New research has investigated the link between shingles and stroke, whether or not shingles increases an individuals risk of stroke.
Researchers on this study believe that the answer can be found in lipid vesicles called exosomes that shuttle proteins and genetic information between cells.
This study details the mechanisms behind the association between shingles and stroke.
Study lead author, Andrew Bubak, says: “Most people know about the painful rash associated with shingles, but they may not know that the risk of stroke is elevated for a year after infection.
“Importantly, the rash is often completely healed and individuals feel normal but nonetheless are walking around with this significant elevation in stroke risk.”
Shingles is caused by the varicella zoster virus which causes chicken pox.
The virus lingers in the ganglionic neurons and can reactive which causes excruciating pain.
Researchers have discovered that shingles can also increase the risk of stroke, especially for those under age 40 where the shingles vaccine is not typically recommended.
It was discovered that those with rashes on their faces, were at the greatest risk.
This is suspected to be because of the proximity to the brain.
In order to gain a better understanding of how this works, along with his team, Bubak began closer investigations on exosomes.
Bubak says: “Exosomes carry pathogenic cargo that can cause thrombosis and inflammation distant from site of actual infection.
“That could ultimately lead to a stroke in patients.”
Researchers collected plasma samples from 13 patients with shingles and 10 without.
Samples were taken at time of infection and at 3-month follow-ups for a subset of patients and exosomes were extracted from the plasma.
It was also discovered that proinflammatory exosomes that also pose risks for stroke at the 3-month follow-up.
Bubak highlights that the findings suggest that in a subset of individuals with shingles, the virus may not return to latency or the circulating exosomes that induce a prolonged prothrombotic state may persist even after therapy is done and the rash is gone.
He says that by using antiviral agents longer with the addition of antiplatelet and anti-inflammatory agents could help.
Bubak says: “As well as initiatives to increase HZ vaccine uptake to decrease stroke risk, particularly in individuals with known preexisting stroke risk factors.
“If these findings are confirmed with a larger longitudinal study, then this could change clinical practice.”
The association between shingles and stroke is currently unknown to most physicians, to which Bubak says this can be “easily mitigated” and that shingles patients should be “sent home with antiplatelet agents.”
