The majority of the world's population have the virus that causes the disease. The varicella zoster virus can be contracted when you are a child.
Around a third of these people have the same virus that causes shingles.
While most people are familiar with the painful rash that VZV causes for shingles, a wide range of other problems can also occur.
Ischemic strokes occur when the blood supply to the brain is restricted by narrowing arteries or a clot.
People with shingles are 80 percent more likely to have a stroke than people without the disease, and this risk stays elevated for up to a year after the rash has dissipated.
The stroke risk is doubled for those with a rash on their face, and tripled for younger people.
This long-term stroke risk is not known. Infections of the arteries may be the cause according to some research.
Some features of VZV infections suggest that this is not the whole story. Chronic inflammation that spreads beyond the original site is a common theme of VZV infections.
My lab studies how VZV contributes to neurological disorders.
In our recent research, we found that reactivation of VZV causes the formation of cellular sacs, or exosomes, which can cause blood clot and inflammation.
There is a possibility that an increased risk in stroke is caused by an increase in these genes.
Small sacs made inside cells are called exosomes. They are similar to bags that carry cargo from the cell to the distant tissues.
Exosomes play a key role in disease progression and are drug targets for a lot of diseases.
We wanted to know if shingles patients develop exosomes that carry a blood clot-causing factor. We isolated exosomes from the blood of 13 patients who had shingles and compared them to exosomes from healthy donors.
When we looked at the contents of the exosomes, we found that shingles patients had nine times the amount of clotting factors than healthy patients.
Three months after their initial rash, we found elevated levels of the exosomes of the patients.
To functionally confirm that the contents of these exosomes can induce clotting, we exposed healthy people to exosomes from patients or healthy people.
We found that exposing platelets to shingles exosomes caused them to clump together and form aggregates with other types of blood cells.
According to the findings, exosomes may be a possible mechanism for how the varicella zoster virus increases stroke risk.
Shingrix is a vaccine that is approved by the Food and Drug Administration and can be used by people of all ages. Those under the age of 40 are not eligible for Shingrix.
The chickenpox vaccine was only approved for use in the US in 1995 and a large group of these individuals were not up to date on their immunizations.
Even though the vaccine reduces the risk of shingles, it's still possible for the disease to come back.
While our study shows that shingles can cause an increased risk of stroke, more research is needed to find out how long this risk lasts.
We are going to conduct follow-up studies to see if patients have an increased tendency to form blood clot after they have healed from their shingles infections.
Longitudinal studies will look at whether exosomes can be used as a marker for stroke risk after shingles.
We hope that our findings will lead to the development of a treatment for shingles.
The assistant research professor is from the University of Colorado.
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