Medical avatars: mapping our health

 

Building computer versions of our bodies and using them to diagnose symptoms, anticipate future illnesses and predict side effects of treatment is at the heart of a new international project , writes ALISON JONES

IMAGINE ANOTHER you living in a computer. It has your eyes and your body shape. It walks like you, compensating for that injury. It sits like you with that posture your mother told you about. It is allergic to that type of antibiotics. It should probably drink less. Meet your medical avatar.

This is the vision of truly personalised medicine, which is at the heart of the Virtual Physiological Human (VPH) initiative. Spanning a decade and drawing on roughly €350 million from the European Commission, the VPH project is no mean feat.

At the moment the finer details of our medical histories are stored in many different places. When we move to a different city or a different country, fine fragments of this information are lost on the way.

The knowledge about how our bodies behave is also divided up. The function of the liver is dealt with in a different medical speciality to the performance of the lungs or diseases of the hip joint.

Your personal Virtual Physiological Human – your computer-based avatar – would contain both your medical data and the technical knowledge about how your bodily systems work. It could be used to diagnose current symptoms, anticipate future illnesses and predict side-effects of treatment.

A condition such as auto immune disease cuts across several organs and systems in the body. Making the links between symptoms in these separate areas may take months. Within a personalised avatar they would all be linked together from the start, speeding up diagnosis as a result.

Drugs could be given to the virtual you before being prescribed in reality, to test your response. Allergic reactions and effects on your organs could be predicted. Importantly, doctors could tell whether a drug would do its job.

Building even one of these virtual humans is a massive challenge. The interactions within the body go from the molecular level, to the tissue, to the organs, and back the other way, explains Viceconti of the Rizzoli Orthopaedic Institute, Bologna, Italy. The idea is to integrate all knowledge of how the human body works at every scale.

It is tempting to think that this kind of thing exists only in science-fiction films. But plans were officially written down in 2006, when 600 scientists, clinicians and policy makers, joined together to produce a “road map” for the VPH work.

They wanted to create a “framework of methods and technology that when established will make possible the investigation of the human body as a whole”, says Viceconti, one of the founders of the VPH initiative, who is currently a key researcher within it.

The road map also includes discussion on the need for extensive computer technology and to ensure privacy of patient data.

THERE ARE NOW roughly 20 active VPH research projects supported by the European Commission funding, with half as many again in the planning stage. Other related research has been funded by the member states, including the UK and Germany.

Research groups, companies and hospitals all over the world are now involved in the initiative. “Building the Virtual Physiological Human is a world-class challenge,” says Viceconti. “The project is driven by Europe but it is a worldwide initiative.”

The projects focus on a variety of diseases including cancer and Alzheimers. They all share the aim of using computer technology to integrate everything we know on those subjects. Some of these projects have progressed as far as clinical trials.

The VPH is not “just a dream for a bunch of geeks”, Viceconti explains. Steps are being taken towards the virtual human, “in practice, in reality and in hospitals”.

The first in a series of international VPH conferences starts on the September 30th in Brussels, Belgium. This will be a meeting of up to 200 people, presenting the highlights of the work so far. Future meetings are expected to be much larger.

One of the current projects tackles the problem of bone fractures in osteoporotic patients. These fractures cost the European health system more than €30 billion per year.

Integration of information is also at work in this project. Risk factors will be taken into account from the activity of bone-building cells to the fitness of the patient themselves. The multi-scale models generated will improve the prediction and treatment of these fractures.

It is “re-inventing the clinical pathway for osteoporosis” a disease particularly important for women, and “reducing the chance of spontaneous fracture”, says Viceconti.


Alison Jones is a British Science Association media fellow on placement with The Irish Times.