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ORIGINAL RESEARCH ARTICLE

Effect of acupuncture on sperm mitochondrial function: A study based on the Keap1–nuclear factor erythroid 2-related factor 2/heme oxygenase-1 signaling pathway

Yu Zhao1† ,  Zhou Bo2† ,  Xiao-li Zhao3 ,  Rui-hong Ma3 ,  Bao-juan Wang3 ,  Qiang Geng1 ,  Tian Xia3*
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1 Department of Andrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine, Tianjin, China
2 Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine, Tianjin, China
3 Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine, Tianjin, China
†These authors contributed equally to this work.
EJMO, 026060063 https://doi.org/10.36922/EJMO026060063
Received: 3 February 2026 | Revised: 14 May 2026 | Accepted: 14 May 2026 | Published online: 13 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Asthenozoospermia, characterized by impaired sperm motility, is a major contributor to male infertility. Mitochondrial dysfunction driven by oxidative stress plays a critical role in its pathogenesis, and the Kelch-like ECH-associated protein 1 (Keap1)–nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) signaling pathway serves as the principal regulator of cellular antioxidant defense. Acupuncture has shown clinical benefits for sperm quality, yet its underlying molecular mechanism remains inadequately defined.

Objective: To examine the regulating influence of acupuncture on mitochondrial oxidative stress in asthenozoospermic rat sperm and to clarify its underlying mechanism related to the Keap1–Nrf2/HO-1 signaling pathway.

Methods: Thirty-two male Sprague–Dawley rats were randomly assigned to four groups (n=8): normal, model, acupuncture, and curcumin. After model induction with ornidazole, the acupuncture group received electro-acupuncture (2 Hz, 2 mA) at Guanyuan (CV4), Shenshu (BL23), Zusanli (ST36), and Sanyinjiao (SP6) for 28 days, while the curcumin group received oral curcumin (300 mg/kg/day). Sperm motility was assessed using computer-assisted sperm analysis. Mitochondrial membrane potential (MMP) was measured using JC-1 staining. Oxidative stress markers were evaluated by biochemical assays. Keap1, Nrf2, and HO-1 mRNA and protein expression were determined by real-time quantitative polymerase chain reaction and Western blotting.

Results: Compared with the normal group, the model group exhibited significantly reduced sperm motility and MMP, elevated malondialdehyde levels, and decreased superoxide dismutase and glutathione peroxidase activities (p<0.01). Both acupuncture and curcumin effectively reversed these changes (p<0.01). Furthermore, acupuncture downregulated Keap1 expression while upregulating Nrf2 and HO-1 at both transcriptional and translational levels (p<0.01), consistent with the curcumin group.

Conclusion: Acupuncture improves sperm motility in ornidazole-induced asthenozoospermic rats by stimulating the Keap1–Nrf2/HO-1 signaling pathway, hence reducing oxidative stress, maintaining mitochondrial function, and increasing antioxidant capacity. These findings provide mechanistic evidence for acupuncture as a viable treatment for oxidative stress-related male infertility.

Keywords
Acupuncture
Asthenozoospermia
Sperm mitochondria
Oxidative stress
Keap1–nuclear factor erythroid 2-related factor 2/heme oxygenase-1
Funding
This study was supported by the Science and Technology Development Fund of Tianjin Education Commission for Higher Education (2022KJ166).
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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