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ME/CFS is a complex multisystemic disease characterised by profound, unexplained, disabling fatigue which is not relieved by rest and is exacerbated by mental or physical activities [4,5,6,7,8]

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Despite the main phases of mitochondrial sheath assembly being described, the specific biological mechanisms that underpin its formation and maturation remain poorly defined and, in many cases, unknown

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Concurrently, EV-QuerCar elevated HES1 expression (Notch signaling) by 1.9-fold and 3.4-fold compared to NC and UV group, respectively (Fig