Towards generative digital twins in biomedical research

Crosstalk of glutamine metabolism between cancer-associated fibroblasts and cancer cells

Glutamine (Gln), a critical metabolic substrate, fuels the uncontrolled proliferation of cancer cells. Cancer-associated fibroblasts (CAFs), essential components of the tumor microenvironment, facilitate tumor progression by supplying Gln to cancer cells and driving drug resistance through metabolic reprogramming. This review highlights the key processes of Gln uptake, transport, and catabolism and explores the metabolic crosstalk between CAFs and cancer cells. It also examines the roles of major oncogenic regulators-c-Myc, mTORC, KRAS, p53, and HIF-in controlling Gln metabolism and shaping therapeutic resistance. Current pharmacological approaches targeting Gln metabolism, including enzyme inhibitors and transporter blockers, are discussed alongside emerging therapeutic strategies and ongoing clinical trials. Lastly, we underscore the importance of integrating advanced technologies like artificial intelligence and spatial omics to refine treatment targeting and develop more effective, personalized therapeutic interventions.

Taking the 3Rs to a higher level: replacement and reduction of animal testing in life sciences in space research

Human settlements on the Moon, crewed missions to Mars and space tourism will become a reality in the next few decades. Human presence in space, especially for extended periods of time, will therefore steeply increase. However, despite more than 60 years of spaceflight, the mechanisms underlying the effects of the space environment on human physiology are still not fully understood. Animals, ranging in complexity from flies to monkeys, have played a pioneering role in understanding the (patho)physiological outcome of critical environmental factors in space, in particular altered gravity and cosmic radiation. The use of animals in biomedical research is increasingly being criticized because of ethical reasons and limited human relevance. Driven by the 3Rs concept, calling for replacement, reduction and refinement of animal experimentation, major efforts have been focused in the past decades on the development of alternative methods that fully bypass animal testing or so-called new approach methodologies. These new approach methodologies range from simple monolayer cultures of individual primary or stem cells all up to bioprinted 3D organoids and microfluidic chips that recapitulate the complex cellular architecture of organs. Other approaches applied in life sciences in space research contribute to the reduction of animal experimentation. These include methods to mimic space conditions on Earth, such as microgravity and radiation simulators, as well as tools to support the processing, analysis or application of testing results obtained in life sciences in space research, including systems biology, live-cell, high-content and real-time analysis, high-throughput analysis, artificial intelligence and digital twins. The present paper provides an in-depth overview of such methods to replace or reduce animal testing in life sciences in space research.

Exploring the Potential of Digital Twins in Cancer Treatment: A Narrative Review of Reviews

Background: Digital twin (DT) technology, integrated with artificial intelligence (AI) and machine learning (ML), holds significant potential to transform oncology care. By creating dynamic virtual replicas of patients, DTs allow clinicians to simulate disease progression and treatment responses, offering a personalized approach to cancer treatment. Aim: This narrative review aimed to synthesize existing review studies on the application of digital twins in oncology, focusing on their potential benefits, challenges, and ethical considerations. Methods: The narrative review of reviews (NRR) followed a structured selection process using a standardized checklist. Searches were conducted in PubMed and Scopus with a predefined query on digital twins in oncology. Reviews were prioritized based on their synthesis of prior studies, with a focus on digital twins in oncology. Studies were evaluated using quality parameters (clear rationale, research design, methodology, results, conclusions, and conflict disclosure). Only studies with scores above a prefixed threshold and disclosed conflicts of interest were included in the final synthesis; seventeen studies were selected. Results and Discussion: DTs in oncology offer advantages such as enhanced decision-making, optimized treatment regimens, and improved clinical trial design. Moreover, economic forecasts suggest that the integration of digital twins into healthcare systems may significantly reduce treatment costs and drive growth in the precision medicine market. However, challenges include data integration issues, the complexity of biological modeling, and the need for robust computational resources. A comparison to cutting-edge research studies contributes to this direction and confirms also that ethical and legal considerations, particularly concerning AI, data privacy, and accountability, remain significant barriers. Conclusions: The integration of digital twins in oncology holds great promise, but requires careful attention to ethical, legal, and operational challenges. Multidisciplinary efforts, supported by evolving regulatory frameworks like those in the EU, are essential for ensuring responsible and effective implementation to improve patient outcomes.

How to promote healthy aging across the life cycle

The global rise in aging populations is challenging healthcare systems, especially in developed countries. Despite advancements in healthcare and living standards, the extension of lifespan has not been matched by an equivalent improvement in healthspan, leading to a higher prevalence of chronic diseases and disabilities in older adults. This review examines strategies to promote healthy aging throughout the life cycle, emphasizing the importance of a comprehensive strategy that integrates individual, healthcare, and environmental approaches. Individual strategies include lifestyle factors like diet, physical activity, and social connections. Healthcare approaches focus on improving health literacy, vaccinations, and screenings. Environmental approaches aim to mitigate climate change, reduce pollution, and design longevity-ready cities. A comprehensive strategy combining individual approaches, public health measures, innovative policies, and community support is essential for helping populations live longer, healthier, and more independent lives. Looking forward, this will be complemented by personalized approaches, focusing on individual traits and biological backgrounds. The key to this lies in geroscience, which studies the biological and molecular mechanisms of aging and how they contribute to age-related diseases and functional decline, aiming to design targeted interventions to slow aging and improve quality of life. Artificial intelligence will play a key role in analyzing these complex factors and creating innovative solutions. In conclusion, aging is shaped by various factors, requiring more than one solution. A combination of comprehensive and personalized strategies can bridge the gap between public health measures and personalized care, offering the scientific insights needed to slow aging and enhance quality of life.