Sulfur ion pharmacopuncture is a newly developed treatment method of traditional Korean medicine (TKM). Sulfur ion pharmacopuncture is a form of pharmacopuncture that uses ionized sulfur compounds to induce tissue regeneration, immune modulation, and organ function restoration. This treatment method is different from sulfur pharmacopuncture, which mainly uses organic sulfur compounds, such as MSM (Methylsulfonylmethane). The proposed therapeutic effects of sulfur ion pharmacopuncture are based on the roles of sulfur in glutathione synthesis, hydrogen sulfide (H₂S) production, sulfation, mitochondrial energy production, ECM (Extracellular Matrix) remodeling, etc. In addition, stimulation of acupoints and the Primo Vascular System (PVS) are also considered mechanisms of sulfur ion pharmacopuncture. The PVS is a newly identified structure that is considered to be the anatomical basis of the meridian system. Although its biological significance is unclear and needs to be validated by further experiments, it is believed to play a role in intercellular communication, immune modulation, and tissue repair. This review will discuss the current knowledge and molecular effects of sulfur ion pharmacopuncture and compare it with other pharmacopunctures, such as bee venom pharmacopuncture, mountain ginseng pharmacopuncture, and Hwangryun pharmacopuncture. In addition, future research directions for sulfur ion pharmacopuncture in the context of regenerative and integrative medicine will also be proposed. Although initial clinical observations have provided promising results in the treatment of metabolic disorders, thyroid dysfunction, chronic fatigue, autonomic imbalance, and chronic inflammatory diseases, well-designed experimental studies and clinical trials are needed to confirm its efficacy and safety.

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