New concepts in microvascular function and metabolic diseases: importance of cephalic phase of insulin response

Homeostasis is defined as the property of a system in which variables are regulated to maintain internal conditions stable and relatively constant. It is a robust, dynamic, intergenerational, diachronic (acrosstime) mechanism for maintenance, perpetuation, and modification of physiological structure and function.1 During the process of human evolution, an enormous variety of mechanisms were selected in order to keep physiological functions within tightly regulated and controlled limits. Neurally-mediated anticipatory responses, also named cephalic phase responses (CPR), and microcirculatory regulation are examples of these mechanisms. The hypothesis of an interaction between CPR and the microcirculation for maintenance of metabolic homeostasis and the search for consequences related to disruptions of these physiological mechanisms constitute an exciting field of research for understanding, not only human physiology but especially the pathophysiology of metabolic diseases.