Extracellular matrix protein signature of recurrent spontaneous cervical artery dissection

Objective To assess whether connective tissue disorder is evident in patients with spontaneous cervical artery dissection and therefore identify patients at risk of recurrence using a cutting-edge quantitative proteomics approach. Methods In the ReSect-study all patients with spontaneous cervical artery dissection treated at the Innsbruck University Hospital since 1996 were invited to attend a standardized clinical follow-up examination. Protein abundance in skin punch biopsies (n=50) was evaluated by a cutting-edge quantitative proteomics approach (liquid chromatography-mass spectrometry) which has hitherto not been applied to such patients. Results Patients with one-time single-vessel (n=19) or –multiple-vessel (n=13) dissections did not differ between each other or compared to healthy controls (n=12) in protein composition. Patients with recurrent spontaneous cervical artery dissection (n=6) however, showed significantly different expression of 25 proteins compared to the other groups combined. Literature review and gene ontology term annotation check revealed that 13 of the differently expressed proteins play a major role in the structural integrity of connective tissue or are linked to connective tissue disorders. These proteins showed clustering to a collagen/elastin cluster and one consisting of desmosome related proteins. Conclusion This study unravels an extracellular matrix protein signature of recurrent spontaneous cervical artery dissection. On a long run and dependent on large-scale validation, our findings may well assist in identifying patients at risk of recurrent spontaneous cervical artery dissection and thus guide therapy.