Building digital twins of the human immune system: toward a roadmap

Abstract

Digital twins, customized simulation models pioneered in industry, are beginning to be deployed in medicine and healthcare, with some major successes, for instance in cardiovascular diagnostics and in insulin pump control. Personalized computational models are also assisting in applications ranging from drug development to treatment optimization. More advanced medical digital twins will be essential to making precision medicine a reality. Because the immune system plays an important role in such a wide range of diseases and health conditions, from fighting pathogens to autoimmune disorders, digital twins of the immune system will have an especially high impact. However, their development presents major challenges, stemming from the inherent complexity of the immune system and the difficulty of measuring many aspects of a patient's immune state in vivo. This perspective outlines a roadmap for meeting these challenges and building a prototype of an immune digital twin. It is structured as a four-stage process that proceeds from a specification of a concrete use case to model constructions, personalization, and continued improvement.

Fig. 1. The construction and use of a digital twin.

At each relevant physiological scale, known biology and relevant mechanisms are characterized through data collection that informs one or more computational models. The models at the individual scales are then integrated into a comprehensive multiscale base model. In the second step, this base model is personalized by parameterizing it with data collected from an individual patient. The resulting digital twin can then be used for clinical decision-making for this patient. (The images are public domain images from Servier Medical Art (https://smart.servier.com/smart_image/tendon-anatomy/), https://all-free-download.com/free-vector/flat-screen-computer-monitor.html, and https://pixabay.com/vectors/man-male-boy-human-people-persons-2099114/). All other images were produced by the authors).

Fig. 2. Immune digital twin workflow.

The 11 steps in the four-stage workflow to construct an immune digital twin.