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Abstract
This commentary provides a novel synthesis of how biological systems adapt to a broad
spectrum of environmental and age-related stresses that are underlying causes of numerous
degenerative diseases and debilitating effects of aging. It proposes that the most
fundamental, evolutionary-based integrative strategy to sustain and protect health
is based on the concept of hormesis. This concept integrates anti-oxidant, anti-inflammatory
and cellular repair responses at all levels of biological organization (i.e., cell,
organ and organism) within the framework of biphasic dose responses that describe
the quantitative limits of biological plasticity in all cells and organisms from bacteria
and plants to humans. A major feature of the hormetic concept is that low levels of
biological, chemical, physical and psychological stress upregulate adaptive responses
that not only precondition, repair and restore normal functions to damaged tissues/organs
but modestly overcompensate, reducing ongoing background damage, thereby enhancing
health beyond that in control groups, lacking the low level "beneficial" stress. Higher
doses of such stress often become counterproductive and eventually harmful. Hormesis
is active throughout the life-cycle and can be diminished by aging processes affecting
the onset and severity of debilitating conditions/diseases, especially in elderly
subjects. The most significant feature of the hormetic dose response is that the limits
of biological plasticity for adaptive processes are less than twice that of control
group responses, with most, at maximum, being 30-60 % greater than control group values.
Yet, these modest increases can make the difference between health or disease and
living or dying. The quantitative features of these adaptive hormetic dose responses
are also independent of mechanism. These features of the hormetic dose response determine
the capacity to which systems can adapt/be protected, the extent to which biological
performance (e.g., memory, resistance to injury/disease, wound healing, hair growth
or lifespan) can be enhanced/extended and the extent to which synergistic interactions
may occur. Hormesis defines the quantitative rules within which adaptive processes
operate and is central to evolution and biology and should become transformational
for experimental concepts and study design strategies, public health practices and
a vast range of therapeutic strategies and interventions.
Although intermittent increases in inflammation are critical for survival during physical injury and infection, recent research has revealed that certain social, environmental and lifestyle factors can promote systemic chronic inflammation (SCI) that can, in turn, lead to several diseases that collectively represent the leading causes of disability and mortality worldwide, such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and autoimmune and neurodegenerative disorders. In the present Perspective we describe the multi-level mechanisms underlying SCI and several risk factors that promote this health-damaging phenotype, including infections, physical inactivity, poor diet, environmental and industrial toxicants and psychological stress. Furthermore, we suggest potential strategies for advancing the early diagnosis, prevention and treatment of SCI.
Aging is driven by hallmarks fulfilling the following three premises: (1) their age-associated manifestation, (2) the acceleration of aging by experimentally accentuating them, and (3) the opportunity to decelerate, stop, or reverse aging by therapeutic interventions on them. We propose the following twelve hallmarks of aging: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, disabled macroautophagy, deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, chronic inflammation, and dysbiosis. These hallmarks are interconnected among each other, as well as to the recently proposed hallmarks of health, which include organizational features of spatial compartmentalization, maintenance of homeostasis, and adequate responses to stress.
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