in clearing influenza infections and in the development of a protective antibody response.
Based primarily on studies in animal models, T-cell responses are also thought to play an important role in clearing influenza virus infection [18], [19], [20], [21], [22], [23], [24].
The fact that effector CD4 and CD8 T cells are required for the clearance of RNA virus infections, the increased percentages of activated CD4 and CD8 T cells likely plays a imperative role in clearing influenza viruses from the lung despite altering the inflammatory cells recruited to the lung.
Controlling and clearing influenza virus infection requires neutralizing antibodies and cell-mediated immunity (for example, activation of T cells) [ 3].
A multi-pronged innate (McGill et al., 2009) and adaptive (Brown et al., 2004) immune response has been described for clearing influenza infection.
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This may result in different behaviors towards influenza compared to temperate countries with clear influenza seasons during winter months - for example the generally lower influenza vaccination uptake in the tropics [ 14].
In addition, countries should have had clear influenza activity, i.e. in relation to historical data and with a defined peak of influenza activity, for at least 4 winter seasons including the pandemic season, to be included in the analysis.
In previous studies mice lacking SPP1 and CCL5 were found to clear influenza infection with no adverse effects [ 10, 11], while mice lacking CCR2 survived infection by a mouse-adapted influenza A virus that killed wild-type mice [ 12].
Therefore, it is not unexpected that the initial impairment in an appropriate immune response due to As exposure could have significant consequences on the ability to clear influenza infection, whereas prolonged viral carriage may predispose to enhanced tissue injury.
A key difference between IAV and CVB3 infections is in the crucial role of adaptive immunity to clear influenza virus [ 50, 51], whereas T lymphocytes and virus neutralizing antibodies are of limited value for elimination of picornaviruses [ 40, 47].
Previous reports indicated that mindin-deficient mice had an impaired capability to clear influenza virus and bacterial infection, and mindin-deficient macrophages exhibit defective responses to a broad spectrum of microbial stimuli.
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