中医药调控免疫细胞治疗溃疡性结肠炎的研究进展

Research progress of Traditional Chinese Medicine in the treatment of ulcerative colitis by targeting immune cells

摘要:

溃疡性结肠炎是一类病因尚未完全阐明、病程迁延且易复发的肠道炎症性疾病，其发生发展与肠道黏 膜免疫细胞紊乱密切相关。研究证实，宿主与肠道微生物互作可通过神经-内分泌、代谢等多条途径调控肠黏膜免 疫细胞分化及效应功能，是溃疡性结肠炎核心发病机制与临床诊疗的关键靶点。中医药凭借整体调节、多靶点干 预的特点展现出独特治疗优势。中医药可改善肠道微生态，逆转黏膜免疫微环境失衡，恢复免疫细胞功能并修复 肠黏膜损伤，进而对溃疡性结肠炎发挥治疗作用。本文就中医药调控免疫微环境治疗溃疡性结肠炎的疗效及机制 研究进展进行综述，其免疫调节机制主要包括调控巨噬细胞、树突状细胞成熟分化，抑制中性粒细胞胞外陷阱形 成，维持辅助性T细胞17/调节性T细胞（Th17/Treg）及Th1/Th2免疫稳态等。

Abstract:

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease the etiology of which remains incompletely understood. Its development is closely associated with the dysregulation of mucosal immune cells. Research confirms that host-microbiota interactions regulate the differentiation and effector functions of mucosal immune cells through multiple pathways, including neuro-endocrine and metabolic mechanisms. These interactions represent key targets for understanding the underlying pathogenesis and clinical management of UC. Traditional Chinese medicine (TCM) demonstrates unique therapeutic advantages due to its holistic regulation and multi-targeted interventions. TCM has demonstrated efficacy in UC by effectively improving the gut microbiome, reversing the imbalance in mucosal immune microenvironment, restoring immune cell function, and repairing mucosal damage. This review summarizes recent advances in the therapeutic efficacy and mechanisms of TCM in regulating the immune microenvironment for UC treatment. The summarized immunomodulatory mechanisms primarily involve influencing the maturation and differentiation of macrophages or dendritic cells, inhibiting the formation of neutrophil extracellular traps, and restoring immune homeostasis of the T helper cell 17 (Th17)/regulatory T cell (Treg) and Th1/Th2.