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A Comparison of Mathematical and Statistical Modeling with Longitudinal Data: An Application to Ecological Momentary Assessment of Behavior Change in Individuals with Alcohol Use Disorder. Bull Math Biol 2022; 85:5. [PMID: 36495364 DOI: 10.1007/s11538-022-01097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 10/12/2022] [Indexed: 12/13/2022]
Abstract
Ecological momentary assessment (EMA) has been broadly used to collect real-time longitudinal data in behavioral research. Several analytic methods have been applied to EMA data to understand the changes of motivation, behavior, and emotions on a daily or within-day basis. One challenge when utilizing those methods on intensive datasets in the behavioral field is to understand when and why the methods are appropriate to investigate particular research questions. In this manuscript, we compared two widely used methods (generalized estimating equations and generalized linear mixed models) in behavioral research with three other less frequently used methods (Markov models, generalized linear mixed-effects Markov models, and differential equations) in behavioral research but widely used in other fields. The purpose of this manuscript is to illustrate the application of five distinct analytic methods to one dataset of intensive longitudinal data on drinking behavior, highlighting the utility of each method.
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Martínez-Román P, Crespo-Bermejo C, Valle-Millares D, Lara-Aguilar V, Arca-Lafuente S, Martín-Carbonero L, Ryan P, de los Santos I, López-Huertas MR, Palladino C, Muñoz-Muñoz M, Fernández-Rodríguez A, Coiras M, Briz V. Dynamics of HIV Reservoir and HIV-1 Viral Splicing in HCV-Exposed Individuals after Elimination with DAAs or Spontaneous Clearance. J Clin Med 2022; 11:3579. [PMID: 35806864 PMCID: PMC9267476 DOI: 10.3390/jcm11133579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Although human immunodeficiency virus type 1 (HIV-1) reservoir size is very stable under antiretroviral therapy (ART), individuals exposed to the Hepatitis C virus (HCV) (chronically coinfected and spontaneous clarifiers) show an increase in HIV reservoir size and in spliced viral RNA, which could indicate that the viral protein regulator Tat is being more actively synthesized and, thus, could lead to a higher yield of new HIV. However, it is still unknown whether the effect of HCV elimination with direct-acting antivirals (DAAs) could modify the HIV reservoir and splicing. Methods: This longitudinal study (48 weeks’ follow-up after sustained virological response) involves 22 HIV+-monoinfected individuals, 17 HIV+/HCV- spontaneous clarifiers, and 24 HIV+/HCV+ chronically infected subjects who eliminated HCV with DAAs (all of them aviremic, viral load < 50). Viral-spliced RNA transcripts and proviral DNA copies were quantified by qPCR. Paired samples were analyzed using a mixed generalized linear model. Results: A decrease in HIV proviral DNA was observed in HIV+/HCV- subjects, but no significant differences were found for the other study groups. An increased production of multiple spliced transcripts was found in HIV+ and HIV+/HCV+ individuals. Conclusions: We conclude that elimination of HCV by DAAs was unable to revert the consequences derived from chronic HCV infection for the reservoir size and viral splicing, which could indicate an increased risk of rapid HIV-reservoir reactivation. Moreover, spontaneous clarifiers showed a significant decrease in the HIV reservoir, likely due to an enhanced immune response in these individuals.
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Affiliation(s)
- Paula Martínez-Román
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Celia Crespo-Bermejo
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Daniel Valle-Millares
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Violeta Lara-Aguilar
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Sonia Arca-Lafuente
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Luz Martín-Carbonero
- Instituto de Investigación Sanitaria Hospital de la Paz (IdiPAZ), 28046 Madrid, Spain;
| | - Pablo Ryan
- Department of Infectious Diseases, Infanta Leonor Hospital, 28031 Madrid, Spain;
| | - Ignacio de los Santos
- Servicio de Medicina Interna-Infecciosas, Hospital Universitario de La Princesa, 28006 Madrid, Spain;
| | - María Rosa López-Huertas
- Immunopathology Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.R.L.-H.); (M.C.)
| | - Claudia Palladino
- Faculty of Pharmacy, Research Institute for Medicines (iMed.ULisboa), Universidade de Lisboa, 1649-003 Lisbon, Portugal;
| | - María Muñoz-Muñoz
- Department of Animal Genetics, Instituto Nacional de Investigación y Tecnnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain;
| | - Amanda Fernández-Rodríguez
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
| | - Mayte Coiras
- Immunopathology Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.R.L.-H.); (M.C.)
| | - Verónica Briz
- Laboratory of Reference and Research on Viral Hepatitis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Madrid, Spain; (P.M.-R.); (C.C.-B.); (D.V.-M.); (V.L.-A.); (S.A.-L.)
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Cody JW, Ellis-Connell AL, O’Connor SL, Pienaar E. Mathematical modeling of N-803 treatment in SIV-infected non-human primates. PLoS Comput Biol 2021; 17:e1009204. [PMID: 34319980 PMCID: PMC8351941 DOI: 10.1371/journal.pcbi.1009204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 08/09/2021] [Accepted: 06/21/2021] [Indexed: 12/01/2022] Open
Abstract
Immunomodulatory drugs could contribute to a functional cure for Human Immunodeficiency Virus (HIV). Interleukin-15 (IL-15) promotes expansion and activation of CD8+ T cell and natural killer (NK) cell populations. In one study, an IL-15 superagonist, N-803, suppressed Simian Immunodeficiency Virus (SIV) in non-human primates (NHPs) who had received prior SIV vaccination. However, viral suppression attenuated with continued N-803 treatment, partially returning after long treatment interruption. While there is evidence of concurrent drug tolerance, immune regulation, and viral escape, the relative contributions of these mechanisms to the observed viral dynamics have not been quantified. Here, we utilize mathematical models of N-803 treatment in SIV-infected macaques to estimate contributions of these three key mechanisms to treatment outcomes: 1) drug tolerance, 2) immune regulation, and 3) viral escape. We calibrated our model to viral and lymphocyte responses from the above-mentioned NHP study. Our models track CD8+ T cell and NK cell populations with N-803-dependent proliferation and activation, as well as viral dynamics in response to these immune cell populations. We compared mathematical models with different combinations of the three key mechanisms based on Akaike Information Criterion and important qualitative features of the NHP data. Two minimal models were capable of reproducing the observed SIV response to N-803. In both models, immune regulation strongly reduced cytotoxic cell activation to enable viral rebound. Either long-term drug tolerance or viral escape (or some combination thereof) could account for changes to viral dynamics across long breaks in N-803 treatment. Theoretical explorations with the models showed that less-frequent N-803 dosing and concurrent immune regulation blockade (e.g. PD-L1 inhibition) may improve N-803 efficacy. However, N-803 may need to be combined with other immune therapies to countermand viral escape from the CD8+ T cell response. Our mechanistic model will inform such therapy design and guide future studies. Immune therapy may be a critical component in the functional cure for Human Immunodeficiency Virus (HIV). N-803 is an immunotherapeutic drug that activates antigen-specific CD8+ T cells of the immune system. These CD8+ T cells eliminate HIV-infected cells in order to limit the spread of infection in the body. In one study, N-803 reduced plasma viremia in macaques that were infected with Simian Immunodeficiency Virus, an analog of HIV. Here, we used mathematical models to analyze the data from this study to better understand the effects of N-803 therapy on the immune system. Our models indicated that inhibitory signals may be reversing the stimulatory effect of N-803. Results also suggested the possibilities that tolerance to N-803 could build up within the CD8+ T cells themselves and that the treatment may be selecting for virus strains that are not targeted by CD8+ T cells. Our models predict that N-803 therapy may be made more effective if the time between doses is increased or if inhibitory signals are blocked by an additional drug. Also, N-803 may need to be combined with other immune therapies to target virus that would otherwise evade CD8+ T cells.
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Affiliation(s)
- Jonathan W. Cody
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States of America
| | - Amy L. Ellis-Connell
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Shelby L. O’Connor
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Elsje Pienaar
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail:
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McDaniel M, Flores KB, Akpa BS. Predicting Inter-individual Variability During Lipid Resuscitation of Bupivacaine Cardiotoxicity in Rats: A Virtual Population Modeling Study. Drugs R D 2021; 21:305-320. [PMID: 34279844 PMCID: PMC8363697 DOI: 10.1007/s40268-021-00353-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Intravenous lipid emulsions (ILE) have been credited for successful resuscitation in drug intoxication cases where other cardiac life-support methods have failed. However, inter-individual variability can function as a confounder that challenges our ability to define the scope of efficacy for lipid interventions, particularly as relevant data are scarce. To address this challenge, we developed a quantitative systems pharmacology model to predict outcome variability and shed light on causal mechanisms in a virtual population of rats subjected to bupivacaine toxicity and ILE intervention. Materials and Methods We combined a physiologically based pharmacokinetic–pharmacodynamic model with data from a small study in Sprague-Dawley rats to characterize individual-specific cardiac responses to lipid infusion. We used the resulting individual parameter estimates to posit a population distribution of responses to lipid infusion. On that basis, we constructed a large virtual population of rats (N = 10,000) undergoing lipid therapy following bupivacaine cardiotoxicity. Results Using unsupervised clustering to assign resuscitation endpoints, our simulations predicted that treatment with a 30% lipid emulsion increases bupivacaine median lethal dose (LD50) by 46% when compared with a simulated control fluid. Prior experimental findings indicated an LD50 increase of 48%. Causal analysis of the population data suggested that muscle accumulation rather than liver accumulation of bupivacaine drives survival outcomes. Conclusion Our results represent a successful prediction of complex, dynamic physiological outcomes over a virtual population. Despite being informed by very limited data, our mechanistic model predicted a plausible range of treatment outcomes that accurately predicts changes in LD50 when extrapolated to putatively toxic doses of bupivacaine. Furthermore, causal analysis of the predicted survival outcomes indicated a critical synergy between scavenging and direct cardiotonic mechanisms of ILE action. Supplementary Information The online version contains supplementary material available at 10.1007/s40268-021-00353-4.
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Affiliation(s)
- Matthew McDaniel
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
| | - Kevin B Flores
- Department of Mathematics, North Carolina State University, Raleigh, NC, USA
| | - Belinda S Akpa
- Division of Biosciences, Oak Ridge National Laboratory, Oak Ridge, TN, USA. .,Department of Chemical and Biomolecular Engineering, University of Tennessee, Knoxville, TN, USA. .,Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC, USA.
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Alshorman A, Samarasinghe C, Lu W, Rong L. An HIV model with age-structured latently infected cells. JOURNAL OF BIOLOGICAL DYNAMICS 2017; 11:192-215. [PMID: 27338168 DOI: 10.1080/17513758.2016.1198835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
HIV latency remains a major obstacle to viral elimination. The activation rate of latently infected cells may depend on the age of latent infection. In this paper, we develop a model of HIV infection including age-structured latently infected cells. We mathematically analyse the model and use numerical simulations with different activation functions to show that the model can explain the persistence of low-level viremia and the latent reservoir stability in patients on therapy. Sensitivity tests suggest that the model is robust to the changes of most parameters but is sensitive to the relative magnitude of the net generation rate and the long-term activation rate of latently infected cells. To reduce the sensitivity, we extend the model to include homeostatic proliferation of latently infected cells. The new model is robust in reproducing the long-term dynamics of the virus and latently infected cells observed in patients receiving prolonged combination therapy.
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Affiliation(s)
- Areej Alshorman
- a Department of Mathematics and Statistics , Oakland University , Rochester , MI , USA
| | - Chathuri Samarasinghe
- a Department of Mathematics and Statistics , Oakland University , Rochester , MI , USA
| | - Wenlian Lu
- b School of Mathematical Science , Fudan University , Shanghai , People's Republic of China
| | - Libin Rong
- a Department of Mathematics and Statistics , Oakland University , Rochester , MI , USA
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Banks HT, Hu S, Rosenberg E. A Dynamical Modeling Approach for Analysis of Longitudinal Clinical Trials in the Presence of Missing Endpoints. APPLIED MATHEMATICS LETTERS 2017; 63:109-117. [PMID: 28344385 PMCID: PMC5363994 DOI: 10.1016/j.aml.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Randomized longitudinal clinical trials are the gold standard to evaluate the effectiveness of interventions among different patient treatment groups. However, analysis of such clinical trials becomes difficult in the presence of missing data, especially in the case where the study endpoints become difficult to measure because of subject dropout rates or/and the time to discontinue the assigned interventions are different among the patient groups. Here we report on using a validated mathematical model combined with an inverse problem approach to predict the values for the missing endpoints. A small randomized HIV clinical trial where endpoints for most of patients are missing is used to demonstrate this approach.
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Affiliation(s)
- H T Banks
- Center for Research in Scientific Computation, North Carolina State University, Raleigh, NC 27695-8212
| | - Shuhua Hu
- Center for Research in Scientific Computation, North Carolina State University, Raleigh, NC 27695-8212; Certara, Inc., Cary, NC 27518
| | - Eric Rosenberg
- Center for Research in Scientific Computation, North Carolina State University, Raleigh, NC 27695-8212; Departments of Pathology and Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
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