[Exploring comorbidity mechanism of systemic lupus erythematosus with osteoporosis and progress in TCM intervention from perspective of kidney-bone-immune axis].

Patients with systemic lupus erythematosus( SLE) have a significantly elevated risk of developing osteoporosis, a condition driven by complex interactions among immune inflammation, hormonal imbalances, and medication-related factors. Current western therapies often struggle to concurrently address immune regulation and bone protection. Based on the theory that " the kidney governs the bones and generates marrow", TCM characterizes the core pathogenesis as " kidney deficiency and marrow emptiness as the root, with heat toxin and blood stasis obstruction as the manifestations ". This concept aligns closely with the modern osteoimmunological concept of " immune-skeletal system crosstalk", giving rise to the integrated Chinese-western medicine theoretical framework known as the kidney-bone-immune axis. This review systematically summarized contemporary pathological mechanisms and TCM understanding of the pathogenesis of osteoporosis in SLE patients. It elaborated on the scientific implications of the kidney-boneimmune axis and highlighted the application of herbal formulas within the TCM syndrome differentiation system, as well as the osteoimmune-regulatory mechanisms of single and compound TCM herbs. Currently, research in this field remains nascent, lacking high-quality evidence and systematic mechanistic exploration. Future efforts should deepen the disease-pattern combination research paradigm and establish a multi-level evidence system to promote the systematic integration and clinical translation of TCM in the prevention and management of osteoporosis in SLE patients.