Epidemiological investigation and proteomic profiling of typical TCM syndrome in HIV/AIDS immunological nonresponders(sic)(sic)(sic)

HIV/AIDS pandemic remains the world's most severe public health challenge, especially for HIV/AIDS immunological nonresponders (HIV/AIDS-INRs), who tend to have higher mortality. Due to the advantages in promoting patients' immune reconstitution, Traditional Chinese medicine (TCM) has become one of the mainstays of complementary treatments for HIV/AIDS-INRs. Given that effective TCM treatments largely depend on precise syndrome differentiation, there is an increasing interest in exploring biological evidence for the classification of TCM syndromes in HIV/AIDS-INRs. In our study, to identify the typical HIV/AIDS-INRs syndrome, an epidemiological survey was first conducted in the Liangshan prefecture (China), a high HIV/AIDS prevalence region. The key TCM syndrome, Yang deficiency of spleen and kidney (YDSK), was evaluated by using a tandem mass tag combined with liquid chromatography-tandem mass spectrometry (TMT-LC-MS/MS). A total of 62 differentially expressed proteins (DEPs) of YDSK syndrome compared with healthy people were screened out. Comparative bioinformatics analyses showed that DEPs in YDSK syndrome were mainly associated with response to wounding and acute inflammatory response in the biological process. The pathway annotation is mainly enriched in complement and coagulation cascades. Finally, the YDSK syndrome-specific DEPs such as HP and S100A9 were verified by ELISA, and confirmed as potential biomarkers for YDSK syndrome. Our study may lay the biological and scientific basis for the specificity of TCM syndromes in HIV/AIDs-INRs, and may provide more opportunities for the deep understanding of TCM syndromes and the developing more effective and stable TCM treatment for HIV/AIDS-INRs.

Automated summary

HIV/AIDS infection is the most severe public health challenge worldwide, with high mortality among HIV/AIDS immunological nonresponders (HIV/AIDS-INRs). Traditional Chinese medicine (TCM) has become a mainstay of complementary treatment for HIV/AIDS-INRs due to its advantages in promoting immune reconstitution. This study conducted an epidemiological survey and utilized biological evidence to identify a specific TCM syndrome, Yang deficiency of spleen and kidney (YDSK), in HIV/AIDS-INRs. The differentially expressed proteins associated with YDSK were primarily involved in response to wounding and acute inflammatory response, as well as complement and coagulation cascades. The study confirmed potential biomarkers for YDSK syndrome and laid the foundation for a deeper understanding of TCM syndromes and the development of more effective TCM treatments for HIV/AIDS-INRs.