Clinicians need to predict patient outcomes with high accuracy as early as possible after disease inception. In this manuscript, we show that patient-to-patient variability sets a fundamental limit on outcome prediction accuracy for a general class of mathematical models for the immune response to infection. However, accuracy can be increased at the expense of delayed prognosis. We investigate several systems of ordinary differential equations (ODEs) that model the host immune response to a pathogen load. Advantages of systems of ODEs for investigating the immune response to infection include the ability to collect data on large numbers of `virtual patients', each with a given set of model parameters, and obtain many time points during the course of the infection. We implement patient-to-patient variability $v$ in the ODE models by randomly selecting the model parameters from Gaussian distributions with variance $v$ that are centered on physiological values. We use logistic regression with one-versus-all classification to predict the discrete steady-state outcomes of the system. We find that the prediction algorithm achieves near $100\%$ accuracy for $v=0$, and the accuracy decreases with increasing $v$ for all ODE models studied. The fact that multiple steady-state outcomes can be obtained for a given initial condition, i.e. the basins of attraction overlap in the space of initial conditions, limits the prediction accuracy for $v>0$. Increasing the elapsed time of the variables used to train and test the classifier, increases the prediction accuracy, while adding explicit external noise to the ODE models decreases the prediction accuracy. Our results quantify the competition between early prognosis and high prediction accuracy that is frequently encountered by clinicians.
Hepatitis B virus is a global health threat, and its elimination by 2030 has been prioritised by the World Health Organisation. Here we present an age-structured model for the immune response to an HBV infection, which takes into account contributions from both cell-mediated and humoral immunity. The model has been validated using published patient data recorded during acute infection. It has been adapted to the scenarios of chronic infection, clearance of infection, and flare-ups via variation of the immune response parameters. The impacts of immune response exhaustion and non-infectious subv…
A major contribution to the onset and development of autoimmune disease is known to come from infections. An important practical problem is identifying the precise mechanism by which the breakdown of immune tolerance as a result of immune response to infection leads to autoimmunity. In this paper, we develop a mathematical model of immune response to a viral infection, which includes T cells with different activation thresholds, regulatory T cells (Tregs), and~a cytokine mediating immune dynamics. Particular emphasis is made on the role of time delays associated with the processes of infection…
In this paper, we investigate global dynamics for a system of delay differential equations which describes a virus-immune interaction in \textit{vivo}. The model has two distributed time delays describing time needed for infection of cell and virus replication. Our model admits three possible equilibria, an uninfected equilibrium and infected equilibrium with or without immune response depending on the basic reproduction number for viral infection $R_{0}$ and for CTL response $R_{1}$ such that $R_{1}<R_{0}$. It is shown that there always exists one equilibrium which is globally asymptotically …
When highly active antiretroviral therapy is administered for long periods of time to HIV-1 infected patients, most patients achieve viral loads that are ``undetectable'' by standard assay (i.e., HIV-1 RNA $ < 50$ copies/ml). Yet despite exhibiting sustained viral loads below the level of detection, a number of these patients experience unexplained episodes of transient viremia or viral "blips". We propose here that transient activation of the immune system by opportunistic infection may explain these episodes of viremia. Indeed, immune activation by opportunistic infection may spur HIV replic…
Multiscale modeling of host-pathogen interactions and mucociliary clearance during non-tuberculous mycobacterial pulmonary infection
University of Oxford（牛津大学）；Purdue University（普渡大学）；Indiana University School of Medicine（印第安纳大学医学院）；Morgan State University（摩根州立大学）；Stellenbosch Institute for Advanced Study (STIAS)（斯特伦博斯高等研究院）；The Pennsylvania State University（宾夕法尼亚州立大学）
It has been known for some time that human autoimmune diseases can be triggered by viral infections. Several possible mechanisms of interactions between a virus and immune system have been analysed, with a prevailing opinion being that the onset of autoimmunity can in many cases be attributed to "molecular mimicry", where linear peptide epitopes, processed from viral proteins, mimic normal host self proteins, thus leading to a cross-reaction of immune response against virus with host cells. In this paper we present a mathematical model for the dynamics of an immune response to a viral infectio…
The search to understand how the HIV virus spreads inside the human body and how the immune response works to control it has motivated studies related to Mathematical Immunology. Actually, researches include the idea of mathematical models representing the dynamics of healthy and infected cell populations and focusing on mechanisms used by HIV to invade target-host cells, viral dissemination (which leads to depletion of the T-cell pool and collapse of the immune system), and impairment of immune response. In this work, we show the importance of specific cells of immune response, as infection v…
In the studies of plant infections, the plant immune response is known to play an essential role. In this paper we derive and analyse a new mathematical model of plant immune response with particular account for post-transcriptional gene silencing (PTGS). Besides biologically accurate representation of the PTGS dynamics, the model explicitly includes two time delays to represent the maturation time of the growing plant tissue and the non-instantaneous nature of the PTGS. Through analytical and numerical analysis of stability of the steady states of the model we identify parameter regions assoc…
In the last decades, the interest to understand the connection between brain and body has grown notably. For example, in psychoneuroimmunology many studies associate stress, arising from many different sources and situations, to changes in the immune system from the medical or immunological point of view as well as from the biochemical one. In this paper we identify important behaviours of this interplay between the immune system and stress from medical studies and seek to represent them qualitatively in a paradigmatic, yet simple, mathematical model. To that end we develop a differential equa…
Biological processes at the cellular level are stochastic in nature, and the immune response system is no different. Therefore, models that attempt to explain this system need to also incorporate noise or fluctuations that can account for the observed variability. In this work, a stochastic model of the immune response system is presented in terms of the dynamics of the T cells and the virus particles. Making use of the Green's function and the Wilemski-Fixman approximation, this model is then solved to obtain the analytical expression for the joint probability density function of these variab…
High-throughput sequencing of B- and T-cell receptors makes it possible to track immune repertoires across time, in different tissues, and in acute and chronic diseases or in healthy individuals. However, quantitative comparison between repertoires is confounded by variability in the read count of each receptor clonotype due to sampling, library preparation, and expression noise. Here, we present a general Bayesian approach to disentangle repertoire variations from these stochastic effects. Using replicate experiments, we first show how to learn the natural variability of read counts by inferr…
Systems that evolve over time and follow mathematical laws as they do so, are called dynamical systems. Lymphocyte recovery and clinical outcomes in 41 allograft recipients conditioned using anti-thymocyte globulin (ATG) and 4.5 Gray total-body-irradiation were studied to determine if immune reconstitution could be described as a dynamical system. Survival, relapse, and graft vs. host disease (GVHD) were not significantly different in two cohorts of patients receiving different doses of ATG. However, donor-derived CD3+ (ddCD3) cell reconstitution was superior in the lower ATG dose cohort, and …
We consider a simple deterministic model which describes an asymmetric competition between an immune system with a specific and powerful response, and a virus with a broad toxicity and fast mutations. Interest in this model relies on the fact that in spite of it simplicity, it reproduces some of the features of the asymptomatic phase of the infection by HIV-1. In particular, there is a domain of parameters in which the dynamics is characterized by the apparition of \blips", associated here to an instability which develops at high virus reproduction rate. Various possible extensions of this sim…
The coronavirus pandemic (COVID) has been an exceptional test of current scientific evidence that inform and shape policy. Many US states, cities, and counties implemented public orders for mask use on the notion that this intervention would delay and flatten the epidemic peak and largely benefit public health outcomes. P-value plotting was used to evaluate statistical reproducibility of meta-analysis research claims of a benefit for medical (surgical) mask use in community settings to prevent COVID infection. Eight studies (seven meta-analyses, one systematic review) published between 1 Janua…
This paper investigates the dynamics of immune response and autoimmunity with particular emphasis on the role of regulatory T cells (Tregs), T cells with different activation thresholds, and cytokines in mediating T cell activity. Analysis of the steady states yields parameter regions corresponding to regimes of normal clearance of viral infection, chronic infection, or autoimmune behaviour, and the boundaries of stability and bifurcations of relevant steady states are found in terms of system parameters. Numerical simulations are performed to illustrate different dynamical scenarios, and to i…
The adaptive immune system provides a diverse set of molecules that can mount specific responses against a multitude of pathogens. Memory is a key feature of adaptive immunity, which allows organisms to respond more readily upon re-infections. However, differentiation of memory cells is still one of the least understood cell fate decisions. Here, we introduce a mathematical framework to characterize optimal strategies to store memory to maximize the utility of immune response over an organism's lifetime. We show that memory production should be actively regulated to balance between affinity an…
High-throughput sequencing can detect tens of thousands of genes in parallel, providing opportunities for improving the diagnostic accuracy of multiple diseases including sepsis, which is an aggressive inflammatory response to infection that can cause organ failure and death. Early screening of sepsis is essential in clinic, but no effective diagnostic biomarkers are available yet. Here, we present a novel method, Recurrent Logistic Regression, to identify diagnostic biomarkers for sepsis from the blood transcriptome data. A panel including five immune-related genes, LRRN3, IL2RB, FCER1A, TLR5…
The transmission rate of many acute infectious diseases varies significantly in time, but the underlying mechanisms are usually uncertain. They may include seasonal changes in the environment, contact rate, immune system response, etc. The transmission rate has been thought difficult to measure directly. We present a new algorithm to compute the time-dependent transmission rate directly from prevalence data, which makes no assumptions about the number of susceptibles or vital rates. The algorithm follows our complete and explicit solution of a mathematical inverse problem for SIR-type transmis…
Within the human respiratory tract (HRT), viruses diffuse through the periciliary fluid (PCF) bathing the epithelium, and travel upwards via advection towards the nose and mouth, as the mucus escalator entrains the PCF. While many mathematical models (MMs) to date have described the course of influenza A virus (IAV) infections in vivo, none have considered the impact of both diffusion and advection on the kinetics and localization of the infection. The MM herein represents the HRT as a one-dimensional track extending from the nose down to a depth of 30 cm, wherein stationary cells interact wit…
Within-host models of COVID-19 infection dynamics enable the merits of different forms of antiviral therapy to be assessed in individual patients. A stochastic agent-based model of COVID-19 intracellular dynamics is introduced here, that incorporates essential steps of the viral life cycle targeted by treatment options. Integration of model predictions with an intercellular ODE model of within-host infection dynamics, fitted to patient data, generates a generic profile of disease progression in patients that have recovered in the absence of treatment. This is contrasted with the profiles obtai…
An interesting inference drawn by some Covid-19 epidemiological models is that there exists a proportion of the population who are not susceptible to infection -- even at the start of the current pandemic. This paper introduces a model of the immune response to a virus. This is based upon the same sort of mean-field dynamics as used in epidemiology. However, in place of the location, clinical status, and other attributes of people in an epidemiological model, we consider the state of a virus, B and T-lymphocytes, and the antibodies they generate. Our aim is to formalise some key hypotheses as …
Serology testing can identify past infection by quantifying the immune response of an infected individual providing important public health guidance. Individual immune responses are time-dependent, which is reflected in antibody measurements. Moreover, the probability of obtaining a particular measurement changes due to prevalence as the disease progresses. Taking into account these personal and population-level effects, we develop a mathematical model that suggests a natural adaptive scheme for estimating prevalence as a function of time. We then combine the estimated prevalence with optimal …
