Zoster-Associated Prothrombotic Plasma Exosomes and Increased Stroke Risk 2022 Bubak et al

Abstract

Herpes zoster (HZ; shingles) caused by varicella zoster virus reactivation increases stroke risk for up to 1 year after HZ. The underlying mechanisms are unclear, however, the development of stroke distant from the site of zoster (eg, thoracic, lumbar, sacral) that can occur months after resolution of rash points to a long-lasting, virus-induced soluble factor (or factors) that can trigger thrombosis and/or vasculitis. Herein, we investigated the content and contributions of circulating plasma exosomes from HZ and non-HZ patient samples. Compared with non-HZ exosomes, HZ exosomes (1) contained proteins conferring a prothrombotic state to recipient cells and (2) activated platelets leading to the formation of platelet-leukocyte aggregates. Exosomes 3 months after HZ yielded similar results and also triggered cerebrovascular cells to secrete the proinflammatory cytokines, interleukin 6 and 8. These results can potentially change clinical practice through addition of antiplatelet agents for HZ and initiatives to increase HZ vaccine uptake to decrease stroke risk.

Paywall, https://academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiac405/6749009

 

There's a Powerful Link Between Chickenpox And Stroke Risk. We May Finally Know Why

"People with shingles have an approximately 80 percent higher risk of stroke than those without the disease, and this risk stays elevated for up to a year after the rash has resolved.

Stroke risk is nearly doubled for those with the rash on their face, and tripled for those under the age of 40.

The mechanism behind this long-term stroke risk is mostly unknown. Some researchers have proposed that direct infection of the arteries may be the cause.

However, some features of VZV infections suggest that this is not the full picture. A common theme of VZV infections is chronic inflammation that spreads beyond the original infection site, which can persist for weeks to months after the virus is no longer detectable and presumably dormant again.

I am a neurovirologist, and my lab studies how VZV contributes to neurological disorders such as stroke and dementia.

In our recently published research, we found that VZV reactivation triggers the formation of cellular sacs, or exosomes, carrying proteins that contribute to blood clotting and inflammation."

https://www.sciencealert.com/theres...enpox-and-stroke-risk-we-may-finally-know-why