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Factor XII–driven coagulation traps bacterial infections
Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Clinical Chemistry, Department of Molecular Medicine and Surgery, and Center of Molecular Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden.ORCID iD: 0000-0003-1287-6766
Clinical Chemistry, Medical Diagnostics, Karolinska University Hospital, Stockholm, Sweden.ORCID iD: 0009-0009-7663-5700
Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID iD: 0009-0007-2336-8982
Department of Laboratory Medicine, Biomedical Center (BMC), Lund University, Lund, Sweden.ORCID iD: 0000-0002-3872-478X
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2025 (English)In: Journal of Experimental Medicine, ISSN 0022-1007, E-ISSN 1540-9538, Vol. 222, no 7, article id e20250049Article in journal (Refereed) Published
Abstract [en]

Blood coagulation is essential for stopping bleeding but also drives thromboembolic disorders. Factor XII (FXII)–triggered coagulation promotes thrombosis while being dispensable for hemostasis, making it a potential anticoagulant target. However, its physiological role remains unclear. Here, we demonstrate that FXII-driven coagulation enhances innate immunity by trapping pathogens and restricting bacterial infection in mice. Streptococcus pneumoniae infection was more severe in FXII-deficient (F12−/−) mice, with increased pulmonary bacterial burden, systemic spread, and mortality. Similarly, Staphylococcus aureus skin infections and systemic dissemination were exacerbated in F12−/−mice. Reconstitution with human FXII restored bacterial containment. Plasma kallikrein amplifies FXII activation, and its deficiency aggravated S. aureus skin infections, similarly to F12−/−mice. FXII deficiency impaired fibrin deposition in abscess walls, leading to leaky capsules and bacterial escape. Bacterial long-chain polyphosphate activated FXII, triggering fibrin formation. Deficiency in FXII substrate factor XI or FXII/factor XI co-deficiency similarly exacerbated S. aureus infection. The data reveal a protective role for FXII-driven coagulation in host defense, urging caution in developing therapeutic strategies targeting this pathway.

Place, publisher, year, edition, pages
Rockefeller University Press , 2025. Vol. 222, no 7, article id e20250049
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Hematology Infectious Medicine Immunology in the Medical Area Microbiology in the Medical Area
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URN: urn:nbn:se:kth:diva-383724DOI: 10.1084/jem.20250049ISI: 001472545000001PubMedID: 40261297Scopus ID: 2-s2.0-105003896985OAI: oai:DiVA.org:kth-383724DiVA, id: diva2:2074820
Note

QC 20260618

Available from: 2026-06-18 Created: 2026-06-18 Last updated: 2026-06-18Bibliographically approved

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Butler, Lynn M.

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Nickel, Katrin F.Jämsä, AnneKonrath, SandraPapareddy, PraveenButler, Lynn M.Stavrou, Evi X.Frye, MaikeGelderblom, MathiasNieswandt, BernhardHammerschmidt, SvenHerwald, HeikoRenné, Thomas
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HematologyInfectious MedicineImmunology in the Medical AreaMicrobiology in the Medical Area

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