Research progress on acupuncture and moxibustion in regulating mitochondrial function for chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a neurological disorder primarily characterized by persistent fatigue, post-exertional malaise, and cognitive dysfunction. Mitochondrial dysfunction is considered as a core mechanism underlying its pathological changes. Acupuncture and moxibustion therapy has been shown to be a safe and effective treatment for CFS, with part of its therapeutic effects achieved through the regulation of mitochondrial function. This review summarized the research progress on acupuncture and moxibustion in regulating mitochondrial function for the treatment of CFS. The findings indicated that acupuncture and moxibustion can modulate mitochondrial quality control systems through multiple pathways, including repairing mitochondrial morphology and structure, promoting mitochondrial biogenesis, restoring mitochondrial dynamics balance, enhancing autophagy of damaged mitochondria, regulating calcium homeostasis, and modulating the activity of the electron transport chain (ETC) complexes, thereby improving mitochondrial function. In addition, acupuncture and moxibustion can further promote mitochondrial function recovery through reducing oxidative stress and inhibiting immune-inflammatory responses. Future research may further reveal the mechanisms of acupuncture and moxibustion in regulating ETC complex activity, explore the role of alleviating endoplasmic reticulum stress in acupuncture and moxibustion treatment of CFS, investigate potential synergistic effects among different mechanisms, and elucidate the differential effect mechanisms among various acupuncture and moxibustion treatment protocols, so as to optimize clinical treatment strategies and improve the clinical efficacy of acupuncture and moxibustion for CFS.