Background
The underlying mechanisms of thrombosis in Lemierre’s syndrome and other septic thrombophlebitis are incompletely understood. Therefore, in this case-control study we aimed to generate hypotheses on its pathogenesis by studying the plasma proteome in patients with these conditions.
Methods
All patients with Lemierre’s syndrome in the Skåne Region, Sweden were enrolled prospectively during 2017-2021 as cases. Age-matched patients with other severe infections were enrolled as controls. Patient plasma samples were analyzed using label-free data-independent acquisition liquid chromatography tandem mass spectrometry. Differentially expressed proteins in Lemierre’s syndrome vs. other severe infections were highlighted. Functions of differentially expressed proteins were defined based on a literature search focused on previous associations with thrombosis.
Results
Eight patients with Lemierre’s syndrome and 15 with other severe infections were compared. Here, 20/449 identified proteins were differentially expressed between the groups. Of these, 14/20 had functions previously associated with thrombosis. 12/14 had a suggested prothrombotic effect in Lemierre’s syndrome, whereas 2/14 had a suggested antithrombotic effect.
Conclusion
Proteins involved in several thrombogenic pathways were differentially expressed in Lemierre’s syndrome compared to other severe infections. Among identified proteins, several were associated with endothelial damage, platelet activation and degranulation and warrant further targeted studies.