Digital modeling of the chronic tonsillopharyngitis process with low-grade fever associated with herpesvirus infection
Keywords:
digital modeling, digital twin, artificial intelligence, chronic tonsillopharyngitis tonsillitis, subfebrile temperature, herpesvirus infections
Abstract
This study focuses on the application of digital modeling to investigate the process of chronic tonsillopharyngitis (CTP) with low-grade fever, associated with herpesvirus infection (EBV and HHV-6). In the context of active integration of digital technologies into healthcare, particular attention is given to the concept of the digital twin—a virtual model of a patient or pathological process that allows for analysis of disease dynamics, outcome prediction, and selection of the most effective treatment strategies. Based on retrospective patient data, a mathematical model was developed incorporating clinical parameters, laboratory findings, symptom severity, and therapeutic response. Using this model, a digital twin of the pathological process was created, enabling scenario-based simulations of disease progression and evaluation of various treatment approaches. The modeling results revealed the high effectiveness of combination therapy (valacyclovir + aminodihydrophthalazinedione sodium) in reducing symptom severity. Statistically significant correlations were also identified between viral load, temperature response, and clinical manifestations, confirming the diagnostic and prognostic value of digital modeling. Thus, the use of digital twins in CTP demonstrates strong potential for the development of personalized therapeutic strategies and optimization of clinical decision-making.
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References
1. Grieves M. Origins of the Digital Twin Concept. Florida Institute of Technology. 2016. https://doi.org/10.13140/RG.2.2.26367.61609
2. Grieves M., Vickers J. Digital Twin: Mitigating Unpredictable, Undesirable Emergent Behavior in Complex Systems. In: Transdisciplinary Perspectives on Complex Systems. — Springer, 2017.
3. Tao F., Qi Q., Liu A., Kusiak A. Digital Twins and Cyber–Physical Systems toward Smart Manufacturing and Industry 4.0: Correlation and Comparison. Engineering, 2019, 5(4), 653–661.
4. Kritzinger W., Karner M., Traar G., Henjes J., Sihn W. Digital Twin in manufacturing: A categorical literature review and classification. IFAC-PapersOnLine, 2018, 51(11), 1016–1022.
5. Ivanov D., Dolgui A., Sokolov B., Ivanova M., Werner F., Scholl A. A digital supply chain twin for managing the disruption risks and resilience in the era of Industry 4.0. Production Planning & Control, 2022.
6. Зуенкова Ю.А.."ОПЫТ И ПЕРСПЕКТИВЫ ПРИМЕНЕНИЯ ЦИФРОВЫХ ДВОЙНИКОВ В ОБЩЕСТВЕННОМ ЗДРАВООХРАНЕНИИ" Менеджер здравоохранения, no. 6, 2022, pp. 69-77.
7. Glaessgen Ed., Stargel D. NASA – the digital twin paradigm for NASA and U.S. air force vehicles. 53rd Structures, Structural Dynamics, and Materials Conf., 2013. DOI: https://doi.org/10.2514/6.2012-1818
8. Corral-Acero J. et al. The ‘Digital Twin’to enable the vision of precision cardiology //European heart journal. – 2020. – Т. 41. – №. 48. – С. 4556-4564. DOI: 10.1093/eurheartj/ehaa159
9. Wise H. C., Solit D. B. Precision oncology: three small steps forward //Cancer Cell. – 2019. – Т. 35. – №. 6. – С. 825-826. DOI: 10.1016/j.ccell.2019.05.009
10. Куракова Н.Г., Цветкова Л.А., Полякова Ю.В. Цифровые двойники в хирургии: достижения и ограничения. Хирургия. Журнал им. Н.И. Пирогова. 2022;(5):97‑110. DOI: 10.17116/hirurgia202205197
11. Лазарев А.В., Калининская А.А. Цифровое здравоохранение и цифровые двойники как его составляющие (систематический обзор). Проблемы социальной гигиены, здравоохранения и истории медицины. 2024; 32(3): 318–324.
12. Еремин С. А. и др. БАЗИСНАЯ ТЕРАПИЯ ПРИ ВИРУСНЫХ ЗАБОЛЕВАНИЯХ ВЕРХНИХ ДЫХАТЕЛЬНЫХ ПУТЕЙ //Медицинский совет. – 2023. – Т. 17. – №. 7. – С. 188-195.
13. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. The Lancet Infectious Diseases. 2005;5(11):685–94. DOI: 10.1016/S1473-3099(05)70267-X
14. Янов Ю.К., Мальцева Г.С., Дроздова М.В., Захарова Г.П., Гринчук О.Н. Выбор лечебной тактики у больных хроническим тонзиллитом стрептококковой этиологии и длительным субфебрилитетом. Вестник оториноларингологии. 2019;84(1):64‑67. https://doi.org/10.17116/otorino20198401164
15. Роль бактериологического исследования в диагностике хронического тонзиллита / А. И. Крюков, А. С. Товмасян, Н. А. Антонова [и др.] // Вестник оториноларингологии. – 2008. – № 3. – С. 35-38. – EDN IUKRIB.
16. В. Т. Пальчун, Л. А. Лучихин, А. И. Крюков "Воспалительные заболевания глотки". Москва, ГЭОТАР-Медиа; 2007.
17. Dogan B. et al. The correlation between EBV viral load in the palatine tonsils of patients with recurrent tonsillitis and concurrent serum titers of VCA–IgG //European archives of oto-rhino-laryngology. – 2010. – Т. 267. – С. 143-148.
18. Berkhout A., Georghiou P. R., Nourse C. Pharyngotonsillitis in adolescents: Remember herpes simplex virus //Journal of Paediatrics and Child Health. – 2022. – Т. 58. – №. 6. – С. 1081-1082.
19. Huang C. W. et al. Clinical features of gingivostomatitis due to primary infection of herpes simplex virus in children //BMC Infectious Diseases. – 2020. – Т. 20. – С. 1-9.
20. Bennett JM, Glaser R, Malarkey WB, Beversdorf DQ, Peng J, Kiecolt-Glaser JK. Inflammation and reactivation of latent herpesviruses in older adults. Brain Behav Immun. 2012 Jul;26(5):739-46. doi: 10.1016/j.bbi.2011.11.007. Epub 2011 Dec 1. PMID: 22155500; PMCID: PMC3370109.
21. Bertram G, Dreiner N, Krueger GR, Ramon A, Ablashi DV, Salahuddin SZ, Balachandram N. Frequent double infection with Epstein-Barr virus and human herpesvirus-6 in patients with acute infectious mononucleosis. In Vivo. 1991 May-Jun;5(3):271-9. PMID: 1654150.
22. De Bolle L, Naesens L, De Clercq E. Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev. 2005 Jan;18(1):217-45. doi: 10.1128/CMR.18.1.217-245.2005. PMID: 15653828; PMCID: PMC544175.
23. Hu J, Li Y, Li H, Shi F, Xie L, Zhao L et al. Targeting Epstein-Barr virus oncoprotein LMP1-mediated high oxidative stress suppresses EBV lytic reactivation and sensitizes tumors to radiation therapy. Theranostics. 2020 Oct; 10(26): 11921. Erratum in: Theranostics. 2022 Apr; 12(8): 3609. DOI:10.7150/thno.46006
24. Shetty AK, Attaluri S, Kodali M, Shuai B., Shetty GA, Upadhya D. et al. Monosodium luminol reinstates redox homeostasis, improves cognition, mood and neurogenesis, and alleviates neuro-and systemic inflammation in a model of Gulf War Illness. Redox biology. 2020 Jan; 28: 101389.
25. Di Stefano A, Maniscalco M, Balbi B, Ricciardolo FL (2020). Oxidative and nitrosative stress in the pathogenesis of obstructive lung diseases of increasing severity. Current Medicinal Chemistry. 2020 Jan: 27(42): 7149-7158.
26. Попова Инга Александровна. "ГАЛАВИТ®: СОВРЕМЕННЫЙ ВЗГЛЯД НА ТЕРАПИЮ ИНФЕКЦИОННО-ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ" Фармакология & Фармакотерапия, no. 1, 2020, pp. 26-33.
27. Bist A, Savitha A, Gumma KM. Efficacy of valacyclovir and famciclovir in herpes zoster: A comparative study. Indian Journal of Pharmacology. 2020 Nov-Dec; 52(6): 472-5.
28. Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother. 1995 Jul;39(7):1546-53. doi: 10.1128/AAC.39.7.1546
29. Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T. Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology. 2000 Aug;107(8):1507-11. doi: 10.1016/s0161-6420(00)00222-0.
30. Орлов А.А., Орлов А.И. Коэффициенты корреляции: шкала Чеддока и значимость // Контроллинг. 2024. – № 4 (94). – С. 28-37.
2. Grieves M., Vickers J. Digital Twin: Mitigating Unpredictable, Undesirable Emergent Behavior in Complex Systems. In: Transdisciplinary Perspectives on Complex Systems. — Springer, 2017.
3. Tao F., Qi Q., Liu A., Kusiak A. Digital Twins and Cyber–Physical Systems toward Smart Manufacturing and Industry 4.0: Correlation and Comparison. Engineering, 2019, 5(4), 653–661.
4. Kritzinger W., Karner M., Traar G., Henjes J., Sihn W. Digital Twin in manufacturing: A categorical literature review and classification. IFAC-PapersOnLine, 2018, 51(11), 1016–1022.
5. Ivanov D., Dolgui A., Sokolov B., Ivanova M., Werner F., Scholl A. A digital supply chain twin for managing the disruption risks and resilience in the era of Industry 4.0. Production Planning & Control, 2022.
6. Зуенкова Ю.А.."ОПЫТ И ПЕРСПЕКТИВЫ ПРИМЕНЕНИЯ ЦИФРОВЫХ ДВОЙНИКОВ В ОБЩЕСТВЕННОМ ЗДРАВООХРАНЕНИИ" Менеджер здравоохранения, no. 6, 2022, pp. 69-77.
7. Glaessgen Ed., Stargel D. NASA – the digital twin paradigm for NASA and U.S. air force vehicles. 53rd Structures, Structural Dynamics, and Materials Conf., 2013. DOI: https://doi.org/10.2514/6.2012-1818
8. Corral-Acero J. et al. The ‘Digital Twin’to enable the vision of precision cardiology //European heart journal. – 2020. – Т. 41. – №. 48. – С. 4556-4564. DOI: 10.1093/eurheartj/ehaa159
9. Wise H. C., Solit D. B. Precision oncology: three small steps forward //Cancer Cell. – 2019. – Т. 35. – №. 6. – С. 825-826. DOI: 10.1016/j.ccell.2019.05.009
10. Куракова Н.Г., Цветкова Л.А., Полякова Ю.В. Цифровые двойники в хирургии: достижения и ограничения. Хирургия. Журнал им. Н.И. Пирогова. 2022;(5):97‑110. DOI: 10.17116/hirurgia202205197
11. Лазарев А.В., Калининская А.А. Цифровое здравоохранение и цифровые двойники как его составляющие (систематический обзор). Проблемы социальной гигиены, здравоохранения и истории медицины. 2024; 32(3): 318–324.
12. Еремин С. А. и др. БАЗИСНАЯ ТЕРАПИЯ ПРИ ВИРУСНЫХ ЗАБОЛЕВАНИЯХ ВЕРХНИХ ДЫХАТЕЛЬНЫХ ПУТЕЙ //Медицинский совет. – 2023. – Т. 17. – №. 7. – С. 188-195.
13. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. The Lancet Infectious Diseases. 2005;5(11):685–94. DOI: 10.1016/S1473-3099(05)70267-X
14. Янов Ю.К., Мальцева Г.С., Дроздова М.В., Захарова Г.П., Гринчук О.Н. Выбор лечебной тактики у больных хроническим тонзиллитом стрептококковой этиологии и длительным субфебрилитетом. Вестник оториноларингологии. 2019;84(1):64‑67. https://doi.org/10.17116/otorino20198401164
15. Роль бактериологического исследования в диагностике хронического тонзиллита / А. И. Крюков, А. С. Товмасян, Н. А. Антонова [и др.] // Вестник оториноларингологии. – 2008. – № 3. – С. 35-38. – EDN IUKRIB.
16. В. Т. Пальчун, Л. А. Лучихин, А. И. Крюков "Воспалительные заболевания глотки". Москва, ГЭОТАР-Медиа; 2007.
17. Dogan B. et al. The correlation between EBV viral load in the palatine tonsils of patients with recurrent tonsillitis and concurrent serum titers of VCA–IgG //European archives of oto-rhino-laryngology. – 2010. – Т. 267. – С. 143-148.
18. Berkhout A., Georghiou P. R., Nourse C. Pharyngotonsillitis in adolescents: Remember herpes simplex virus //Journal of Paediatrics and Child Health. – 2022. – Т. 58. – №. 6. – С. 1081-1082.
19. Huang C. W. et al. Clinical features of gingivostomatitis due to primary infection of herpes simplex virus in children //BMC Infectious Diseases. – 2020. – Т. 20. – С. 1-9.
20. Bennett JM, Glaser R, Malarkey WB, Beversdorf DQ, Peng J, Kiecolt-Glaser JK. Inflammation and reactivation of latent herpesviruses in older adults. Brain Behav Immun. 2012 Jul;26(5):739-46. doi: 10.1016/j.bbi.2011.11.007. Epub 2011 Dec 1. PMID: 22155500; PMCID: PMC3370109.
21. Bertram G, Dreiner N, Krueger GR, Ramon A, Ablashi DV, Salahuddin SZ, Balachandram N. Frequent double infection with Epstein-Barr virus and human herpesvirus-6 in patients with acute infectious mononucleosis. In Vivo. 1991 May-Jun;5(3):271-9. PMID: 1654150.
22. De Bolle L, Naesens L, De Clercq E. Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev. 2005 Jan;18(1):217-45. doi: 10.1128/CMR.18.1.217-245.2005. PMID: 15653828; PMCID: PMC544175.
23. Hu J, Li Y, Li H, Shi F, Xie L, Zhao L et al. Targeting Epstein-Barr virus oncoprotein LMP1-mediated high oxidative stress suppresses EBV lytic reactivation and sensitizes tumors to radiation therapy. Theranostics. 2020 Oct; 10(26): 11921. Erratum in: Theranostics. 2022 Apr; 12(8): 3609. DOI:10.7150/thno.46006
24. Shetty AK, Attaluri S, Kodali M, Shuai B., Shetty GA, Upadhya D. et al. Monosodium luminol reinstates redox homeostasis, improves cognition, mood and neurogenesis, and alleviates neuro-and systemic inflammation in a model of Gulf War Illness. Redox biology. 2020 Jan; 28: 101389.
25. Di Stefano A, Maniscalco M, Balbi B, Ricciardolo FL (2020). Oxidative and nitrosative stress in the pathogenesis of obstructive lung diseases of increasing severity. Current Medicinal Chemistry. 2020 Jan: 27(42): 7149-7158.
26. Попова Инга Александровна. "ГАЛАВИТ®: СОВРЕМЕННЫЙ ВЗГЛЯД НА ТЕРАПИЮ ИНФЕКЦИОННО-ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ" Фармакология & Фармакотерапия, no. 1, 2020, pp. 26-33.
27. Bist A, Savitha A, Gumma KM. Efficacy of valacyclovir and famciclovir in herpes zoster: A comparative study. Indian Journal of Pharmacology. 2020 Nov-Dec; 52(6): 472-5.
28. Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother. 1995 Jul;39(7):1546-53. doi: 10.1128/AAC.39.7.1546
29. Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T. Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology. 2000 Aug;107(8):1507-11. doi: 10.1016/s0161-6420(00)00222-0.
30. Орлов А.А., Орлов А.И. Коэффициенты корреляции: шкала Чеддока и значимость // Контроллинг. 2024. – № 4 (94). – С. 28-37.
Published
27-10-2025
How to Cite
Popova I. A., Litvitskii P. F., Vukolova M. N., Maltseva L. D., Boiko . A. A., Apollonova I. A., Silaeva A. S. Digital modeling of the chronic tonsillopharyngitis process with low-grade fever associated with herpesvirus infection // Patologicheskaya Fiziologiya i Eksperimental’naya Terapiya (Pathological physiology and experimental therapy). 2025. VOL. 69. № 4. PP. 133–149.
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Original research
