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Digital Twins for Predictive, Preventive Personalized, and Participatory Treatment of Immune-Mediated Diseases

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.122.318331

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clinic; complex system; disease; drug; genome

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Digital twins are computational models designed to optimize and understand complex systems more effectively. They can be translated into individual patients to computationally treat diseases and select the most suitable drugs for curing them. However, the challenge lies in the inadequate response of many patients to drug treatment, highlighting the gap between disease complexity and clinical practice.
Digital twins are computational models of complex systems, which aim to understand and optimize those systems more effectively than would be possible in real life. Ideally, digital twins can be translated to individual patients, to characterize and computationally treat their diseases with thousands of drugs, to select the drug or drugs that cure the patients. The background problem is that many patients do not respond adequately to drug treatment. This problem reflects a wide gap between the complexity of diseases and clinical practice. Each disease may involve altered interactions between thousands of genes that vary between different cell types in different organs. To our knowledge, these altered interactions have not been characterized on a genome-, cellulome-, and organ-wide scale in any disease. Thus, clinical translation of the digital twin ideal for predictive, preventive, personalized and participatory treatment involves formidable challenges, which are close to the limits of, or beyond today's technologies. Here, I discuss recent developments and challenges in relation to that ideal focusing on immune-mediated inflammatory diseases, as well as examples from other diseases.

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