Theoretical models can help to overcome experimental limitations to better our understanding of lung physiology and disease. While such efforts often begin in broad terms by determining the effect of a disease process on a relevant biological output, more narrowly defined simulations may inform clinical practice. Two such examples are phenotype-specific and patient-specific models, the former being specific to a group of patients with common characteristics, and the latter to an individual patient, in view of likely differences (heterogeneity) between patients. However, in order for such models to be useful, they must be sufficiently accurate, given the available data about the specific characteristics of the patient. We show that, for asthma in particular, this approach is promising: phenotype-specific targeting may be an effective way of selecting patients for treatment based on their airway remodelling phenotype, and patient-specific targeting may be viable with the use of a clinically-plausible dataset. Specifically we consider asthma and its treatment by bronchial thermoplasty, in which the airway smooth muscle layer is directly targeted by thermal energy. Patient-specific and phenotype-specific models in this context are considered using a combination of biobank data from ex vivo tissue samples, CT imaging, and optical coherence tomography which allows more detailed resolution of the airway wall structures.

理论模型可以帮助克服实验的局限性，以更好地了解肺部生理和疾病。尽管通常通过确定疾病过程对相关生物输出的影响来广泛地开展此类工作，但定义更为狭窄的模拟可能会为临床实践提供参考。考虑到患者之间可能的差异（异质性），两个这样的例子是表型特异性和患者特异性模型，前者特定于一组具有共同特征的患者，后者特定于个体患者。但是，为了使此类模型有用，给定有关患者特定特征的可用数据，它们必须足够准确。我们表明，特别是对于哮喘，这种方法很有希望：表型特异性靶向可能是基于患者气道重塑表型选择治疗方案的有效方法，而患者特异性靶向可能通过使用临床上合理的数据集是可行的。具体而言，我们考虑哮喘及其通过支气管热成形术的治疗，其中气道平滑肌层直接被热能作为目标。在这种情况下，应结合使用来自离体组织样本的生物库数据，CT成像和光学相干断层扫描技术，结合患者特异性和表型特异性模型，以更详细地解析气道壁结构。具体而言，我们考虑哮喘及其通过支气管热成形术的治疗，其中气道平滑肌层直接被热能作为目标。在此情况下，使用来自离体组织样本的生物库数据，CT成像和光学相干断层扫描相结合，可以考虑患者特异性和表型特异性模型，从而可以更详细地分辨气道壁结构。具体来说，我们考虑哮喘及其通过支气管热成形术的治疗，其中气道平滑肌层直接被热能作为目标。在此情况下，使用来自离体组织样本的生物库数据，CT成像和光学相干断层扫描相结合，可以考虑患者特异性和表型特异性模型，从而可以更详细地分辨气道壁结构。