Stephen Straus

Stephen E. Straus (November 23, 1946[1] May

14, 2007) was an American physician, immunologist,
virologist and science administrator. He is particularly
known for his research into human herpesviruses and
chronic fatigue syndrome, and for his discovery of the
autoimmune lymphoproliferative syndrome genetic disorder. He headed the Laboratory of Clinical Investigation of the National Institute of Allergy and Infectious
Diseases, National Institutes of Health (NIH), and served
as the founding director of the NIHs National Center for
Complementary and Alternative Medicine.

Biography
Electron micrograph of varicella zoster virus, one of the herpesviruses that Straus studied

[1][2]

and grew
Straus was born in New York City in 1946,
up in Brooklyn.[3] He attended the Massachusetts Institute of Technology, switching from physics to biology,[3]
2 Research
and gained his BS in life sciences in 1968. He gained
his MD from the Columbia University College of Physicians and Surgeons in 1972.[1][2] He subsequently trained 2.1 Herpesviral and other viral diseases
at Barnes Hospital in St. Louis, Missouri, and also held
a fellowship in infectious diseases at Washington Univer- Straus is particularly known for his wide-ranging resity in St. Louis.[1]
search on herpesviruses that infect humans, including herpes simplex virus (HSV), varicella zoster virus
In 197375, Straus researched adenoviruses as a research
(VZV)
and EpsteinBarr virus (EBV). His studies inassociate at the National Institute of Allergy and Infeccluded herpesvirus pathogenesis, immune responses and
[1][2][4]
tious Diseases (NIAID).
He rejoined NIAID as
[4]
a senior investigator in 1979, working in the Labora- transmission, as well as antiviral drugs and vaccines.
tory of Clinical Investigation. He rose to head rst the
medical virology section and then, from 1991, the entire
laboratory.[1][4] In October 1999, Straus was appointed
the National Center for Complementary and Alternative
Medicine (NCCAM)'s rst director (while continuing
his work at NIAID), a position he held until November
2006.[1][4][5]

He researched the mechanisms by which HSV establishes

latency and later recurs. His group was one of the rst
to show that treating patients with the antiviral acyclovir
can prevent genital and oral herpes from recurring.[4][6]
He found that people with asymptomatic genital herpes
can transmit the virus to their sexual partners.[4] With
Lawrence Corey and David M. Knipe, Straus developed
against HSV, inStraus served on the Institute of Medicine's Clinical Re- prophylactic and therapeutic vaccines [4]
cluding
a
glycoprotein
subunit
vaccine.
search Roundtable and the NIH Steering Committee. He
chaired the NIH Committee on the Recruitment and Ca- With William Ruyechan and John Hay, Straus cloned
reer Development of Clinical Investigators, as well as VZV and mapped its genome. They showed that
multiple committees associated with the NIH Roadmap chickenpox (varicella) and shingles (herpes zoster) are
for Medical Research. He also advised the NIH direc- both caused by this virus.[4] Straus also studied the
tor, Elias Zerhouni.[2][4] He was on the editorial boards of persistent pain that can occur after shingles has cleared
the academic journals Journal of Virology and Virology, up.[2][6] He worked with Mike Oxman and Myron Levin
and co-edited several textbooks, including Fields Virol- on the Shingles Prevention Study, a large clinical trial
ogy.[1][4]
which demonstrated that a live-attenuated VZV vaccine
1

is eective against shingles.[4][6][7]

Straus discovered that infection with EBV very occasionally results in a life-threatening chronic progressive
disease, now called chronic active EBV infection.[6][8][9]
Other viral diseases Straus worked on include HIV/AIDS,
inuenza and chronic hepatitis B. He also researched
Lyme disease, which is caused by Borrelia bacteria.[4][6]

2.2

Chronic fatigue syndrome

Straus started to research what is now known as chronic

fatigue syndrome in 1979.[10][11] Working on the thencurrent hypothesis that the syndrome might be caused
by EBV, he started a clinical trial of acyclovir therapy
in 1984. Although the study showed no benet from
the drug, it provided evidence that EBV did not cause
the syndrome.[4][10] In 1988, Straus was one of a group
of physicians to propose the name chronic fatigue syndrome for the condition,[12] and was subsequently one
of the lead authors of the International Chronic Fatigue
Syndrome Study Groups guidelines.[13] He also pursued
various virological, immunological, neuroendocrine and
neuropsychological studies of the syndrome.[11]

2.3

Autoimmune lymphoproliferative syndrome

In the early 1990s, Straus and colleagues discovered

autoimmune lymphoproliferative syndrome (ALPS), a
rare genetic disorder in which the normal Fas-mediated
apoptosis of lymphocytes is disrupted, leading to uncontrolled proliferation.[2][4][6][14] He found mutations in the
genes encoding Fas and Fas ligand, as well as caspase-10
and N-Ras, are associated with the disorder. He followed
a cohort of over 200 people with ALPS, and showed
that they have a substantially elevated risk of developing
lymphoma.[4][6]

AWARDS AND HONORS

using complementary and alternative therapies.

If the public is spending billions of dollars on
these things, they are either deluded en masse,
or there is some communal wisdom they are expressing. I believe that the tools of science can
provide very powerful answers on what they are
doing.[3]
Under his leadership, NIH-funded research into complementary and alternative medicine tripled,[2][6] with
NCCAM funding large (phase III) clinical trials of St
Johns wort for depression, Ginkgo biloba extracts for
dementia, and acupuncture and glucosamine/chondroitin
sulfate supplements for osteoarthritis of the knee joint,
among other treatment modalities.[1][5][15] Early in his
tenure as director, Straus prioritised the clinical assessment of treatments widely used in America which
had previously shown promising results in small clinical
trials.[3] He later wrote: In the early years of NCCAM,
there was a sense of urgency to scientically assess a
range of CAM therapies that had been in long use by the
public in the absence of proof of safety or ecacy.[15] By
2006, the centers research focus had shifted away from
large clinical trials and towards investigating how treatments might work, as well as the optimal dosing strategy
for botanical extracts and their interactions with prescription drugs.[15]
NCCAM was criticised for funding trials of EDTA
chelation therapy in coronary artery disease and the
Gonzalez regimen in pancreatic cancer.[3][16][17] Donald
M. Marcus and Arthur P. Grollman, in a 2006 Science
opinion article, claimed that the center funded proposals of dubious merit, and that its research strategy was
shaped more by politics than by science.[16] Straus responded that the center had made important contributions in a eld that is fraught with controversy and challenges and that it was applying the same scientic standards to the conduct of research and its review as used by
other NIH institutes.[15]

National Center for Complementary and Alternative Medicine

4 Awards and honors

NCCAM was founded as an independent NIH center in October 1998, replacing the Oce of Alternative Medicine, and Straus was appointed the founding
director,[1][4][5] responsible for an annual budget of a little
under $90 million.[3] He stated in a 2001 interview that
he did not use alternative therapies,[3] and he accepted the
position because:
I think the only way to change the dialogue
on complementary and alternative medicine
what we call CAM is to have a serious person
here at the N.I.H., doing serious work, with serious funding. The fact is that Americans are

Straus was an elected fellow of the American Society

for Clinical Investigation, the Association of American
Physicians and the Infectious Diseases Society of America (IDSA).[1][2][4] He was honored with the National ME
Fund Award of the Netherlands in 1999,[1] IDSAs John
F. Enders Lectureship in medical virology in 2005,[18]
and Columbia University College of Physicians and Surgeonss Gold Medal for Distinguished Achievements in
Medicine in 2007.[19] He also received ve US Public
Health Service medals.[1][2] In 2009, NCCAM founded
a lecture series, the Stephen E. Straus Distinguished Lecture in the Science of Complementary Therapies, as a
memorial to him.[20]

Personal life

[12] GP Holmes, JE Kaplan, NM Gantz, AL Komaro, LB

Schonberger, SE Straus et al. (1988), Chronic Fatigue
Syndrome: A Working Case Denition, Annals of Internal Medicine, 108: 38789, doi:10.7326/0003-4819-1083-387

Strauss wife, Barbara, worked in education; the couple

had a son and two daughters. In November 2004, Straus
was diagnosed with a brain tumor, from which he died at
[13] Keiji Fukuda, Stephen E. Straus, Ian Hickie, Michael C.
Potomac, Maryland in 2007, aged 60.[2][4]

References

[1] Expanding Horizons of Healthcare: Five-Year Strategic

Plan 20012005 (PDF), National Center for Complementary and Alternative Medicine, pp. 13, 29, retrieved 31
August 2016
[2] Patricia Sullivan (2 June 2007), Stephen E. Straus, 60;
Led NIHs Center for Alternative Medicine, Washington
Post, retrieved 31 August 2016
[3] Claudia Dreifus (3 April 2001), A Conversation with:
Stephen Straus; Separating Remedies From Snake Oil,
The New York Times, retrieved 3 September 2016
[4] Richard J. Whitley, Ann Arvin, Jerey I. Cohen, Larry
Corey, David Knipe, Henry Masur (2007), A Tribute to
Stephen E. Straus, M.D. (19462007)", The Journal of
Infectious Diseases, 196: 96364, doi:10.1086/522382
[5] NCCIH Timeline, National Center for Complementary and
Alternative Medicine, retrieved 2 September 2016
[6] Stephen E. Straus Biography, National Center for Complementary and Integrative Health, retrieved 1 September
2016
[7] M.N. Oxman, M.J. Levin, G.R. Johnson, K.E. Schmader,
S.E. Straus, L.D. Gelb et al. for the Shingles Prevention Study Group (2005), A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults,
New England Journal of Medicine, 352: 227184,
doi:10.1056/NEJMoa051016
[8] Straus SE, Tosato G, Armstrong G, Lawley T, Preble
OT, Henle W et al. (1985), Persisting Illness and
Fatigue in Adults with Evidence of Epstein-Barr Virus
Infection, Annals of Internal Medicine, 102: 716,
doi:10.7326/0003-4819-102-1-7
[9] Jerey I. Cohen, Elaine S. Jae, Janet K. Dale, Stefania Pittaluga, Helen E. Heslop, Cliona M. Rooney
(2011), Characterization and treatment of chronic active
Epstein-Barr virus disease: a 28-year experience in the
United States, Blood, 117: 583549, doi:10.1182/blood2010-11-316745
[10] Stephen E. Straus (1988), The Chronic Mononucleosis
Syndrome, The Journal of Infectious Diseases, 157: 405
12, doi:10.1093/infdis/157.3.405 via JSTOR, (registration required (help))
[11] Stephen E. Straus, MD, appointed Director, National Center for Complementary and Alternative Medicine, National
Institutes of Health, 5 October 1999, retrieved 1 September 2016

Sharpe, James G. Dobbins, Anthony Komaro, International Chronic Fatigue Syndrome Study Group (1994),
The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Denition and Study, Annals of Internal
Medicine, 121: 95359, doi:10.7326/0003-4819-121-12199412150-00009
[14] Michael C. Sneller, Stephen E. Straus, Elaine S. Jae,
Jonathan S. Jae, Thomas A. Fleisher, Maryalice StetlerStevenson, Warren Strober (1992), A novel lymphoproliferative/autoimmune syndrome resembling murine
lpr/gld disease., Journal of Clinical Investigation, 90:
33441, doi:10.1172/JCI115867
[15] Stephen E. Strauss, Margaret A. Chesney (2006),
In Defense of NCCAM, Science, 313: 3034,
doi:10.1126/science.1131608 via JSTOR, (registration
required (help))
[16] Donald M. Marcus and Arthur P. Grollman (2006),
Review for NCCAM Is Overdue, Science, 313: 3012,
doi:10.1126/science.1126978 via JSTOR, (registration
required (help))
[17] Kimball C. Atwood, Elizabeth Woeckner, Robert S.
Baratz, Wallace I. Sampson (2008), Why the NIH Trial
to Assess Chelation Therapy (TACT) should be abandoned, Medscape Journal of Medicine, 10 (5): 115, PMC
2438277 , PMID 18596934
[18] John F. Enders Lectureship, Infectious Diseases Society of
America, retrieved 1 September 2016
[19] In Memoriam, Columbia University College of Physicians
and Surgeons, retrieved 31 August 2016
[20] Stephen E. Straus Distinguished Lecture in the Science of
Complementary Therapies, National Center for Complementary and Integrative Health, 12 April 2016, retrieved
2 September 2016

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