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Regulatory context continues to develop

During a marathon, creatine kinase from the muscle-brain type (CK-MB) activity peaks resulting in ultrastructural changes after the competition that indicate local fiber damage and repair: intracellular edema with endothelial damage, myofibrillar lysis, dilatation and disruption of the T-tubule system as well as focal mitochondrial degeneration without inflammatory infiltrates (30)