The virtual esophagus: investigating esophageal functions in silico

Abstract

Esophageal and gastroesophageal junction (GEJ) diseases are highly prevalent worldwide and are a significant socioeconomic burden. Recently, applications of multiscale mathematical models of the upper gastrointestinal tract have gained attention. These in silico investigations can contribute to the development of a virtual esophagus modeling framework as part of the larger GIome and Physiome initiatives. There are also other modeling investigations that have potential screening and treatment applications. These models incorporate detailed anatomical models of the esophagus and GEJ, tissue biomechanical properties and bolus transport, sensory properties, and, potentially, bioelectrical models of the neural and myogenic pathways of esophageal and GEJ functions. A next step is to improve the integration between the different components of the virtual esophagus, encoding standards, and simulation environments to perform more realistic simulations of normal and pathophysiological functions. Ultimately, the models will be validated and will provide predictive evaluations of the effects of novel endoscopic, surgical, and pharmaceutical treatment options and will facilitate the clinical translation of these treatments.

Impedance in the evaluation of the esophagus

“…Some work has been done in the GI tract on anatomical and mechanical models. 44,45,[47][48][49]132 However, owing to the complex neural modulation of esophagus function, we still lack models of the sensory-motor system, electrophysiology, and electrical conductance properties of the esophagus. Preliminary work has been done by Brock and coworkers on electrical field distribution induced by electrical stimulation, 46 but this work seems not to have been followed up.…”

Reconstruction of the human lower esophageal sphincter based on ultra-mill imaging for biomechanical analysis

“…In addition to measurement methods, advances in computation and visualization techniques have been critical to the effective processing and interpretation of various measurements. Finite element method (FEM) based mathematical models of the LES have been developed based on realistic human anatomy to simulate intraluminal pressure development and/or fluid dynamics ( Yassi et al, 2009 ; Du et al, 2016 ; Acharya et al, 2021 ). Nicosia and Brasseur proposed a model based on distinctive passive and active components of circular muscle tension within the upper esophageal sphincter during bolus transport ( Nicosia and Brasseur, 2002 ).…”

The esophagiome: integrated anatomical, mechanical, and physiological analysis of the esophago‐gastric segment

“…It is a multicenter, integrated program to design, develop, implement, test, document, archive, and disseminate quantitative data and integrative models of the functional behavior of the human body . Development of multiscale mathematical models capable of predictive investigations of biological function is receiving attention in a number of disciplines in the Physiome Project …”

“…2 Development of multiscale mathematical models capable of predictive investigations of biological function is receiving attention in a number of disciplines in the Physiome Project. 2,3 The physiome concept has for decades been recognized in cardiology and orthopedics but only recently gained attention for the gastrointestinal (GI) tract. An effort related to the GI tract was first described in 2006 as the GIOME 4 and work has been presented in a series of papers from different groups related to the virtual stomach and intestines.…”