From “Blood Heat Syndrome” to Systemic Inflammation: A Contemporary Immunological Exposition of the Etiology of Psoriasis in the Context of Traditional Chinese Medicine

Abstract

Objective: This article aims to systematically elucidate the modern scientific connotation of the “Blood-Heat Syndrome” pathogenesis of psoriasis in Traditional Chinese Medicine (TCM), construct a theoretical bridge between it and the “systemic inflammation” concept in modern medicine, and provide a theoretical basis for the integrated prevention and treatment of psoriasis using both Chinese and Western medicine. Methods: Through theoretical tracing and literature research, the clinical manifestations and pathological evolution patterns of “Blood-Heat Syndrome” in psoriasis were systematized. This was integrated with modern immunological research progress on the core role of the IL-23/Th17 axis in the pathogenesis of psoriasis, conducting a critical dialogue and mutual interpretation of the pathomechanisms. Results: The state of excessive Yang heat described by TCM’s “Blood-Heat Syndrome” is highly consistent biologically with the “pro-inflammatory cytokine storm” driven by abnormal activation of the IL-23/Th17 immune axis. Pathomechanisms such as “Heat forcing blood to move recklessly” can correspond at the micro-level to immune cell circulation, vasodilation, and increased vascular permeability. In terms of treatment, Chinese herbs for “clearing heat and cooling the blood” (e.g., Sheng Di Huang [Rehmannia Root], Dan Pi [Tree Peony Bark]) have been confirmed to inhibit the IL-23/Th17 axis, regulate T-cell balance, and inhibit keratinocyte proliferation through multi-target actions, aligning with Western immunomodulatory strategies. Integrated Chinese and Western medicine has shown significant advantages in enhancing efficacy, reducing side effects, and preventing recurrence. Conclusion: The “Blood-Heat Syndrome” in psoriasis is a unique and precise macroscopic expression of the “systemic inflammation” state in modern medicine. This study successfully establishes a connection between the two, not only deepening the understanding of the scientific connotation of TCM syndromes but also paving new paths for promoting the integrated diagnosis and treatment of psoriasis using Chinese and Western medicine.