Invited response to definition of hormesis (EJ Calabrese and LA Baldwin)

How does hormesis impact biology, toxicology, and medicine?

Hormesis refers to adaptive responses of biological systems to moderate environmental or self-imposed challenges through which the system improves its functionality and/or tolerance to more severe challenges. The past two decades have witnessed an expanding recognition of the concept of hormesis, elucidation of its evolutionary foundations, and underlying cellular and molecular mechanisms, and practical applications to improve quality of life. To better inform future basic and applied research, we organized and re-evaluated recent hormesis-related findings with the intent of incorporating new knowledge of biological mechanisms, and providing fundamental insights into the biological, biomedical and risk assessment implications of hormesis. As the literature on hormesis is expanding rapidly into new areas of basic and applied research, it is important to provide refined conceptualization of hormesis to aid in designing and interpreting future studies. Here, we establish a working compartmentalization of hormesis into ten categories that provide an integrated understanding of the biological meaning and applications of hormesis.

Hormesis and its place in nonmonotonic dose-response relationships: some scientific reality checks

OBJECTIVE

This analysis is a critical assessment of current hormesis literature. I discuss definitions, characterization, generalizability, mechanisms, absence of empirical data specific for hormesis hypothesis testing, and arguments that hormesis be the "default assumption" in risk assessment.

DATA SOURCES

Hormesis, a biological phenomenon typically described as low-dose stimulation from substances producing higher-dose inhibition, has recently garnered interest in several quarters. The principal sources of published materials for this analysis are the writings of certain proponents of hormesis. Surprisingly few systematic critiques of current hormesis literature exist. Limits to the phenomenon's appropriate role in risk assessment and health policy have been published.

DATA SYNTHESIS

Serious gaps in scientific understanding remain: a stable definition; generalizability, especially for humans; a clear mechanistic basis; limitations in the presence of multiple toxic end points, target organs, and mechanisms. Absence of both arms-length, consensus-driven, scientific evaluations and empirical data from studies specifically designed for hormesis testing have limited its acceptance.

CONCLUSIONS

Definition, characterization, occurrence, and mechanistic rationale for hormesis will remain speculative, absent rigorous studies done specifically for hormesis testing. Any role for hormesis in current risk assessment and regulatory policies for toxics remains to be determined.

Examining the risks and benefits of replacing traditional dose-response with hormesis

In responding to Drs Calabrese and Baldwin's question, 'At what point, if ever, should hormesis be employed as the principal dose response default assumption in risk assessment?', we examined the benefits of replacing traditional dose-response with hormesis. In general, hormesis provides more complete useful information for risk assessment than does traditional dose-response. A major limitation of using hormesis as a default assumption in risk estimation is the difficulty of differentiating complex low-level hormetic responses from the placebo effect. A second limitation is that hormesis merely further defines one response. Most toxicoses have many responses. The most complete information takes all responses and their connections into account.