Straub · Brain, behavior, and immunity 2011 · narrative review / conceptual framework · n=?

Concepts of evolutionary medicine and energy regulation contribute to the etiology of systemic chronic inflammatory diseases.

Cited 71 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and conceptual address based on mechanistic reasoning without original empirical data.

PubMed 20705130 · doi:10.1016/j.bbi.2010.08.002 · record verified 2026-08-28

What was done

This conceptual review and address analyzed the etiology of chronic inflammatory diseases (CIDs). The author proposed adding a fifth criterion—the systemic response—to the four established etiologic criteria of CIDs (genetic susceptibility, complex environmental priming, exaggerated and continuous immune response, and tissue destruction with fibrotic scarring), examining this through the framework of evolutionary medicine and bioenergetic regulation.

What was found

No quantitative data or numerical findings were reported in the abstract. Conceptually, the paper describes the immune system as a primary energy consumer alongside the brain and muscle. In chronic inflammatory conditions, persistent immune activation prompts neuroendocrine pathways to reallocate energy-rich fuels to the immune system. The author terms this process an energy appeal reaction (updating Selye's alarm reaction) and proposes that continuous fuel reallocation drives systemic complications of CIDs, such as metabolic syndrome.

Why it matters

This paper provides an evolutionary bioenergetics framework explaining why systemic comorbidities like metabolic syndrome emerge during chronic inflammation. It argues that addressing whole-body systemic energy reallocation is essential for future therapeutic strategies in chronic inflammatory diseases.

Limits

The paper is a theoretical address and narrative review providing no primary human data, clinical trials, or quantitative measurements. Specific sample sizes, patient demographics, and systematic study selection criteria were not present in the abstract, and the proposed mechanisms remain theoretical without direct empirical testing.

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