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Prepublished online as a Blood First Edition Paper on August 21, 2003; DOI 10.1182/blood-2003-05-1467.

Submitted May 9, 2003
Accepted July 24, 2003
Factor XIII A subunit-deficient mice developed severe uterine bleeding events and subsequent spontaneous miscarriages
Shiori Koseki-Kuno, Mitsunori Yamakawa, Gerhard Dickneite, and Akitada Ichinose*
Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan
Second Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
Department of Preclinical Pharmacology and Toxicology, Aventis Behring, Marburg, Germany
* Corresponding author; email: aichinos{at}med.id.yamagata-u.ac.jp.
In order to understand the molecular pathology of factor XIII (XIII) deficiency in vivo, its A subunit (XIIIA)-knockout (KO) mice were functionally analyzed. Although homozygous XIIIA female KO mice were capable of becoming pregnant, most of them died due to excessive vaginal bleeding during gestation. Abdominal incisions revealed that the uteri of the dead mice were filled with blood and that some embryos were much smaller than others within a single uterus. A series of histological examinations of the pregnant animals suggested that massive placental hemorrhage and subsequent necrosis developed in the uteri of the XIIIA KO mice on day 10 of gestation. This was true regardless of the genotypes of fetuses. These results are reminiscent of spontaneous miscarriage in human female patients with factor XIII deficiency, and indicate that maternal XIII plays a critical role in uterine hemostasis and maintaining the placenta during gestation.

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