The long-term health of the cell is inextricably linked to protein quality control. Under optimal conditions this is accomplished by protein homeostasis, a highly complex network of molecular interactions that balances protein biosynthesis, folding, translocation, assembly/disassembly, and clearance. This review will examine the consequences of an imbalance in homeostasis on the flux of misfolded proteins that, if unattended, can result in severe molecular damage to the cell. Adaptation and survival requires the ability to sense damaged proteins and to coordinate the activities of protective stress response pathways and chaperone networks. Yet, despite the abundance and apparent capacity of chaperones and other components of homeostasis to restore folding equilibrium, the cell appears poorly adapted for chronic proteotoxic stress when conformationally challenged aggregation-prone proteins are expressed in cancer, metabolic disease, and neurodegenerative disease. The decline in biosynthetic and repair activities that compromises the integrity of the proteome is influenced strongly by genes that control aging, thus linking stress and protein homeostasis with the health and life span of the organism.Protein homeostasis is the cellular process that governs the "life of proteins." More than protein quality control alone, protein homeostasis encompasses RNA metabolism and processing, protein synthesis, folding, translocation, assembly/disassembly, and clearance (Balch et al. 2008). These processes and their roles in protein homeostasis can be viewed as a systems network in which each process, or hub, is organized as mininetworks interconnected to other hubs. An implicit assumption of protein homeostasis is that each hub should be dynamic, and therefore have sufficient "buffering" capacity to respond to various imbalances in network components and flux of misfolded species and damaged proteins. Tissue-specific differences in expression of components of the homeostasis network such as chaperones and components of the proteasome, autophagy, or transport machinery could be a basis for the sensitivity of neuronal cells during aging and disease.Two prominent modulators of protein homeostasis are molecular chaperones and stress-inducible responses. Chaperones are abundantly expressed in multiple compartments of the cell and are thought to comprise a significant fraction of the cellular machinery (Bukau et al. 2006;Ron and Walter 2007). Only limited information is available on the concentration of chaperones in a eukaryotic cell and the fraction that is functionally engaged with substrates or freely available in reserve. Nevertheless, this has led to a commonly held expectation that within the cell, chaperones have excess folding capacity and can exist in a free state to buffer unexpected folding requirements. This would require the cell to maintain a stockpile of chaperones for protein folding emergencies. A counter view is that the cell has little excess chaperone capacity, and that the concentration of chaperones is titrat...