Clinical Applications and Therapeutic Mechanisms of Chinese Herbal Medicine Yiaikang Capsules in Treating Acquired Immune Deficiency Syndrome

Abstract

Yiaikang (YAK) is a 22-component traditional herbal medicine, exhibiting a powerful inhibitory effect on viral replication and immunity-boosting activities in clinical applications, and is widely used to treat diseases in people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in China. In clinical studies, YAK alleviates the clinical symptoms of HIV/AIDS (eg, weakness, shortness of breath, spontaneous sweating, and diarrhea) while enhancing quality of life and improving survival rates of patients. In the molecular mechanism studies, its main therapeutic action is inhibition of HIV replication, alongside increased numbers of CD4⁺ T cells. These are achieved through inhibition of the viral transactivator of transcription (Tat) and regulatory protein Rev, and host intercellular adhesion molecule 1 (ICAM-1). During HIV infection, the extensive destruction of CD4+ T cells consumes the Th17 subset of intestinal-associated lymphoid tissue, resulting in the loss of mucosal integrity. YAK also restores the normal expression of C-C chemokine receptor type 5 (CCR5) and C-X-C chemokine receptor type 4 (CXCR4), promotes the proliferation of natural killer cells, regulates the balance between T helper 17 cells and regulatory T cells, and maintains the integrity of the intestinal mucosal barrier. In this review, we describe the clinical applications and therapeutic mechanisms of YAK in treating AIDS, with the goal of identifying new and efficacious therapies targets and approaches and provides new clues for the clinical application of YAK.

Keywords: Yiaikang capsule; acquired immune deficiency syndrome; human immunodeficiency virus.

Figure 1

Therapeutic actions of Yiaikang (YAK) capsules. (A) YAK inhibits the viral Tat and Rev proteins as well as host intercellular adhesion molecule 1 (ICAM-1), assisting with the replication of HIV. YAK also increases CD4⁺ T-cell counts, possibly by restoring the expression of C-C chemokine receptor type 5 (CCR5) and C-X-C chemokine receptor type 4 (CXCR4), as well as T-cell activation levels. YAK significantly inhibits interleukin (IL)-13, increases the IL-2 and interferon (IFN)-γ cytokine response, and enhances host antiviral defense. (B) YAK significantly promotes the proliferation of natural killer (NK) cells and increases secretion of IFN-γ, enhancing immune function. (C) YAK regulates the imbalance in T helper 17 (Th17) cell/ regulatory T cell (Treg) imbalance by increasing RORγt expression and reducing FoxP3 expression, enhancing host antiviral defense. (D) YAK maintains the integrity of the intestinal mucosal barrier through inhibition of the expression of tight junction proteins ZO-1, Claudin-1, and Claudin-5, and chemokines. Created in BioRender. Xue, D. (2025) https://BioRender.com/l95e206.