Sustained Depletion of FXIII-A by Inducing Acquired FXIII-B Deficiency

Amy Strilchuk, Scott C. Meixner, Jerry Leung, Nooshin Safikhan, Jayesh A. Kulkarni, Hannah M. Russel, Roy van der Meel, Michael R. Sutherland, A. Philip Owens III, Joseph Palumbo, Edward M. Conway, Edward L.G. Pryzdial, Pieter R. Cullis, Christian J. Kastrup (Corresponding author)

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The activated form of coagulation factor XIII (FXIII-A2B2), FXIII-A*, is a hemostatic enzyme essential for inhibiting fibrinolysis by irreversibly crosslinking fibrin and antifibrinolytic proteins. Despite its importance, there are no modulatory therapeutics. Guided by the observation that humans deficient in FXIII-B have reduced FXIII-A without severe bleeding, we hypothesized that a suitable small interfering RNA (siRNA) targeting hepatic FXIII-B could safely decrease FXIII-A. Here we show that knockdown of FXIII-B with siRNA in mice and rabbits using lipid nanoparticles resulted in a sustained and controlled decrease in FXIII-A. The concentration of FXIII-A in plasma was reduced by 90% for weeks after a single injection and for more than 5 months with repeated injections, whereas the concentration of FXIII-A in platelets was unchanged. Ex vivo, crosslinking of α2-antiplasmin and fibrin was impaired and fibrinolysis was enhanced. In vivo, reperfusion of carotid artery thrombotic occlusion was also enhanced. Re-bleeding events were increased after challenge, but blood loss was not significantly increased. This approach, which mimics congenital FXIII-B deficiency, provides a potential pharmacologic and experimental tool to modulate FXIII-A2B2 activity.

Original languageEnglish
Pages (from-to)2946-2954
Number of pages9
JournalBlood : the Journal of Hematology
Issue number25
Publication statusPublished - 17 Dec 2020


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