Drug toxicity and market withdrawals are two issues that often obstruct the lengthy and intricate drug discovery process. In order to enhance drug effectiveness and safety, this review examines withdrawn drugs and presents a novel paradigm for their redesign. In addition to addressing methodological issues with toxicity datasets, this study highlights important shortcomings in in silico drug toxicity prediction models and suggests solutions. High-throughput screening (HTS) has greatly progressed with the advent of 3D organoid and organ-on-chip (OoC) technologies, which provide physiologically appropriate systems that replicate the structure and function of human tissue. These systems provide accurate, human-relevant data for drug development, toxicity evaluation, and disease modeling, overcoming the limitations of traditional 2D cell cultures and animal models. Their integration into HTS pipelines has shown to have a major influence, promoting drug redesign efforts and enabling improved accuracy in preclinical research. The potential of fragment-based drug discovery to enhance pharmacokinetics (PK) and pharmacodynamics (PD) when combined with conventional techniques is highlighted in this study. The limits of animal models are discussed, with a focus on the need of bioengineered humanized systems such OoC technologies and 3D organoids. To improve drug candidate screening and simulate real illnesses, advanced models are crucial. This leads to improved target affinity and fewer adverse effects.

The problem of protein structure determination is usually solved by X-ray crystallography. Several in silico deep learning methods have been developed to overcome the high attrition rate, cost of experiments and extensive trial-and-error settings, for predicting the crystallization propensities of proteins based on their sequences. In this work, we benchmark the power of open protein language models (PLMs) through the TRILL platform, a be-spoke framework democratizing the usage of PLMs for the task of predicting crystallization propensities of proteins. By comparing LightGBM / XGBoost classifiers built on the average embedding representations of proteins learned by different PLMs, such as ESM2, Ankh, ProtT5-XL, ProstT5, xTrimoPGLM, SaProt with the performance of state-of-the-art sequence-based methods like DeepCrystal, ATTCrys and CLPred, we identify the most effective methods for predicting crystallization outcomes. The LightGBM classifiers utilizing embeddings from ESM2 model with 30 and 36 transformer layers and 150 and 3000 million parameters respectively have performance gains by 3-\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$5\%$$\end{document} than all compared models for various evaluation metrics, including AUPR (Area Under Precision-Recall Curve), AUC (Area Under the Receiver Operating Characteristic Curve), and F1 on independent test sets. Furthermore, we fine-tune the ProtGPT2 model available via TRILL to generate crystallizable proteins. Starting with 3000 generated proteins and through a step of filtration processes including consensus of all open PLM-based classifiers, sequence identity through CD-HIT, secondary structure compatibility, aggregation screening, homology search and foldability evaluation, we identified a set of 5 novel proteins as potentially crystallizable.

Background and Objective: Hepatoblastoma is the most common pediatric liver cancer and represents a serious clinical challenge as no effective therapies have yet been found for advanced states and relapses of the disease. Methods: In this work, we use a well-established agent-based model of the immune response now equipped with anti-cancer therapy response to study the evolution of the disease and the role of the immune system in its containment. Results: We simulate the course of hepatoblastoma over three years in a population of virtual patients, successfully mimicking clinical mortality and symptom onset rates, as well as observations on the main tumor transcriptomic subtypes. Conclusions: The capacity of the introduced framework to reproduce clinical data and the heterogeneity of hepatoblastoma, combined with the possibility of observing the dynamics of cellular entities at the microscopic scale and the key chemical signals involved in disease progression, makes the model a promising resource for future research on in silico trials.

: Objectives: The quantitative analysis of tumor progression-monitored during and immediately after therapeutic interventions-can yield valuable insights into both long-term disease dynamics and treatment efficacy. Methods: We used a computational approach designed to support clinical decision-making, with a focus on personalized patient care, based on modeling therapy effects using effective parameters of the Gompertz law. Results: The method is applied to data from in vivo models undergoing neoadjuvant chemoradiotherapy, as well as conventional and FLASH radiation treatments. Conclusions: This user-friendly, phenomenological model captures distinct phases of treatment response and identifies a critical dose threshold distinguishing complete response from partial response or tumor regrowth. These findings lay the groundwork for real-time quantitative monitoring of disease progression during therapy and contribute to a more tailored and predictive clinical strategy.

Threshold Boolean Networks (TBNs) are constructed using threshold functions that evaluate whether the input values are strong enough for the function to be either "on" or "off." In this work, we explore the properties of the dynamics of TBNs. We propose a new approach to assess the robustness of these networks while addressing the issue of multiple attractors. This method suggests the existence of a set of dominant attractors in the dynamics of TBNs, a phenomenon not commonly observed in Kauffman's networks. We demonstrate this by conducting comparative experiments between the dynamics of TBNs and Random Boolean Networks (RBNs), focusing on variations in the number of inputs per variable. Our experiments also indicate that TBNs tend to exhibit a greater number of attractors per network, though these attractors are typically shorter in length. Finally, we conduct a sensitivity analysis to examine the stability of the dominant attractors in TBNs, which shows that the dominant fixed-point attractors do not always exhibit remarkable stability across the tested size and connectivity configurations.

Personalized medicine strategies are gaining momentum nowadays, enabling the introduction of targeted treatments based on individual differences that can lead to greater therapeutic efficacy by reducing adverse effects. Despite its crucial role, studying the contribution of the immune system (IS) in this context is difficult because of the intricate interplay between host, pathogen, therapy, and other external stimuli. To address this problem, a multidisciplinary approach involving in silico models can be of great help. In this perspective, we will discuss the use of a well-established agent-based model of the immune response, C-ImmSim, to study the relationship between long-lasting diseases and the combined effects of IS, drug therapies and exogenous factors such as physical activity and dietary habits.

Multiple sclerosis (MS) is a demyelinating neurological disorder with a highly heterogeneous clinical presentation and course of progression. Disease-modifying therapies are the only available treatment, as there is no known cure for the disease. Careful selection of suitable therapies is necessary, as they can be accompanied by serious risks and adverse effects such as infection. Magnetic resonance imaging (MRI) plays a central role in the diagnosis and management of MS, though MRI lesions have displayed only moderate associations with MS clinical outcomes, known as the clinico-radiological paradox. With the advent of machine learning (ML) in healthcare, the predictive power of MRI can be improved by leveraging both traditional and advanced ML algorithms capable of analyzing increasingly complex patterns within neuroimaging data. The purpose of this review was to examine the application of MRI-based ML for prediction of MS disease progression. Studies were divided into five main categories: predicting the conversion of clinically isolated syndrome to MS, cognitive outcome, EDSS-related disability, motor disability and disease activity. The performance of ML models is discussed along with highlighting the influential MRI-derived biomarkers. Overall, MRI-based ML presents a promising avenue for MS prognosis. However, integration of imaging biomarkers with other multimodal patient data shows great potential for advancing personalized healthcare approaches in MS.

Medical digital twins are computational models of human biology relevant to a given medical condition, which are tailored to an individual patient, thereby predicting the course of disease and individualized treatments, an important goal of personalized medicine. The immune system, which has a central role in many diseases, is highly heterogeneous between individuals, and thus poses a major challenge for this technology. In February 2023, an international group of experts convened for two days to discuss these challenges related to immune digital twins. The group consisted of clinicians, immunologists, biologists, and mathematical modelers, representative of the interdisciplinary nature of medical digital twin development. A video recording of the entire event is available. This paper presents a synopsis of the discussions, brief descriptions of ongoing digital twin projects at different stages of progress. It also proposes a 5-year action plan for further developing this technology. The main recommendations are to identify and pursue a small number of promising use cases, to develop stimulation-specific assays of immune function in a clinical setting, and to develop a database of existing computational immune models, as well as advanced modeling technology and infrastructure.

Peptide- and protein-based therapeutics are becoming a promising treatment regimen for myriad diseases. Toxicity of proteins is the primary hurdle for protein-based therapies. Thus, there is an urgent need for accurate in silico methods for determining toxic proteins to filter the pool of potential candidates. At the same time, it is imperative to precisely identify non-toxic proteins to expand the possibilities for protein-based biologics. To address this challenge, we proposed an ensemble framework, called VISH-Pred, comprising models built by fine-tuning ESM2 transformer models on a large, experimentally validated, curated dataset of protein and peptide toxicities. The primary steps in the VISH-Pred framework are to efficiently estimate protein toxicities taking just the protein sequence as input, employing an under sampling technique to handle the humongous class-imbalance in the data and learning representations from fine-tuned ESM2 protein language models which are then fed to machine learning techniques such as Lightgbm and XGBoost. The VISH-Pred framework is able to correctly identify both peptides/proteins with potential toxicity and non-toxic proteins, achieving a Matthews correlation coefficient of 0.737, 0.716 and 0.322 and F1-score of 0.759, 0.696 and 0.713 on three non-redundant blind tests, respectively, outperforming other methods by over on these quality metrics. Moreover, VISH-Pred achieved the best accuracy and area under receiver operating curve scores on these independent test sets, highlighting the robustness and generalization capability of the framework. By making VISH-Pred available as an easy-to-use web server, we expect it to serve as a valuable asset for future endeavors aimed at discerning the toxicity of peptides and enabling efficient protein-based therapeutics.

The field of precision radiation therapy has seen remarkable advancements in both experimental and computational methods. Recent literature has introduced various approaches such as Spatially Fractionated Radiation Therapy (SFRT). This unconventional treatment, demanding high-precision radiotherapy, has shown promising clinical outcomes. A comprehensive computational scheme for SFRT, extrapolated from a case report, is proposed. This framework exhibits exceptional flexibility, accommodating diverse initial conditions (shape, inhomogeneity, etc.) and enabling specific choices for sub-volume selection with administrated higher radiation doses. The approach integrates the standard linear quadratic model and, significantly, considers the activation of the immune system due to radiotherapy. This activation enhances the immune response in comparison to the untreated case. We delve into the distinct roles of the native immune system, immune activation by radiation, and post-radiotherapy immunotherapy, discussing their implications for either complete recovery or disease regrowth.

Antimicrobial resistance prediction is a pivotal ongoing research activity that is currently being explored across various levels. In this context, we present the application of two prediction methods that model the antimicrobial resistance of Neisseria gonorrhoeae on the national level as an outcome of socio-economic processes. The methods use two different implementations of the principal component analysis combined with classification algorithms. Using these two methods, we generated forecasts concerning antimicrobial resistance of Neisseria gonorrhoeae, using publicly available databases encompassing over 200 countries from 1998 to 2021. Both approaches exhibit similar mean absolute averages and correlations when comparing available measurements with predictions. Steps of statistical analysis and applications are discussed, including population-weighted central tendencies, geographical correlations, time trends and error reduction possibilities.

A fundamental challenge for personalized medicine is to capture enough of the complexity of an individual patient to determine an optimal way to keep them healthy or restore their health. This will require personalized computational models of sufficient resolution and with enough mechanistic information to provide actionable information to the clinician. Such personalized models are increasingly referred to as medical digital twins. Digital twin technology for health applications is still in its infancy, and extensive research and development is required. This article focuses on several projects in different stages of development that can lead to specific—and practical–medical digital twins or digital twin modeling platforms. It emerged from a two-day forum on problems related to medical digital twins, particularly those involving an immune system component. Open access video recordings of the forum discussions are available.

Introduction While radiotherapy has long been recognized for its ability to directly ablate cancer cells through necrosis or apoptosis, radiotherapy-induced abscopal effect suggests that its impact extends beyond local tumor destruction thanks to immune response. Cellular proliferation and necrosis have been extensively studied using mathematical models that simulate tumor growth, such as Gompertz law, and the radiation effects, such as the linear-quadratic model. However, the effectiveness of radiotherapy-induced immune responses may vary among patients due to individual differences in radiation sensitivity and other factors.Methods We present a novel macroscopic approach designed to quantitatively analyze the intricate dynamics governing the interactions among the immune system, radiotherapy, and tumor progression. Building upon previous research demonstrating the synergistic effects of radiotherapy and immunotherapy in cancer treatment, we provide a comprehensive mathematical framework for understanding the underlying mechanisms driving these interactions.Results Our method leverages macroscopic observations and mathematical modeling to capture the overarching dynamics of this interplay, offering valuable insights for optimizing cancer treatment strategies. One shows that Gompertz law can describe therapy effects with two effective parameters. This result permits quantitative data analyses, which give useful indications for the disease progression and clinical decisions.Discussion Through validation against diverse data sets from the literature, we demonstrate the reliability and versatility of our approach in predicting the time evolution of the disease and assessing the potential efficacy of radiotherapy-immunotherapy combinations. This further supports the promising potential of the abscopal effect, suggesting that in select cases, depending on tumor size, it may confer full efficacy to radiotherapy.

Leishmania spp. commonly infects phagocytic cells of the immune system, particularly macrophages, employing various immune evasion strategies that enable their survival by altering the intracellular environment. In mammals, these parasites establish persistent infections by modulating gene expression in macrophages, thus interfering with immune signaling and response pathways, ultimately creating a favorable environment for the parasite’s survival and reproduction. In this study, our objective was to use data mining and subsequent filtering techniques to identify the genes that play a crucial role in the infection process of Leishmania spp. We aimed to pinpoint genes that have the potential to influence the progression of Leishmania infection. To achieve this, we exploited prior, curated knowledge from major databases and constructed 16 datasets of human molecular information consisting of coding genes and corresponding proteins. We obtained over 400 proteins, identifying approximately 200 genes. The proteins coded by these genes were subsequently used to build a network of protein–protein interactions, which enabled the identification of key players; we named this set Predicted Genes. Then, we selected approximately 10% of Predicted Genes for biological validation. THP-1 cells, a line of human macrophages, were infected with Leishmania major in vitro for the validation process. We observed that L. major has the capacity to impact crucial genes involved in the immune response, resulting in macrophage inactivation and creating a conducive environment for the survival of Leishmania parasites.

Background: Major Depressive Disorder (MDD) is a psychiatric illness that is often associated with potentially life -threatening physiological changes and increased risk for suicidal behavior. Electroencephalography (EEG) research suggests an association between depression and specific frequency imbalances in the frontal brain re-gion. Further, while recently developed technology has been proposed to simplify EEG data acquisition, more research is still needed to support its use in patients with MDD.Methods: Using the 14-channel EMOTIV EPOC cap, we recorded resting state EEG from 15 MDD patients with suicidal ideation (SI) vs. 12 healthy controls (HC) to investigate putative power spectral density (PSD) between -group differences at the F3 and F4 electrode sites. Specifically, we explored 1) between-group alpha power asymmetries (AA), 2) between-group differences in delta, theta, alpha and beta power, 3) correlations between PSD data and scores in the Beck's Depression Inventory-II (BDI-II), Beck's Anxiety Inventory (BAI), Reasons for Living Inventory (RFL), and Self-Disgust Questionnaire (SDS).Results: When compared to HC, patients had higher scores on the BAI (p = 0.0018), BDI-II (p = 0.0001) or SDS (p = 0.0142) scale and lower scores in the RFL (p = 0.0006) scale. The PSD analysis revealed no between-group difference or correlation with questionnaire scores for any of the measures considered.Conclusions: The present study could not confirm previous research suggesting frequency-specific anomalies in depressed persons with SI but might suggest that frontal EEG imbalances reflect greater anxiety and negative self -referencing. Future studies should confirm these findings in a larger population sample.

No abstract available

This contribution outlines current research aimed at developing models for personalized type 2 diabetes mellitus (T2D) prevention in the framework of the European project PRAESIIDIUM (Physics Informed Machine Learn-ing-Based Prediction and Reversion of Impaired Fasting Glucose Management) aimed at building a digital twin for preventing T2D in patients at risk. Specifically, the modelling approaches include both a multiscale, hybrid computational model of the human metaflammatory (metabolic and inflammatory) status, and data-driven models of the risk of developing T2D able to generate personalized recommendations for mitigating the individ-ual risk. The prediction algorithm will draw on a rich set of information for training, derived from prior clinical data, the individual's family history, and prospective clinical trials including clinical variables, wearable sensors, and a tracking mobile app (for diet, physical activity, and lifestyle). The models developed within the project will be the basis for building a platform for healthcare professionals and patients to estimate and monitor the indi-vidual risk of T2D in real time, thus potentially supporting personalized prevention and patient engagement.

Type 2 diabetes mellitus (T2D), the most common form of diabetes, is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance, and insulin deficiency. Although genetic predisposition determines in part the susceptibility to T2D, an unhealthy diet and a sedentary lifestyle are commonly recognised as essential drivers for the onset of the disease. Indeed, considerable evidence suggests that regular exercise and appropriate nutrition bring undeniable health benefits by reducing the risk of developing T2D or delaying its onset. The literature dealing with mathematical modelling for diabetes is abundant and in the view of a growing more personalized medicine the benefits of having tools to represent different virtual patient populations are clear. In this study, we describe a multi-scale computational model of the human metabolic and inflammatory status that is determined by individual dietary and activity habits. It includes a description of the immune activation and inflammation, a model for the food intake, stomach emptying and gut absorption of all three macronutrients (proteins, carbohydrates, fats), a component to account for the effects of physical activity on the hormones' regulation and the inflammatory state of the individual, and finally, a characterization of energy intake-expenditure balance. All these pieces are merged into a single integrated simulation tool to provide a helpful aid that can be used proactively to prevent the onset of the disease. Moreover, this model turns out to help design virtual cohorts of patients to conduct in silico studies.

Regular physical exercise and appropriate nutrition affect metabolic and hormonal responses and may reduce the risk of developing chronic non-communicable diseases such as high blood pressure, ischemic stroke, coronary heart disease, some types of cancer, and type 2 diabetes mellitus. Computational models describing the metabolic and hormonal changes due to the synergistic action of exercise and meal intake are, to date, scarce and mostly focussed on glucose absorption, ignoring the contribution of the other macronutrients. We here describe a model of nutrient intake, stomach emptying, and absorption of macronutrients in the gastrointestinal tract during and after the ingestion of a mixed meal, including the contribution of proteins and fats. We integrated this effort to our previous work in which we modeled the effects of a bout of physical exercise on metabolic homeostasis. We validated the computational model with reliable data from the literature. The simulations are overall physiologically consistent and helpful in describing the metabolic changes due to everyday life stimuli such as multiple mixed meals and variable periods of physical exercise over prolonged periods of time. This computational model may be used to design virtual cohorts of subjects differing in sex, age, height, weight, and fitness status, for specialized in silico challenge studies aimed at designing exercise and nutrition schemes to support health.