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Allostasis is the process of achieving stability, or homeostasis, through physiological or behavioral change (Copstead & Banasik 2013) harv error: no target: CITEREFCopsteadBanasik_2013 (help). This can be carried out by means of alteration in HPA axis hormones, the autonomic nervous system, cytokines, or a number of other systems, and is generally adaptive in the short term (McEwen & Wingfield 2003). Allostasis is essential in order to maintain internal viability amid changing conditions (Sterling & Eyer 1988; McEwen 1998a; McEwen 1998b; Schulkin 2003).
Allostasis provides compensation for various problems, such as in compensated heart failure, compensated kidney failure, and compensated liver failure. However, such allostatic states are inherently fragile, and decompensation can occur quickly, as in acute decompensated heart failure.
Nature of concept
The concept of allostasis was proposed by Sterling and Eyer in 1988 as a process of reestablishing stability in response to a challenge. Allostasis was coined from the Greek allo, which means "variable;" thus, "remaining stable by being variable" (Sterling & Eyer 1988; Klein 2004). Allostatic regulation reflects, at least partly, cephalic involvement in primary regulatory events, in that it is anticipatory to systemic physiological regulation (Sterling & Eyer 1988; Schulkin 2003). This is different from homeostasis, which occurs in response to subtle ebb and flow. Both homeostasis and allostasis are endogenous systems responsible for maintaining the internal stability of an organism. Homeostasis is formed from the Greek adjective homoios, meaning "similar," and the noun stasis, meaning "standing;" thus, "standing at about the same level." (Sterling & Eyer 1988);
The concept of allostasis, maintaining stability through change, is a fundamental process through which organisms actively adjust to both predictable and unpredictable events... Allostatic load refers to the cumulative cost to the body of allostasis, with allostatic overload... being a state in which serious pathophysiology can occur... Using the balance between energy input and expenditure as the basis for applying the concept of allostasis, two types of allostatic overload have been proposed (Wingfield 2003).
Sterling (2004) proposed six interrelated principles that underlie allostasis:
- Organisms are designed to be efficient
- Efficiency requires reciprocal trade-offs
- Efficiency also requires being able to predict future needs
- Such prediction requires each sensor to adapt to the expected range of input
- Prediction also demands that each effector adapt its output to the expected range of demand
- Predictive regulation depends on behavior whilst neural mechanisms also adapt.
McEwen and Wingfield propose two types of allostatic load which result in different responses:
Type 1 allostatic overload occurs when energy demand exceeds supply, resulting in activation of the emergency life history stage. This serves to direct the animal away from normal life history stages into a survival mode that decreases allostatic load and regains positive energy balance. The normal life cycle can be resumed when the perturbation passes.
Type 2 allostatic overload begins when there is sufficient or even excess energy consumption accompanied by social conflict and other types of social dysfunction. The latter is the case in human society and certain situations affecting animals in captivity. In all cases, secretion of glucocorticosteroids and activity of other mediators of allostasis such as the autonomic nervous system, CNS neurotransmitters, and inflammatory cytokines wax and wane with allostatic load. If allostatic load is chronically high, then pathologies develop. Type 2 allostatic overload does not trigger an escape response, and can only be counteracted through learning and changes in the social structure (McEwen & Wingfield 2003; Sterling & Eyer 1988)
Whereas both types of allostasis are associated with increased release of cortisol and catecholamines, they differentially affect thyroid homeostasis: Concentrations of the thyroid hormone triiodothyronine are decreased in type 1 allostasis, but elevated in type 2 allostasis (Chatzitomaris et al. 2017). This may result from type 2 allostatic load increasing the set point of pituitary-thyroid feedback control (Dietrich et al. 2020).
In the long run, the maintenance of allostatic changes over a long period may result in wear and tear, the so-called allostatic load. If a dehydrated individual is helped but continues to be stressed and hence does not reinstate normal body function, the individual's body systems will wear out.
In 2005, Trevor A. Day has argued that the concept of allostasis is no more than a renaming of the original concept of homeostasis (Day 2005).
- Chatzitomaris, Apostolos; Hoermann, Rudolf; Midgley, John E.; Hering, Steffen; Urban, Aline; Dietrich, Barbara; Abood, Assjana; Klein, Harald H.; Dietrich, Johannes W. (20 July 2017). "Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming". Frontiers in Endocrinology. 8: 163. doi:10.3389/fendo.2017.00163. PMC 5517413. PMID 28775711.
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