Perspective: Personalized Management of Oxidative and Nitrosative Stress in Post-Exercise Recovery with a Particular Emphasis on the Potential of Micro-Immunotherapy.

The understanding of oxidative stress is being refined leading to the use of the terms "oxidative distress" and "eustress". This reflects the dual role of reactive oxygen species (ROS) and reactive nitrogen species (RNS) in both pathology and physiology, emphasizing the complexity of the mechanisms influencing the redox status. This review discusses how these redox mechanisms interact with key signaling pathways, specifically the mammalian/mechanistic target of rapamycin (mTOR) and peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α), which are crucial for mitochondrial health and muscle recovery. During exercise, the contraction of skeletal muscles increases ROS production which, through redox signaling, triggers mitochondrial biogenesis, enhances the antioxidant defenses and stimulates glucose metabolism, contributing to cardiovascular function and health. There is a large consensus about the importance of physical exercise in maintaining the redox homeostasis. However, the redox status could be disturbed after an intense and/or long physical effort, and signs such as markers of oxidative distress were identified. In that context, antioxidant strategies are warranted to prevent oxidative damage and help recovery. Given the many factors influencing the redox status of the body, including the training status, the duration and type of exercises and effort, diet, lifestyle, genetic polymorphisms, and circulating cytokines, a personalized approach is necessary. Targeted therapeutic interventions become important for preventing oxidative damage and helping recovery. In this review, we discuss the potential benefits of micro-immunotherapy (MI), as a multi-target approach utilizing signaling molecules, including cytokines at low doses (LD, typically 3-5 centesimal Hahnemannian CH dilutions) and ultra-low doses (ULD, from 6 CH upwards). We focused specifically on the investigational MI medicine 2LMIREG, and propose its application in preventing oxidative distress and restoring redox balance. Additionally, this review explores how the redox status interplays with the immune system, presenting preclinical data on 2LMIREG as a proof-of-concept for a tailored immunoregulatory strategy to enhance both immune and oxidative adaptations.