Chronic Active EBV Infection and Hypersensitivity to Mosquito Bites: Pathophysiology and Pharmacology

Hypersensitivity to mosquito bites (HMB) is characterized clinically by intense skin reactions at mosquito bite sites with severe systemic symptoms. Another important feature is the high mortality rate due to complications, such as malignant NK cell-lineage granular lymphoproliferative disorder (NK-GLPD) and hemophagocytic syndrome (HPS). Previous studies have indicated that chronic active Epstein-Barr virus infection (CAEBV) is closely associated with HMB and its malignant complications. We and other groups have recently shown the abnormal oligoclonal expansion of EBV-infected NK cells in the periphery of HMB patients, which contributes to the pathogenesis of pleiotropic symptoms in HMB. To explore the therapeutic possibility, we have examined the anti-viral drugs on the symptoms, and some drugs have been emerging as the candidates for the treatment for HMB. In this brief review, we show the recent progresses in the studies elucidating the intricate web among CAEBV, NK-GLPD and HMB. The pathophysiology and pharmacology regarding CAEBV and HMB should also be generally important in viral-associated rheumatic diseases and their therapeutics.