Arvin delivers varicella-zoster talk

Her grand rounds presentation was part of a recent award

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Ann Arvin

Ann M. Arvin, MD, chief of pediatric infectious disease at Lucile Packard Children’s Hospital, gave a grand rounds talk Thursday describing her past work and future research on varicella-zoster virus, which causes chicken pox and shingles.

Her presentation was in honor of receiving the Albion Walter Hewlett award, established in 1983 to honor physicians with a Stanford background who serve as dynamic role models and practitioners of scientific medicine. Awardees also display care and skill in a quest to help patients live productive lives through the discovery and use of biological knowledge.

Arvin, the Lucile Salter Packard Professor of Pediatrics, has researched the pathology of varicella-zoster infection, showing how after infecting the mucosal cells of a newly exposed person, the virus replicates in tonsil T cells. Migration of infected T cells to the skin results in the diseaseÂ’s tell-tale rash and itchy lesions.

Although most children with chicken pox recover without incident, about 5 of every 1,000 are hospitalized, and for a very few the infection can be fatal. Healthy adults and children with weakened immune systems who are infected with the virus are more susceptible to serious medical complications or death.

Arvin’s research has led to the development of a vaccination against the virus, now offered as normal childhood immunization.

By preventing or reducing the severity of chicken pox in immunized healthy children, the vaccine can reduce the likelihood that these groups will contract the disease, she explained. In addition, Arvin and her colleagues are now attempting to genetically modify the vaccine to make it safe for even the immunocompromised.

Arvin’s research has provided insight into how the virus can lurk for decades in nerve cells after causing chicken pox, re-emerging later in life to cause shingles -– a devastatingly painful condition that becomes increasingly likely with age or when the immune system is weakened.

Arvin’s preliminary results suggest that boosting the immune response to the virus by vaccinating cancer patients with an inactive version of the virus prior to hematopoetic cell transplantation can reduce the subsequent risk of shingles.

Without vaccination, up to one-third of these patients develop shingles within 12 months of their transplant. Arvin is now studying whether vaccination can provide elderly people with a similar benefit.