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While triptolide presents challenges due to its water-insolubility and high cytotoxicity, innovative delivery systems and derivatives have enabled diverse anti-cancer mechanisms, suggesting promising avenues for future research and therapeutic development

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Pleiotropic effects from germline variants in different genes may also contribute

Genetic variants in HLA genes, especially HLA-A, are linked to the severity and susceptibility of mononucleosis, as well as the risk of autoimmune diseases resulting from EBV infection.[ref] In addition, a 2025 study found that the HLA-E*01:01 was associated with higher MS risk, but only in people who had had mono.[ref] The CD36 gene encodes a protein found on the surface of B cells that influences the behavior of other immune cells, such as T cells, in response to pathogens

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