Integrative immunomodulation in systemic autoimmune diseases: Mechanistic complementarity and therapeutic strategies of traditional Chinese and conventional medicine

Systemic autoimmune diseases (SAIDs) arise from the convergence of genetic susceptibility, epigenetic dysregulation, metabolic imbalance and environmental triggers, ultimately leading to sustained disruption of immune homeostasis. Although targeted therapies and immunosuppressants have significantly improved disease control, their single pathway specificity limits their ability to restore long-term immune tolerance. Preclinical evidence suggests that traditional Chinese medicine (TCM) may exert multi-pathway regulatory effects across T- and B-cell responses, innate immune activation and immunometabolic circuits. This review integrates current mechanistic evidence to illustrate how TCM-based interventions complement the pathway specific actions of modern therapeutics through coordinated modulation of immune, metabolic, microbial and neuro-immune networks. We further propose a '3C' integrative framework-customisation, convergence and continuum-to describe how individualised patient profiling, multi-target mechanistic convergence and stage-specific treatment continuity can enhance the precision and durability of SAID management. Together, these insights provide a mechanistic rationale for developing evidence based and complementary integrative treatment strategies, whilst underscoring the need for improved standardisation, biomarker guided assessment and translational research to advance the clinical application of TCM informed therapeutics.