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doi: 10.1136/annrheumdis-2015-207776 267 RosenzwajgMLorenzonRCacoubPPhamHPPitoisetFSoufiKEet al

McEwen has defined allostatic load as the cost of chronic exposure to fluctuating or heightened neural or neuroendocrine response resulting from repeated or chronic environmental challenge that an individual reacts to as being particularly stressful (287)