# The Vascular effects of Infection in Pediatric Stroke (VIPS II) Study

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $173,417

## Abstract

PROJECT SUMMARY/ABSTRACT – updated for supplement
Pediatric arterial ischemic stroke afflicts ≈2,000 U.S. children every year, permanently disabling most, yet is
poorly understood. The Vascular effects of Infection in Pediatric Stroke (VIPS I) study established an
international network of 37 sites that enrolled 355 children with stroke and 354 controls. We discovered:
(a) minor clinical infections act as a stroke trigger, while routine childhood vaccinations are protective; (b)
almost half of children with stroke have an acute herpesvirus infection (the cause of chicken pox, cold sores,
and other common illnesses); and (c) children with stroke have a high risk of recurrent stroke, particularly if
they have an arteriopathy. A VIPS pilot study suggests that other common childhood pathogens may also
play a role, possibly in combination with herpesviruses. Infection is compelling as a treatable stroke risk
factor, with available therapies for both pathogens and downstream inflammatory effects. However, VIPS I
findings present a paradox: infection is common, while childhood stroke is uncommon. VIPS II is exploring
two potential explanations: (1) the “infection hypothesis”: unusual pathogen strains, or combinations of
pathogens, lead to stroke; and (2) the “host response hypothesis”: an unusual inflammatory response to
infection leads to stroke.
 The specific aims are to (1) identify known and novel pathogens in children with stroke, and determine
whether different pathogens are seen with arteriopathic versus other stroke types; (2) determine whether
children with arteriopathic stroke have a different inflammatory response compared to those with other
stroke types; and (3) use data from Aims 1 and 2 to explore different mechanistic pathways from infection,
to inflammation, to arteriopathic stroke, and other stroke types.
 In February 2022, VIPS II completed enrollment of 205 new cases of childhood stroke and 147 controls.
For Aim 1, we are using next generation sequencing (NGS) of nucleic acids to detect pathogens in blood
samples and throat swabs collected in VIPS II. For Aim 2, we are measuring levels of inflammatory markers
in blood samples from cases and controls. We have already studied the samples from VIPS I cases. Using
these results, we have refined our list of markers and will now proceed with testing the VIPS II samples.
 The goal of VIPS II is to gain the knowledge needed to protect children with stroke from additional brain
injury. Its results will guide the selection of currently available therapies—such as antimicrobials and anti-
inflammatory medications—for a pediatric clinical trial aimed at preventing recurrent stroke.

## Key facts

- **NIH application ID:** 10581363
- **Project number:** 3R01NS104094-05S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** HEATHER J FULLERTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $173,417
- **Award type:** 3
- **Project period:** 2022-04-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10581363

## Citation

> US National Institutes of Health, RePORTER application 10581363, The Vascular effects of Infection in Pediatric Stroke (VIPS II) Study (3R01NS104094-05S1). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10581363. Licensed CC0.

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