Reframing sepsis immunobiology for translation: towards informative subtyping and targeted immunomodulatory therapies

Sepsis is a common and deadly condition. Within the current model of sepsis immunobiology, the framing of dysregulated host immune responses into proinflammatory and immunosuppressive responses for the testing of novel treatments has not resulted in successful immunomodulatory therapies. Thus, the recent focus has been to parse observable heterogeneity into subtypes of sepsis to enable personalised immunomodulation. In this Personal View, we highlight that many fundamental immunological concepts such as resistance, disease tolerance, resilience, resolution, and repair are not incorporated into the current sepsis immunobiology model. The focus for addressing heterogeneity in sepsis should be broadened beyond subtyping to encompass the identification of deterministic molecular networks or dominant mechanisms. We explicitly reframe the dysregulated host immune responses in sepsis as altered homoeostasis with pathological disruption of immune-driven resistance, disease tolerance, resilience, and resolution mechanisms. Our proposal highlights opportunities to identify novel treatment targets and could enable successful immunomodulation in the future.

Calibration methods to fit parameters within complex biological models

Mathematical and computational models of biological systems are increasingly complex, typically comprised of hybrid multi-scale methods such as ordinary differential equations, partial differential equations, agent-based and rule-based models, etc. These mechanistic models concurrently simulate detail at resolutions of whole host, multi-organ, organ, tissue, cellular, molecular, and genomic dynamics. Lacking analytical and numerical methods, solving complex biological models requires iterative parameter sampling-based approaches to establish appropriate ranges of model parameters that capture corresponding experimental datasets. However, these models typically comprise large numbers of parameters and therefore large degrees of freedom. Thus, fitting these models to multiple experimental datasets over time and space presents significant challenges. In this work we undertake the task of reviewing, testing, and advancing calibration practices across models and dataset types to compare methodologies for model calibration. Evaluating the process of calibrating models includes weighing strengths and applicability of each approach as well as standardizing calibration methods. Our work compares the performance of our model agnostic Calibration Protocol (CaliPro) with approximate Bayesian computing (ABC) to highlight strengths, weaknesses, synergies, and differences among these methods. We also present next-generation updates to CaliPro. We explore several model implementations and suggest a decision tree for selecting calibration approaches to match dataset types and modeling constraints.

Cross-Tissue Transcriptomic Analysis Leveraging Machine Learning Approaches Identifies New Biomarkers for Rheumatoid Arthritis

There is an urgent need to identify biomarkers for diagnosis and disease activity monitoring in rheumatoid arthritis (RA). We leveraged publicly available microarray gene expression data in the NCBI GEO database for whole blood (N=1,885) and synovial (N=284) tissues from RA patients and healthy controls. We developed a robust machine learning feature selection pipeline with validation on five independent datasets culminating in 13 genes: TNFAIP6, S100A8, TNFSF10, DRAM1, LY96, QPCT, KYNU, ENTPD1, CLIC1, ATP6V0E1, HSP90AB1, NCL and CIRBP which define the RA score and demonstrate its clinical utility: the score tracks the disease activity DAS28 (p = 7e-9), distinguishes osteoarthritis (OA) from RA (OR 0.57, p = 8e-10) and polyJIA from healthy controls (OR 1.15, p = 2e-4) and monitors treatment effect in RA (p = 2e-4). Finally, the immunoblotting analysis of six proteins on an independent cohort confirmed two proteins, TNFAIP6/TSG6 and HSP90AB1/HSP90.