Previous studies reported that some Streptococcus species activated TGF-β signaling in various diseases, e.g., Streptococcus pneumoniae induced TGF-β1 expression during tympanosclerosis pathogenesis (Qiu et al., 2021), asthma inflammation (Schmit et al., 2020) and pulmonary infection (Peteranderl et al., 2017). The gene discussed is TGFB1; the disease is middle ear disorder.