The human body is a tightly controlled engineering miracle. However, medical training generally does not cover ‘control’ (in the engineering sense) in physiology, pathophysiology and therapeutics. A better understanding of how evolved controls maintain normal homeostasis is critical for understanding the failure mode of controlled systems, i.e., disease. We believe that teaching and research must incorporate an understanding of the control systems in physiology, and take advantage of the quantitative tools used by engineering to understand complex systems.
Control systems are ubiquitous in physiology, though often unrecognized. Here we provide selected examples of the role of control in physiology (heart rate variability, immunity), pathophysiology (inflammation in sepsis), and therapeutic devices (diabetes and the artificial pancreas). We also present a high level background to the concept of robustly controlled systems and examples of clinical insights using the controls framework.