Study on the Correlation Between Different Traditional Chinese Medicine Syndromes and Serum Pro-inflammatory Factors,PD-1,and PD-L1 in Patients with Chronic Obstructive Pulmonary Disease
SHI Yuexin
YAN Jun
WU Caijun
YAO Zhi
Abstract：Objective To investigate the correlation between different traditional Chinese medicine(TCM)syndrome types in chronic obstructive pulmonary disease(COPD)patients and serum programmed cell death protein 1(PD-1)and its ligand PD-L1.Methods A cross-sectional study was conducted,enrolling 160 COPD patients treated at Dongzhimen Hospital,Beijing University of Chinese Medicine from April 2024 to April 2025.Including 20 cases of spleen-lung Qi deficiency syndrome,22 cases of lung-kidney Qi deficiency syndrome,57 cases of phlegm-turbidity obstructing lung syndrome,35 cases of phlegm-heat congesting lung syndrome,and 26 cases of phlegm-stasis intermingling syndrome.Additionally,40 healthy volunteers were included as controls.General patient data were collected,and assessments included the COPD Assessment Test(CAT),modified Medical Research Council Dyspnea Scale(mMRC),and respiratory function parameters(FEV1,FEV1%predicted,FEV1/FVC).Peripheral venous blood was collected to measure NEUT,NLR,PCT,CRP,IL-6,TNF-α,PD-1,and PD-L1.Differences in clinical scores,respiratory function,inflammatory markers,and PD-1/PD-L1 levels across TCM syndromes were compared.Pearson or Spearman correlation analysis and multiple linear regression were used to evaluate relationships between variables.Results Among the five TCM syndromes,significant intergroup differences were observed in CAT scores,mMRC scores,FEV1,FEV1/FVC,NEUT,NLR,CRP,IL-6,and TNF-α(P<0.05),while FEV1%and PCT showed no significant differences(P>0.05).Compared to controls,COPD patients showed significantly higher PD-1 and lower PD-L1 levels,with significant intergroup differences across TCM syndromes(P<0.05).The serum PD-1 level in patients with COPD was positively correlated with CAT score,CRP,NLR,and IL-6(r=0.174,0.159,0.406,0.374,P<0.05),but not significantly correlated with mMRC classification,FEV1,FEV1/FVC,FEV1%,NEUT,and TNF-α(P>0.05).The serum PD-L1 level was negatively correlated with CAT score,CRP,NEUT,NLR,IL-6,and TNF-α(r=-0.205,-0.360,-0.203,-0.171,-0.365,-0.206,P<0.05),but not significantly correlated with mMRC classification,FEV1%,FEV1,and FEV1/FVC(P>0.05).Multiple regression models constructed with PD-1 as the dependent variable is statistically significant(F=18.094,P<0.001).46.2%of PD-1 variation was explained by spleen-lung Qi deficiency,lung-kidney Qi deficiency,phlegm-turbidity obstructing lung syndrome,NLR,and IL-6(adjusted R2=0.462).For PD-L1,multiple regression models constructed with PD-L1 as the dependent variable is statistically significant(F=9.969,P<0.001).36.1%of variation was explained by spleen-lung Qi deficiency,lung-kidney Qi deficiency,phlegm-turbidity obstructing lung syndrome,phlegm-heat congesting lung syndrome,CRP,IL-6,and TNF-α(adjusted R2=0.361).Conclusion TCM syndrome differentiation in COPD correlates with PD-1/PD-L1 levels,providing objective evidence for TCM classification and insights into integrative immunomodulatory therapies.
Keywords：Chronic obstructive pulmonary diseaseTraditional Chinese medicine syndromeInflammatory factorsPD-1PD-L1
Publication Date：2026-03-28
Online Publishing Date：2026-03-31(First online date of this platform, not the publication date of the document)
Pages：8( 639-646 )