Allostasis and it's correlate vitality; measured with reflex action impairment and injury

Figure 1. Alternative models of regulation. Homeostasis describes mechanisms that hold constant a controlled variable by sensing its deviation from a “setpoint” and feeding back to correct the error. Allostasis describes mechanisms that change the controlled variable by predicting what level will be needed and then overriding local feedback to meet anticipated demand, Sterling (2003).

Physiological regulation is considered the cornerstone of animal survival and avoidance of death. Inability to regulate is indicated by vitality impairment and causes an animal to exceed its capacity for life. To understand and predict the causes for survival and death, we must be able to measure appropriate state and rate variables involved in regulation. The generally accepted model of physiological regulation is homeostasis, based on the concept of stability through constancy. However homeostasis is unable to explain accumulating medical evidence that physiological variables do not remain constant. Clearly a more comprehensive model of physiological regulation is needed.  

Allostasis is a model of physiological regulation based on the concept of stability through change (Sterling 2003). Allostasis is able to account for evidence that physiological variables are not constant. The allostasis model connects easily with modern concepts in sensory physiology, neural computation, and optimal design, to produce anticipatory regulation. Allostasis was developed with the recognition that the goal of regulation is not constancy, but rather fitness under natural selection, that implies preventing errors and minimizing costs. Both needs are best accomplished by using prior information to predict physiological demand and then adjusting all variables to meet it. In allostasis an unusual variable value is not a failure to maintain a setpoint, but is a response to some prediction made through perception or prior knowledge. Constancy is not a fundamental condition for life. A mean value need not imply a setpoint but rather the most frequent demand.

The brain has close access to essentially every somatic cell through nerve cell connections. The broad metabolic patterns over short and long time scales, and under mild as well as emergency conditions are controlled by the brain. In other words, the brain regulates both physiology and its supporting behavior (Sterling 2003). The use of reflex action impairment to measure vitality and predict survival and mortality is consistent with the allostatic model because it is representative of key elements of physiological regulation; including perception, behavior, and neural control of somatic cell function. Injury also measures vitality impairment because of its direct effects on neural and somatic cell function, hence allostasis. 

Reflex action impairment and injury can measure vitality and predict survival and mortality in taxa ranging from invertebrates to humans. Clearly the presence of higher brain function is not a necessary condition for the allostatic model. Instead, simple interactions of neural and somatic cells can produce allostasis regulation and its correlate, vitality. It remains to elucidate the comparative details of physiological regulation as it developed in new phyla through evolutionary time.

When studying the causes for death, shifting focus from measurement of lower level plasma variables (cortisol, lactate, glucose, O2, pH) to higher level variables (vitality in its various guises) would advance the assessment of physiological regulation and its role in survival and death. Particular values for plasma variables are of secondary importance, until reaching outer limits of operation. The interactions of plasma variables are of primary importance (Ellis and Del Giudice 2014). The homeostatic model fails to capture the importance of stability through change; how animals adapt and ultimately go beyond their physiological limits. The allostatic model addresses stability through change and invites adaption and evolutionary fitness.

Reflex action impairment is probably a biomarker for impairment of physiological regulation and this is why the RAMP curve is non-linear, reflecting the inflection point where physiological regulation is lost and death results. Addition of injury to RAMP adds details of direct injury effects on physiological functioning and regulation, e.g. compromising integument gatekeeping (skin, gut, gill, lung).