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Researchers believe these symptoms may stem from lingering inflammation, immune system overactivity, oxidative stress, or microvascular damage

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first, ferrylHb is a more powerful inducer of leukocyte infiltration than heme and second, metHb that has the ability to release heme at the same or even higher rate as ferrylHb (87) fails to trigger leukocyte recruitment (34)

Acids 87 , 135141 (2012)

Effects of fatigue on immune function in nurses performing shift work