Department of Sense Organs, Medicine and Dentistry Faculty, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Ophthalmology Unit, Head and Neck Department, Policlinico Umberto I University Hospital, 00161 Rome, Italy.
Int J Mol Sci. 2024 Oct 15;25(20):11074. doi: 10.3390/ijms252011074.
Proliferative vitreoretinopathy (PVR) is a pathological process characterized by the formation of fibrotic membranes that contract and lead to recurrent retinal detachment. Pars plana vitrectomy (PPV) is the primary treatment, but recurrence rates remain high, as surgery does not address the underlying molecular mechanisms driving fibrosis. Despite several proposed pharmacological interventions, no approved therapies exist, partly due to challenges in conducting preclinical and in vivo studies for ethical and safety reasons. This review explores the potential of computational models and Digital Twins, which are increasingly gaining attention in medicine. These tools could enable the development of progressively complex PVR models, from basic simulations to patient-specific Digital Twins. Nintedanib, a tyrosine kinase inhibitor targeting PDGFR, VEGFR, and FGFR, is presented as a prototype for computational models to simulate its effects on fibrotic pathways in virtual patient cohorts. Although still in its early stages, the integration of computational models and Digital Twins offers promising avenues for improving PVR management through more personalized therapeutic strategies.
增生性玻璃体视网膜病变 (PVR) 是一种以纤维膜形成为特征的病理过程，这些纤维膜会收缩并导致视网膜再次脱离。 扁平部玻璃体切除术 (PPV) 是主要的治疗方法，但复发率仍然很高，因为手术并不能解决导致纤维化的潜在分子机制。 尽管提出了几种药理学干预措施，但由于出于伦理和安全原因，进行临床前和体内研究存在挑战，因此尚无批准的治疗方法。 本综述探讨了计算模型和数字孪生的潜力，这些工具在医学领域越来越受到关注。 这些工具可以帮助开发从基本模拟到针对特定患者的数字孪生的越来越复杂的 PVR 模型。 尼达尼布是一种针对 PDGFR、VEGFR 和 FGFR 的酪氨酸激酶抑制剂，被提出作为计算模型的原型，以模拟其在虚拟患者队列中对纤维化途径的影响。 尽管仍处于早期阶段，但计算模型和数字孪生的整合为通过更个性化的治疗策略改善 PVR 管理提供了有前途的途径。
