Graves甲亢的个体化治疗模式。

Q1 Mathematics
Balamurugan Pandiyan, Stephen J Merrill, Flavia Di Bari, Alessandro Antonelli, Salvatore Benvenga
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引用次数: 13

摘要

背景:Graves病是一种由血清中循环抗甲状腺受体抗体(TRAb)引起的甲状腺自身免疫性疾病。TRAb模仿促甲状腺激素(TSH)的作用,刺激甲状腺激素受体(TSHR),从而导致甲状腺功能亢进(甲状腺过度活跃)和甲状腺肿。甲巯咪唑(MMI)用于格雷夫斯病患者甲状腺功能亢进的治疗。方法:我们建立了一个用MMI治疗甲亢的常微分方程组模型。模型有四个状态变量,即MMI浓度(mg/L)、游离甲状腺素- FT4浓度(pg/mL)、TRAb浓度(U/mL)和甲状腺功能大小(mL),共13个参数。通过一个治疗参数,我们模拟了患者从甲状腺功能亢进到甲状腺功能亢进(正常状态)的时间过程。我们用四名患者的数据验证了模型的预测。结果:在不进行MMI治疗的情况下,甲状腺功能亢进有独特的渐近稳定状态。在MMI治疗开始后,甲状腺功能亢进状态向亚临床甲状腺功能亢进发展,进而发展为甲状腺功能亢进。结论:该模型可用于描述或检验和预测患者的治疗计划。更具体地说,我们可以将模型拟合到个体患者的数据中,包括负荷和维持剂量,并描述其机制,甲状腺功能亢进→甲状腺功能亢进。该模型可根据FT4水平在生理范围内预测何时停止治疗,从而有助于维持甲状腺功能亢进的输送,避免甲亢复发。该模型基本可以根据FT4水平指导MMI的口服摄入决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A patient-specific treatment model for Graves' hyperthyroidism.

A patient-specific treatment model for Graves' hyperthyroidism.

A patient-specific treatment model for Graves' hyperthyroidism.

A patient-specific treatment model for Graves' hyperthyroidism.

Background: Graves' is disease an autoimmune disorder of the thyroid gland caused by circulating anti-thyroid receptor antibodies (TRAb) in the serum. TRAb mimics the action of thyroid stimulating hormone (TSH) and stimulates the thyroid hormone receptor (TSHR), which results in hyperthyroidism (overactive thyroid gland) and goiter. Methimazole (MMI) is used for hyperthyroidism treatment for patients with Graves' disease.

Methods: We have developed a model using a system of ordinary differential equations for hyperthyroidism treatment with MMI. The model has four state variables, namely concentration of MMI (in mg/L), concentration of free thyroxine - FT4 (in pg/mL), and concentration of TRAb (in U/mL) and the functional size of the thyroid gland (in mL) with thirteen parameters. With a treatment parameter, we simulate the time-course of patients' progression from hyperthyroidism to euthyroidism (normal condition). We validated the model predictions with data from four patients.

Results: When there is no MMI treatment, there is a unique asymptotically stable hyperthyroid state. After the initiation of MMI treatment, the hyperthyroid state moves towards subclinical hyperthyroidism and then euthyroidism.

Conclusion: We can use the model to describe or test and predict patient treatment schedules. More specifically, we can fit the model to individual patients' data including loading and maintenance doses and describe the mechanism, hyperthyroidism→euthyroidism. The model can be used to predict when to discontinue the treatment based on FT4 levels within the physiological range, which in turn help maintain the remittance of euthyroidism and avoid relapses of hyperthyroidism. Basically, the model can guide with decision-making on oral intake of MMI based on FT4 levels.

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来源期刊
Theoretical Biology and Medical Modelling
Theoretical Biology and Medical Modelling MATHEMATICAL & COMPUTATIONAL BIOLOGY-
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Theoretical Biology and Medical Modelling is an open access peer-reviewed journal adopting a broad definition of "biology" and focusing on theoretical ideas and models associated with developments in biology and medicine. Mathematicians, biologists and clinicians of various specialisms, philosophers and historians of science are all contributing to the emergence of novel concepts in an age of systems biology, bioinformatics and computer modelling. This is the field in which Theoretical Biology and Medical Modelling operates. We welcome submissions that are technically sound and offering either improved understanding in biology and medicine or progress in theory or method.
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