Whereas HE athlete serum exhibited an anti-inflammatory effect in the C2C12 cells represented by the significant decrease in IL-6 (0.4-fold decrease, p = 0.015) (Figure 1C), and there was a trend of decrease in TNF-α concentration (p = 0.06) (Figure 1D) compared to the negative control; both LE/LP and HP athlete sera groups exhibited a pro-inflammatory effect manifested by the significant increase in secreted TNF-α concentration (2-folds, p = 0.04) with serum from the LE/LP group, and 1.5-fold increase (p = 0.001) with serum from HP group (Figure 1D) compared to the negative control. Here, IL6 is linked to hereditary elliptocytosis.