Physical exercise provides a challenge to homeostasis throughout the body. The immune system, like many other physiological systems, displays substantial perturbations in response to a single bout of exercise. As early as 1902, the impact of exercise on the immune system was observed in the increase in blood neutrophil levels in runners following the Boston marathon. Many studies have now documented a stereotypical immune response to endurance exercise, consisting of a biphasic alteration in circulating immune cell numbers, reduced natural killer (NK)–cell activity, reduced mitogen-induced lymphocyte proliferation, reduced salivary immunoglobulin secretion, and elevated circulating cytokines. Several published review articles have summarized the immune response to endurance exercise, characterizing it as a transient perturbation that is increased in severity with increasing volume and intensity of exercise. ...

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