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Although there are a large number of studies detailing immune and inflammatory responses to exercise, it is timely to examine this body of work in the light of broader applications to clinical medicine. Using exercise as an experimental model for examination of discrete aspects of sepsis and inflammation will, as Professor Shephard notes, facilitate a better understanding of the qualitative similarities and the quantitative differences between the two. Whether experimentally manipulated exercise can satisfactorily reproduce the magnitude of the inflammatory response observed in critical care medicine remains a problem. It is clear that selection of subjects and the choice of experimental treatment are the critical factors. Shephard is correct in promoting a multifaceted approach in which novel, prolonged, exhaustive, and possibly eccentrically biased exercise loads are coupled with other environmental, psychological, and nutritional stressors to invoke a sufficient inflammatory response.
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