“肠道菌群–免疫组库”轴：中药方重塑COPD免疫稳态的新视角

The Gut Microbiota-Immune Repertoire Axis: A Novel Perspective on Herbal Formulae Reshaping Immune Homeostasis in COPD

摘要: 慢性阻塞性肺疾病(COPD)的病理本质已超越局部肺部炎症，被视为一种全身性免疫失衡性疾病，现有治疗方案在重塑系统性免疫稳态方面存在局限。中医“肺与大肠相表里”理论为从肠道干预肺部疾病提供了独特的整体视角，而现代医学“肠–肺轴”的发现为其提供了生物学桥梁。本综述提出核心假说：中药方剂通过多靶点调控，重塑COPD紊乱的肠道菌群结构及其代谢谱(如短链脂肪酸)，进而校准系统性免疫组库(TCR/BCR)的多样性与克隆分布，最终通过淋巴细胞归巢等机制逆转肺部免疫病理，实现“肺肠同治”。我们系统整合了“中药–肠道菌群–免疫组库–COPD免疫稳态”这一轴线的证据链，旨在构建一个将中医整体观与现代免疫学、微生物组学深度融合的研究范式，为开发针对COPD的精准中医免疫治疗策略提供理论依据。

Abstract: The pathological nature of Chronic Obstructive Pulmonary Disease (COPD) extends beyond localized pulmonary inflammation and is recognized as a systemic immune dysregulation disorder. Current therapeutic strategies exhibit limitations in restoring systemic immune homeostasis. The traditional Chinese medicine (TCM) theory of “lung and large intestine being interconnected” provides a unique holistic perspective for intervening in lung diseases via the gut, while the modern medical discovery of the “gut-lung axis” offers a biological bridge for this concept. This review proposes a core hypothesis: Herbal formulae, through multi-target regulation, remodel the disrupted gut microbiota structure and its metabolic profile (e.g., short-chain fatty acids) in COPD. This remodeling subsequently recalibrates the diversity and clonal distribution of the systemic immune repertoire (TCR/BCR), ultimately reversing pulmonary immunopathology via mechanisms such as lymphocyte homing, thereby achieving “simultaneous treatment of the lung and intestine”. We systematically integrate the evidence chain along the axis of “herbal medicine-gut microbiota-immune repertoire-COPD immune homeostasis”. This work aims to establish a research paradigm that deeply integrates the holistic view of TCM with modern immunology and microbiomics, providing a theoretical basis for developing precise TCM-based immunotherapeutic strategies for COPD.