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Acknowledgments We thank Vilim Simanek, in memoriam, for his guidance on writing this paper

This hypothetical adverse effect, although not clinically reported until now, is analogous to the hypothalamic-pituitary axis suppression seen with long-term use of systemic corticosteroids Exacerbation of Helicobacter pylori associated peptic ulcers: Helicobacter pylori is known to feed on macrophages and neutrophils abundant at the site of inflammation caused by the ulcer

Goto K, Okuyama R, Sugiyama H et al (2003) Effects of heat stress and mechanical stretch on protein expression in cultured skeletal muscle cells

Chronic antigen stimulation and persistent TCR signaling upregulate death receptors such as Fas (CD95) and tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) receptors on activated T cells, increasing their susceptibility to activation-induced cell death (AICD) [304]
