Stress, adaptation, and disease - Allostasis and allostatic load
Stress, adaptation, and disease - Allostasis and allostatic load
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DOI：
10.1111/j.1749-6632.1998.tb09546.x
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发表时间：
1998-01-01
影响因子：
2.4
通讯作者：
McEwen, BS
中科院分区：
文献类型：
--
作者：
McEwen, BS
面对潜在压力挑战的适应涉及神经、神经内分泌和神经内分泌免疫机制的激活。 Sterling 和 Eyer 将其称为“动态平衡”或“通过变化实现稳定”（Fisher S., Reason J. (eds): Handbook of Life Stress, Cognition and Health. J. Wiley Ltd. 1988, p. 631），动态平衡是维持体内平衡的重要组成部分。当这些自适应系统有效且不太频繁地再次打开和关闭时，身体就能够有效应对原本可能无法生存的挑战。然而，在许多情况下，调节系统可能会受到过度刺激或无法正常运行，这种情况被称为“调节负荷”或适应的代价（McEwen 和 Stellar，Arch. Int. Med. 1993；153：2093）。长期的非稳态负荷会导致疾病。失衡负荷的类型包括（1）频繁激活失衡系统； (2) 应激后未能关闭稳态活动； (3) 压力后，调节系统反应不足，导致其他通常反调节的调节系统活性升高。将给出来自与自主神经、中枢神经系统、神经内分泌和免疫系统活动相关的研究的每种类型的非稳态负荷的示例。还考虑了非稳态负荷与疾病遗传和发育倾向的关系。
Adaptation in the face of potentially stressful challenges involves activation of neural, neuroendocrine and neuroendocrine-immune mechanisms. This has been called "allostasis" or "stability through change" by Sterling and Eyer (Fisher S., Reason J. (eds): Handbook of Life Stress, Cognition and Health. J. Wiley Ltd. 1988, p. 631), and allostasis is an essential component of maintaining homeostasis. When these adaptive systems are turned on and turned off again efficiently and not too frequently, the body is able to cope effectively with challenges that it might not otherwise survive. However, there are a number of circumstances in which allostatic systems may either be overstimulated or not perform normally, and this condition has been termed "allostatic load" or the price of adaptation (McEwen and Stellar, Arch. Int. Med. 1993; 153: 2093.). Allostatic load can lead to disease over long periods. Types of allostatic load include (1) frequent activation of allostatic systems; (2) failure to shut off allostatic activity after stress; (3) inadequate response of allostatic systems leading to elevated activity of other, normally counter-regulated allostatic systems after stress. Examples will be given for each type of allostatic load from research pertaining to autonomic, CNS, neuroendocrine, and immune system activity. The relationship of allostatic load to genetic and developmental predispositions to disease is also considered.