Varicella Zoster Virus and Stroke: An Intricate Relationship

Area of Science:

• Neurology
• Infectious Diseases
• Vascular Biology

Background:

• Varicella Zoster Virus (VZV) causes chickenpox and herpes zoster.
• VZV is increasingly recognized as a factor in cerebrovascular diseases, including stroke.
• VZV reactivation may trigger stroke via vasculopathy, immune issues, and inflammation.

Purpose of the Study:

• To review the link between VZV and stroke.
• To evaluate treatments for VZV-associated stroke, focusing on non-antiviral therapies.
• To synthesize evidence from diverse study types.

Main Methods:

• Literature review of 31 studies.
• Analysis of clinical cohorts, in vitro models, and pathology.
• Evaluation of VZV's role in cerebral arteries and stroke risk.

Main Results:

• VZV antigens found in cerebral arteries contribute to inflammation, dysfunction, and thrombosis, raising stroke risk.
• Adjunctive treatments (corticosteroids, statins, resveratrol) may reduce vascular inflammation.
• Zoster vaccination decreases herpes zoster incidence and potentially stroke risk, but uptake is low.

Conclusions:

• VZV is a significant factor in cerebrovascular disease.
• Combination therapies and improved diagnostics are needed.
• Enhanced vaccination programs are crucial for public health.