Postpartum dysgalactia syndrome: A simple change in homeorhesis?

Mastitis, metritis, and agalactia syndrome (MMA) is a clear entity often reported as postpartum dysgalactia syndrome (PDS). However, MMA may represent only a small emerging part of an iceberg represented by PDS. Until now, investigators have compiled a list of risk factors for PDS related to nutrition, housing, and management practices and suggested that endotoxins and cytokines may play a central role in development of PDS. However, the pathophysiology of PDS has never been defined. The goal of this paper is to fill this gap, basing our proposal on the most recent published scientific literature and on the concept of homeorhesis developed by Bauman and Currie in the 1980s. Homeorhesis, a term that encompasses dynamic systems that return to a trajectory, refers to orchestrated changes in metabolism of body tissues to prioritize a physiological state (such as gestation or lactation) and brings a new perspective to this multifactorial disease that we will try to clarify using a transdisciplinary approach. Indeed, it appears that the clinical approach to PDS must simultaneously take into account physiology, endocrinology, innate immunology, and ethology.