title: Modelling and optimal control of immune response of renal transplant recipients.
abstract: We consider the increasingly important and highly complex immunological control problem: control of the dynamics of immunosuppression for organ transplant recipients. The goal in this problem is to maintain the delicate balance between over-suppression (where opportunistic latent viruses threaten the patient) and under-suppression (where rejection of the transplanted organ is probable). First, a mathematical model is formulated to describe the immune response to both viral infection and introduction of a donor kidney in a renal transplant recipient. Some numerical results are given to qualitatively validate and demonstrate that this initial model exhibits appropriate characteristics of primary infection and reactivation for immunosuppressed transplant recipients. In addition, we develop a computational framework for designing adaptive optimal treatment regimes with partial observations and low-frequency sampling, where the state estimates are obtained by solving a second deterministic optimal tracking problem. Numerical results are given to illustrate the feasibility of this method in obtaining optimal treatment regimes with a balance between under-suppression and over-suppression of the immune system.
authors.affiliation: Center for Research in Scientific Computation, Center for Quantitative Sciences in Biomedicine, North Carolina State University, Raleigh, NC 27695-8212, USA. htbanks@ncsu.edu
authors.forename: H T
authors.initials: HT
authors.lastname: Banks
authors.forename: Shuhua
authors.initials: S
authors.lastname: Hu
authors.forename: Taesoo
authors.initials: T
authors.lastname: Jang
authors.forename: Hee-Dae
authors.initials: HD
authors.lastname: Kwon
mesh_terms: D003198:Computer Simulation; D006801:Humans; D007109:Immunity / Q000187:drug effects / Q000276:immunology*; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007239:Infections / Q000382:microbiology / Q000821:virology; D016030:Kidney Transplantation / Q000276:immunology*; D018448:Models, Immunological; D014181:Transplantation Immunology / Q000187:drug effects; D014775:Virus Activation / Q000187:drug effects
chemical_list: D007166:Immunosuppressive Agents