Table 1

Parallels between immune responses to surgical trauma and stressful bouts of physical activity

• Cellular infiltration dependent on extent of tissue damage.^{12 17–19}

• Activation of neutrophils and macrophages with accumulation of free radicals.^{12 20 21}

• Local release of acute phase reactants^{23 24} and pro-inflammatory cytokines,^{25 26} with activation of complement, coagulation, and fibrinolytic cascades.²³

• Downregulation of CD4 cells and shift in CD4:CD8 ratio.²⁸^–³⁰

• Suppression of natural killer (NK) cell counts and activity^{30 31}

• Suppressed production of immunoglobulins.³²^–³⁴

• Suppressed mitogen stimulated T cell proliferation.^{32 33}