Since much of the pathology of pneumococcal infections is a consequence of host inflammatory responses we also examined the association between IDTR and host immune responses represented by a selected set of cytokines. The form and quantity of iron in humans varies significantly at different anatomical locations and it is likely that bacterial pathogens sense these differences, among other signals, and regulate gene expression in response. The exact mechanisms of iron acquisition and regulation in the pneumococcus are still largely unknown. However, the ability of this pathogen to colonize the highly iron-restricted environment of the nasopharynx and also cause invasive diseases in relatively iron-rich sites suggests that iron may be an important environmental signal for gene regulation. A signature-tagged mutagenesis study in type 3 pneumococcus suggested a role for smrB in pneumococcal virulence. Although the authors proposed the gene AbMole Diniconazole designation smrB, we suggest the more associative idtr nomenclature. This gene was conserved in various unrelated pneumococcal strains and capsule types. We did not detect any significant difference in growth between wild-type and mutant either in presence or absence of iron in vitro. Additionally, no differences were observed between the mutant and wild-type in their ability to utilize a variety of iron sources. The mutant forms clusters and aggregates in both the presence and absence of iron. These observations suggest that idtr has no significant role during pneumococcal growth in vitro but in some way affects bacterial cell-cell adhesion or daughter cell separation during cell division. TIGR4 and Didtr did not differ significantly in growth rates in blood following bacteremia up to 48 hours after infection. In relatively iron-rich environments such as blood idtr is not critical for pneumococcal growth. This observation parallels that seen in vitro in which the mutant was able to replicate as well as wild-type in presence of high iron concentration. The contribution of idtr to pneumococcal sepsis was evaluated using a mouse model and both intravenous and intranasal inoculation. The Didtr mutant was significantly attenuated in the sepsis model by both routes of infection as compared to the parent strain but the more striking difference was observed with the intransal route of infection. We postulate that idtr is essential specifically during transition from the nasopharyngeal mucosa to submucosal tissue and blood. The Didtr mutant could be isolated from the nasopharynx two days after inoculation but not after day five, so lack of idtr may result in an even earlier deficiency, that is, an inability to efficiently colonize the nasopharynx. In either case it is likely that gene regulation by idtr is critical at mucosal surfaces where the concentration of extracellular iron in any form is exceedingly low. Because increased mortality in mice infected with TIGR4 strain was not the result of more rapid cell growth in vivo, we selected ten known and putative virulence genes which might potentially be directly or indirectly regulated by idtr. We had previously studied these same genes in TIGR4 and found that they are differentially regulated in different anatomic sites in mouse models. The expression of the selected genes was not markedly different between wild-type and the mutant in vitro but pronounced differences were noted during growth in vivo. Gene expression in Didtr was increased compared with wild-type in nasopharyngeal colonization and pneumonia.