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Imagine that one day, experiencing a symptom or condition, a person reaches the hospital and can undergo analyses, imaging tests or other relevant procedures and enter this information into a computer. With this data, a type of embodiment will be created that integrates all the characteristics and allows different technologies or interventions to be applied on a trial basis, eliminating the invasive nature of testing them on the human body, and Thus one is able to make the most selection. Profitable option.
This exercise in imagining the future is, in a way, part of the present, at least in the context of research. they say virtual twins And its potential is currently being investigated in various pathologies. In particular, the Val d’Hebron Institute of Research (VHIR), led by Raoul Heurens, participates in it. Artemis Initiative (Accelerating the translation of virtual twins toward personalized management of fatty liver patients). The project began last January and aims to, through these virtual twins, Study fatty liver and its cardiovascular complications,
A total of 22 European and non-European institutions participate in this consortium; These include eight hospitals and 14 other organizations that aim to come together to advance the management of fatty liver disease associated with metabolic dysfunction (MAFLD). The project is funded by Horizon Europe and will run for four years.
“we are Efforts are being made to obtain mathematical models that enable us to simulate the condition of a person’s liver and see in a certain way how fatty liver disease is affecting the heart.n”, explains Raúl Herrens, who is in charge of coordinating the project within VHIR and is also the medical coordinator of the initiative.
towards the medicine of the future
Among the main complications or risks of fatty liver disease at the cardiovascular level, Herens lists “insulin resistance in the heart, calcification in the coronary arteries, decreased myocardial function, or thickening in the myocardial wall that would be related to microcalcifications.” This is an increase in epicardial fat, because having a fatty liver also makes the heart more fatty.
With all this information available as a starting point, the expert indicates that the objective is “a very futuristic vision of medicine, in which a doctor, through various tests carried out on a patient, tries to get you these results. can enter into your computer and generate a virtual liver that allows you to know its pathological condition. “At the same time, it will be possible to see how the disease can affect other organs, in this case the heart, And See how certain interventions, whether surgical or medical, may affect or benefit you”, specifies Herens. Following this formula, he further stated that “it will enter personalized or precision medicine, creating a type of embodiment that will allow thousands of manipulations to be tested and find the one that best suits the patient.”
research phase
“The first thing it’s going to do is,” Herrens said. Identify different phenotypes of MAFLD Because not all patients are the same: some develop into fibrotic processes much faster than others or even others progress to hepatocellular carcinoma, some persist… and we want to make a screening In this aspect. Thus, experts say they would have a sample of between 9,000 and 12,000 people. Along these topics, “information will be obtained from histology, imaging tests, clinical data, biochemistry or ultrasound and we will try to create a score Identifying the different phenotypes as accurately as possible.” “With this we will have already achieved great progress, because today the different stages of the development of fatty liver disease are known, but not all the phenotypes, nor Other aspects that may be relevant such as the differences presented by the pathology between men and women”, he evolves.
Within the framework of this project they will study four areas: MAFLD phenotypes and their progression For fibrotic stages in fatty liver and hepatocellular carcinoma; How does the phenotype affect the presence of cardiovascular problems? And what kind; Effect of transjugular intrahepatic portosystemic shunt (suggestionsfor its short form in English) on fatty liver and its cardiovascular effects and finally, Toxicities and consequences that may occur of immunotherapy in hepatocellular carcinoma at the cardiovascular level, Regarding this last point, Herrans contributes that “although VHIRs have not been documented very much, in France it has been observed that they can occur in about 20 percent of cases, so their study is relevant.”
coordination between teams
To complete this project, coordination is required both inside and outside the hospital. For this reason, Herens explains that he has tried to integrate as many departments as possible into ARTEMIS. Here, it highlights the work of other departments including Liver Disease, Biochemistry, Surgery and Endocrinology. Likewise, the work of technologists is fundamental in this work, as Heerens explains, “They are dedicated to modeling and managing computer processes.”
“We’ve tried to stay a century ahead,” says Herens. And, as he points out, “In people with fatty liver, there’s usually a single treatment or intervention offered and not all patients do well. We do; Apart from efficiency, because risks may arise.”
This research opens the door to a futuristic approach to the management of fatty liver disease. And the possibilities that virtual twins may offer in research and, if their usefulness is demonstrated, in clinical practice cannot be understated. During the Artemis launch meeting, several presentations were given about its potential and, as Herens explains, “This technology allows us to see how cells interact with each other and with everything around them. How to communicate.” It seemed like science fiction; But let’s hop on this science fiction bandwagon, because this is the future,
