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ResearchIn-Press PreviewAutoimmunityInfectious disease Open Access | 10.1172/JCI192619

Combined FXIII-C3 autoantibodies elicit bleeding and complement dysfunction in autoimmune FXIII deficiency

Shanshan Luo,1 Jun Deng,1 Yue Liu,2 Lv Xiong,1 Wanting Wang,1 Chaofan Wang,1 Yaohua Cai,1 Yajie Ding,1 Bahgat Fayed,3 Zhipeng Cheng,1 Lu Zhang,1 Min Zhang,1 Jun Fang,1 Gensheng Zhang,4 Rui Zhu,5 Haiqiang Jiang,6 Yunlun Li,6 Kun Huang,7 Xiang Cheng,8 Liang V. Tang,1 Chunyan Sun,1 Heng Mei,1 Peter F. Zipfel,9 Huafang Wang,1 Yadan Wang,1 Desheng Hu,10 and Yu Hu1

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Luo, S. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Deng, J. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Liu, Y. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Xiong, L. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Wang, W. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Wang, C. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Cai, Y. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Ding, Y. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Fayed, B. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Cheng, Z. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Zhang, L. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Zhang, M. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Fang, J. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Zhang, G. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Zhu, R. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Jiang, H. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Li, Y. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Huang, K. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Cheng, X. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Tang, L. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Sun, C. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Mei, H. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Zipfel, P. in: PubMed | Google Scholar |

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Wang, H. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Wang, Y. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Hu, D. in: PubMed | Google Scholar

1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China

3Department of Chemistry of Natural and Microbial Products, Pharmaceutical and Drug Industries Research Institute, National Research Centre, Giza, Egypt

4Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China

5Department of Integrated Traditional Chinese and Western Medicine, Union Ho, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

6Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

7School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

9Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany

10Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Find articles by Hu, Y. in: PubMed | Google Scholar

Published December 9, 2025 - More info

J Clin Invest. https://doi.org/10.1172/JCI192619.
Copyright © 2025, Luo et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published December 9, 2025 - Version history
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Abstract

Autoimmune factor XIII (FXIII) deficiency is a rare hemorrhagic disease characterized by severe bleeding and a high mortality rate. However, the pathogenesis of this disease remains unclear. Currently, FXIII consumption caused by infections is becoming increasingly common. Our clinical investigation, combined with in vivo experiments, revealed that patients and mice with autoimmune FXIII deficiency displayed complement dysfunction, and that pathogenic infection and autoantibody generation were positively correlated. Further analysis revealed the presence of combined FXIII-C3 autoantibodies in patients with autoimmune FXIII deficiency. These combined autoantibodies neutralize FXIII, causing excessive bleeding, and form a complex with C3, inhibiting complement activation and complement-mediated adaptive immune responses. Therefore, compromised immune responses increase host susceptibility to pathogenic Candida albicans infections. Consequently, uncontrolled exogenous fungal infections further activate platelets and cause platelet-related CD40 ligand (CD40L) release. By interacting with the CD40 on the B cell surface, the released CD40L further promotes auto-reactive B cell activation to produce more autoantibodies, thereby forming a self-amplification loop for the progressive consumption of FXIII. We believe that this study provides a perspective on disease pathogenesis and therapeutic guidance for better treatment of autoimmune FXIII deficiency.

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