RT Journal Article SR Electronic(1) A1 Gao, Huijie A1 Xu, Guanlong A1 Sun, Yipeng A1 Qi, Lu A1 Wang, Jinliang A1 Kong, Weili A1 Sun, Honglei A1 Pu, Juan A1 Chang, Kin-Chow A1 Liu, JinhuaYR 2015 T1 PA-X is a virulence factor in avian H9N2 influenza virus JF Journal of General Virology, VO 96 IS 9 SP 2587 OP 2594 DO https://doi.org/10.1099/jgv.0.000232 PB Microbiology Society, SN 1465-2099, AB H9N2 influenza viruses have been circulating worldwide in multiple avian species, and regularly infect pigs and humans. Recently, a novel protein, PA-X, produced from the PA gene by ribosomal frameshifting, was demonstrated to be an antivirulence factor in pandemic 2009 H1N1, highly pathogenic avian H5N1 and 1918 H1N1 viruses. However, a similar role of PA-X in the prevalent H9N2 avian influenza viruses has not been established. In this study, we compared the virulence and cytopathogenicity of H9N2 WT virus and H9N2 PA-X-deficient virus. Loss of PA-X in H9N2 virus reduced apoptosis and had a marginal effect on progeny virus output in human pulmonary adenocarcinoma (A549) cells. Without PA-X, PA was less able to suppress co-expressed GFP in human embryonic kidney 293T cells. Furthermore, absence of PA-X in H9N2 virus attenuated viral pathogenicity in mice, which showed no mortality, reduced progeny virus production, mild-to-normal lung histopathology, and dampened proinflammatory cytokine and chemokine response. Therefore, unlike previously reported H1N1 and H5N1 viruses, we show that PA-X protein in H9N2 virus is a pro-virulence factor in facilitating viral pathogenicity and that the pro- or antivirulence role of PA-X in influenza viruses is virus strain-dependent., UL https://www.microbiologyresearch.org/content/journal/jgv/10.1099/jgv.0.000232