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Lamb et al

When levels are optimal, this supports a healthy balance between Th1 and Th2 cells

This direction of effect aligns with the pathophysiological hypothesis linking oxidative stress to AMS symptom development (e.g., endothelial dysfunction, increase permeability) and the potential benefit of strategies that modulate ROS production or enhance endogenous antioxidant capacity ( An additional consideration is the methodological quality of the included trials