This review by Yi An and colleagues, published in Zhen Ci Yan Jiu (2026) and indexed in PubMed (PMID 42621719; DOI 10.13702/j.1000-0607.20251120), synthesizes current research on how acupuncture and moxibustion regulate mitochondrial function in chronic fatigue syndrome (CFS). All authors are affiliated with the School of Acupuncture-Moxibustion and Tuina at Chengdu University of Traditional Chinese Medicine. The article is a free review and includes an English abstract summarizing core findings.
The review frames CFS as a neurological disorder characterized chiefly by persistent fatigue, post-exertional malaise, and cognitive dysfunction. Within this pathophysiological model, mitochondrial dysfunction is identified as a central mechanism contributing to disease manifestations. The authors position mitochondrial impairment as a target for therapeutic interventions aimed at restoring cellular energy homeostasis and alleviating symptoms.
According to the review, acupuncture and moxibustion have been shown to be safe and effective treatments for CFS in the literature surveyed. The authors emphasize that a portion of the therapeutic effects observed with these modalities is mediated through modulation of mitochondrial function. The review integrates mechanistic findings reported in animal and experimental studies and relates them to clinical implications for CFS treatment.
One set of mechanisms discussed involves direct effects on mitochondrial integrity. The review reports that acupuncture and moxibustion can improve mitochondrial morphology and structural features that are disrupted in CFS-associated mitochondrial dysfunction. Restoration of normal mitochondrial ultrastructure is presented as a pathway to recover bioenergetic capacity.
The authors summarize evidence that these therapies promote mitochondrial biogenesis, increasing the capacity for ATP production, and help restore the balance of mitochondrial dynamics — the coordinated processes of fission and fusion. Re-establishing dynamics homeostasis is described as important for maintaining functional mitochondrial networks and cellular energy supply in CFS.
The review indicates that acupuncture and moxibustion can enhance selective autophagy of damaged mitochondria (mitophagy), facilitating removal of dysfunctional organelles. In parallel, modulation of cellular calcium homeostasis is identified as an effect pathway; stabilizing calcium signaling contributes to mitochondrial health and function.
A reported mechanism is regulation of the activity of electron transport chain (ETC) complexes. The review states that acupuncture and moxibustion may modulate ETC complex activity to improve mitochondrial oxidative phosphorylation, although it notes that further clarification of the specific mechanisms regulating ETC complexes is a priority for future research.
Beyond direct mitochondrial quality control, the therapies are reported to reduce oxidative stress and to inhibit immune-inflammatory responses. These indirect effects are described as further promoting mitochondrial recovery and amplifying therapeutic benefit in CFS by lowering damaging reactive oxygen species and attenuating inflammatory signaling that can impair mitochondrial function.
The review summarizes the literature as indicating that acupuncture and moxibustion are safe and effective in treating CFS, and that part of their efficacy is mediated through the mitochondrial mechanisms described above. The authors advocate that understanding these mechanisms may help optimize clinical protocols and improve outcomes for patients with CFS.
The review highlights several avenues for further investigation: clarifying how acupuncture and moxibustion specifically regulate ETC complex activity; exploring whether alleviation of endoplasmic reticulum stress contributes to therapeutic effects; investigating potential synergistic interactions among the different mitochondrial-regulating mechanisms; and delineating differential mechanisms across distinct acupuncture and moxibustion treatment protocols. The authors propose that addressing these gaps could inform optimization of clinical strategies and enhance the clinical efficacy of acupuncture and moxibustion in CFS.
The authors declare no conflict of interest.
This article is a narrative review summarizing available preclinical and clinical reports; the abstract and metadata available on PubMed outline mechanisms and research priorities but do not provide detailed experimental data or effect sizes in the abstract itself. Where the review calls for future studies, it indicates that some mechanistic pathways—particularly those involving ETC regulation and endoplasmic reticulum stress—remain insufficiently characterized in the existing literature.