20Streptococcus pneumoniae is a Gram-positive bacterium belonging to the oral 21 streptococcus species, mitis group. This pathogen is a leading cause of 22 community-acquired pneumonia, which often evades host immunity and causes 23 systemic diseases, such as sepsis and meningitis. Previously, we reported that PfbA is a 24 β-helical cell surface protein contributing to pneumococcal adhesion to and invasion of 25 human epithelial cells in addition to its survival in blood. In the present study, we 26 investigated the role of PfbA in pneumococcal pathogenesis. Phylogenetic analysis 27 indicated that the pfbA gene is specific to S. pneumoniae within the mitis group. Our in 28 vitro assays showed that PfbA inhibits neutrophil phagocytosis, leading to 29 pneumococcal survival. We found that PfbA activates NF-κB through TLR2, but not 30 TLR4. In addition, TLR2/4 inhibitor peptide treatment of neutrophils enhanced the 31 survival of the S. pneumoniae ∆pfbA strain as compared to a control peptide treatment, 32whereas the treatment did not affect survival of a wild-type strain. In a mouse 33 pneumonia model, the host mortality and level of TNF-α in bronchoalveolar lavage 34 fluid were comparable between wild-type and ∆pfbA-infected mice, while deletion of 35 4 pfbA increased the bacterial burden in bronchoalveolar lavage fluid. In a mouse sepsis 36 model, the ∆pfbA strain demonstrated significantly increased host mortality and TNF-α 37 levels in plasma, but showed reduced bacterial burden in lung and liver. These results 38 indicate that PfbA may contribute to the success of S. pneumoniae species by inhibiting 39 host cell phagocytosis, excess inflammation, and mortality. 40 41 Importance 42Streptococcus pneumoniae is often isolated from the nasopharynx of healthy 43 children, but the bacterium is also a leading cause of pneumonia, meningitis, and sepsis. 44In this study, we focused on the role of a cell wall anchoring protein, PfbA, in the 45 pathogenesis of S. pneumoniae-related disease. We found that PfbA is a 46 pneumococcus-specific anti-phagocytic factor that functions as a TLR2 ligand, 47indicating that PfbA may represent a pneumococcal-specific therapeutic target. 48However, a mouse pneumonia model revealed that PfbA deficiency reduced the 49 bacterial burden, but did not decrease host mortality. Furthermore, in a mouse sepsis 50 model, PfbA deficiency increased host mortality. These results suggest that S. 51 5 pneumoniae optimizes reproduction by regulating host mortality through PfbA; 52 therefore, PfbA inhibition would not be an effective strategy for combatting 53 pneumococcal infection. Our findings underscore the challenges involved in drug 54 development for a bacterium harboring both commensal and pathogenic states. 55 56