为什么带状疱疹会导致中风？外泌体关联
近期发表在《传染病杂志》上一篇文献，美国科罗拉多大学安舒茨医学院的研究人员详细介绍了带状疱疹和中风之间联系背后的机制。本研究解读了患有带状疱疹的人患中风的风险更高的原因，认为问题在于一种能在细胞之间输送蛋白质和遗传信息的脂质囊泡，即外泌体相关。
带状疱疹是由引起水痘的水痘带状疱疹病毒引起的。病毒在神经节神经元中徘徊，可以重新激活，引起难以忍受的疼痛。但研究人员发现，带状疱疹也会增加中风的风险。“大多数人都知道与带状疱疹相关的疼痛皮疹，但他们可能不知道感染后一年内中风的风险升高，”
皮疹通常会完全愈合，个人感觉正常，却不知道中风风险已显著升高。外泌体携带致病物质，可以在远离实际感染部位的地方引起血栓形成和炎症，这最终可能导致患者中风。
Herpes zoster (HZ) exosomes were enriched for pathways associated with infectious diseases and immune responses. A, Proteins significantly elevated in HZ exosomes (above dotted line; n = 127) compared with non-HZ exosomes, along with the interaction network of these proteins (inset). Abbreviations: FDR, false discovery rate; NS, not significant. B, C, Protein enrichment analyses associated with infectious diseases (B) and immune responses (C).
DOI：https://doi.org/10.1093/infdis/jiac405
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.
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