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Junior group 'Coagulation factors in immunity'

PD Claudine Graf, MD PhD

Group leader

The coagulation system is an integral part of the innate immune defense against tissue injuries. During tumor diseases, systemic changes affect coagulation, platelet-leukocyte interaction, and immune responses. The cellular receptors of the coagulation proteases are "Tissue Factor (TF)" and the "Endothelial Protein C Receptor (EPCR)". They are structurally related to interleukin, CD1d and toll-like receptors (TLR) and are expressed e.g. by tumor, immune and vascular cells. They interact with the coagulation factors FX, FVII and protein C. In addition to their synthesis in the liver, FVII and FX are also expressed by macrophages and dendritic cells and influence their phenotypes. As a result, they also modulate anti-tumor immune responses.

We are interested in the control of macrophage and DC phenotypes mediated by coagulation proteases and platelet-leukocyte interaction. We are investigating this in the context of chronic inflammatory processes, especially malignancies, using mouse models that show special alterations in the expression or signaling of coagulation proteases. Translational relevance results from the synergistic effects of anticoagulants and checkpoint inhibitors observed in preclinical models on reducing tumor growth and improving the anti-tumor immune response.

Research interest

  • Role of coagulation proteases in tumor immunity 
  • Influence of coagulation factors on function of innate immune cells
  • Influence of anticoagulants and checkpoint inhibitors on immune cells

Partners of collaboration

Partners at the University Medical Center Mainz

  • Prof. Wolfram Ruf (CTH)
  • Prof. Krishna Rajalingam (SFB 1292 TP05, FZI, Mainz)
  • Prof. Thomas Kindler (University Cancer Center)
  • Prof. Wilfried Roth (Institute of Pathology)
  • Dr. Daniel Wagner (Institute of Pathology)
  • Dr. Federico Marini (IMBEI)

National Partners

  • Prof. Özlem Türeci (SFB 1292 TP22, HI-TRON, Mainz)
  • Prof. Matthias Gaida (SFB 1292 TP22, TRON Mainz)
  • Prof. Stefan Fröhling (National Center for Tumor Diseases, Heidelberg)
  • Dr. Simon Kreutzfeld (National Center for Tumor Diseases, Heidelberg)

Research funding

Biography - Claudine Graf

since 2018 - Junior Group Leader „Coagulation Proteases in Inflammation“, CTH, University Medical Center, Johannes Gutenberg-University, Mainz

Research Career:

since 2020 - Scientific Management of the GTH-Mediathek
since 2020 - Reviewer for ISTH
2018 - Habilitation in Internal Medicine
2009 - PhD, GRK 1043 „antigen-specific immunotherapy“, Univ.-Prof. Thomas Wölfel, University Medical Center, Johannes Gutenberg-University, Mainz; Title: Analysis of autologous T-cell responses against neoepitopes generated by FLT3 internal tandem duplications (FLT3-ITD), Grade: magna cum laude
2005 - MD, Univ.-Prof. Thomas Wölfel, University Medical Center, Johannes Gutenberg-University, Mainz; Title: Identification of peptide antigens of the vaccinia virus that are recognized by CD8+ T lymphocytes; Grade: summa cum laude

Professional Education:
2018 - Qualification for Specialised Genetic Counseling
2017 - Certification as Hemostaseologist
2013 - Certification as Physician in Palliative Care
2013 - ESMO Certification
2013 - Specialist for Internal Medicine, Hematology and Oncology
2005 - License to practice medicine
1998 – 2005 - Medical studies at the University Medical Center, Johannes Gutenberg-University, Mainz

ORCID Researcher ID:

Team - Junior group Coagulation factors in immunity

PD Claudine Graf, MD PhD

Junior group leader

Physician UCT Mainz


Specialist in Internal Medicine, Hematology and Oncology, Additional qualification: Palliative Care, Hemostaseology

06131 17-8014 (Office) bzw. -8027 (Lab)

Sven Pagel

PhD student

06131 17-8021

06131 17-8047

 Jennifer Pott
Jennifer Pott

PhD student



Petra Wilgenbus


06131 17-8028


We are looking forward to applications from highly motivated scientists per  Email.

Original articles

  • Haist M, Stege H, Pemler S, Heinz J, Fleischer MI, Graf C, Ruf W, Loquai C, Grabbe S. Anticoagulation with factor Xa inhibitors is associated with improved overall response and progression-free survival in patients with metastatic malignant melanoma receiving immune checkpoint inhibitors – a retrospective, real-world cohort study. Cancers (Basel). 2021 Oct 2;13(20):5103.
  • Graf C, Wilgenbus P, Pagel S, Pott J, Marini F, Reyda S, Kitano M, Macher-Göppinger S, Weiler H, Ruf W. Myeloid cell-synthesized coagulation factor X dampens antitumor immunity. Sci Immunol. 2019 Sep 20;4(39). pii: eaaw8405.
  • Müller-Calleja N, Hollerbach A, Ritter S, Pedrosa DG, Strand D, Graf C, Reinhardt C, Strand S, Poncelet P, Griffin JH, Lackner KJ, Ruf W. Tissue factor pathway inhibitor primes monocytes for antiphospholipid antibody-induced thrombosis. Blood. 2019 Oct 3;134(14):1119-1131.
  • Landtwing V, Raykova A, Pezzino G, Beziat V, Marcenaro E, Graf C, Moretta A, Capaul R, Zbinden A, Ferlazzo G, Malmberg KJ, Chijioke O, Munz C.  Cognate HLA absence in trans diminishes human NK cell education. J Clin Invest. 2016;126(10):3772-3782.
  • Becker M*, Graf C*, Tonak M, Radsak MP, Bopp T, Bals R, Bohle RM, Theobald M, Rommens PM, Proschek D, Wehler TC Xenograft models for undifferentiated pleomorphic sarcoma not otherwise specified are essential for preclinical testing of therapeutic agents. Oncol Lett. 2016,12(2):1257-1264 3782.
  • Allami RH*, Graf C*, Martchenko K, Voss B, Becker M, Berger MR, Galle PR, Theobald M, Wehler TC, Schimanski CC. Analysis of the expression of SDF-1 splicing variants in human colorectal cancer and normal mucosa tissues. Oncol Lett. 2016;11(3):1873-1878.
  • Wehler TC, Martchenko K, Allami RH, Becker M, Wehler B, Berger MR, Bals R, Galle PR, Theobald M, Graf C*, Schimanski CC*. Functional diversity of stromal cell-derived factor 1 splice variants in colorectal cancer and melanoma. Int J Colorectal Dis. 2016;31(6):1225-6.
  • Gur-Cohen S, Itkin T, Chakrabarty S, Graf C, Kollet O, Ludin A, Golan K, Kalinkovich A, Ledergor G, Wong E, Niemeyer E, Porat Z, Erez A, Sagi I, Esmon CT, Ruf W, Lapidot T. PAR1 signaling regulates the retention and recruitment of EPCR-expressing bone marrow hematopoietic stem cells. Nat Med. 2015;21(11):1307-17.

*shared authorship


  • Ruf W, Graf C. Coagulation signaling and cancer immunotherapy. Thromb Res. 2020 Jul;191 Suppl 1:S106-S111.
  • Graf C, Ruf W. Tissue factor as a mediator of coagulation and signaling in cancer and chronic inflammation. Thromb Res. 2018;164 Suppl 1:S143-S147.
  • Ruf W, Rothmeier AS, Graf C. Targeting clotting proteins in cancer therapy - progress and challenges. Thromb Res. 2016;140 Suppl 1:S1-7.
  • Gur-Cohen S, Kollet O, Graf C, Esmon CT, Ruf W, Lapidot T. Regulation of long-term repopulating hematopoietic stem cells by EPCR/PAR1 signaling. Ann N Y Acad Sci. 12016;370(1):65-81.