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Organoids: what are they and how do they help regenerative medicine?

Research on stem cells and developmental biology has made it possible to grow small, 3D tissue structures called organoids in the laboratory. Scientists have created organoids that closely resemble many different organs. These include the liver, kidneys, and brain. What do researchers learn from growing organoids? How do they help regenerative medicine? 

What are organoids?

Organoids are groups of cells grown in laboratories that have organised themselves into structures that resemble different organs. The name “organoid” actually means, “organ-like”. In many cases, the cells and cell structures give organoids abilities that are similar to the organ they resemble. For example, brain organoids develop layers of actively signalling nerve cells (neurons) and even distinct ‘brain regions’ that are similar to the distinct regions of the human brain. 

Researchers are currently able to grow organoids which closely resemble some aspects of organs. Still, they are certainly not the same as a fully mature organ. Intestine organoids have many cell structures that resemble parts of the intestinal lining. However these organoids are typically the size of a pea - nowhere as large or as complex as our intestinal tract. Though they may be small, and only have some similarities to full organs, researchers are learning a great deal from organoids. Many researchers believe organoids are the ‘next generation’ of biological tools for research, drug discovery and medicine.

How are organoids made?

Cerebral organoids in a petri dish

Cerebral organoids in a petri dish (Image copyright: Sandra Schartel, Institute of Molecular Biotechnology)

Stem cells are the starting point for growing organoids. Researchers use different types of stem cells depending upon what type of organoid they are trying to make.  

Many different types of stem cells have been used to grow organoids. Pluripotent stem cells, -  both embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) -  and multipotent cells – tissue stem cells, or adult somatic stem cells (ASCs) - have produced successful organoids.. Different stem cells have different abilities, limitations and requirements for growing.

To grow organoids, researchers provide stem cells with specific growing conditions. This which may require precise nutrients, growth factors, signalling molecules and physical environments (such as protein material to grow on). Often procedures for growing organoids require adding components in a particular order and at specific times. The growing conditions allow the stem cells to multiply and change (‘differentiate’) into the many types of cells present in the real organ.  

The cells within organoids organise themselves into tissue-like structures. For example, kidney organoids have cells that behave like typical kidney cells and are organised to form ‘tubules’ just like those found in kidneys.   

The hardest part of making an organoid is figuring out the precise conditions that stimulate and promote the stem cells. This is not a simple task. It often takes years of research to accomplish. Once the correct conditions are provided, the stem cells multiply, differentiate, make cell-based structures and ultimately form the organoids all on their own. 

What do organoids tell researchers?

Fluorescent microscope image showing a cross section of a cerebral organoid

A cross-section of a cerebral organoid (Image copyright: Madeline Lancaster)

Researchers are creating and using organoids for several reasons. 

The first step in organoid development is to create an organoid which is as similar as possible to a real organoid, in terms of cell composition and function. This s process allows researchers to learn what external factors direct different stem cells to make specific organs during growth and development. This can be used to learn about ‘normal’ developmental processes. However, this is just the beginning.  

Once researchers have demonstrated that an organoid closely resembles a particular organ, they can use that organoid to study many other aspects of organ development. These include disease, cell signalling and more. In addition to external signals stem cells receive, researchers are studying the many internal signals, proteins and genes critical for the cells to create a whole organ. These factors are important when trying to understand how a mutation in a gene might lead to a genetic (inherited) disorder.  

As anexample, a study of intestinal organoids created from six individuals with an intestine disorder (multiple intestinal atresia) has lead to the discovery of a gene important for intestine formation. The study showed that all six patients carried mutations in a single gene. As a result, their intestinal stem cells were unable to produce ‘healthy’ organoids in the lab. Researchers were able to determine what signalling pathway the mutated protein affects in stem cells.  

Organoids are also allowing researchers to study infectious diseases in ways that were previously not possible. Brain organoids have been used to study how the ZIKA virus affects brain development and causes microcephaly This is not possible to study with human brain tissue, for obvious ethical reasons. In other cases, organoids are offering opportunities to study infections by viruses, bacteria and parasites. Just one example of this is the study on the life cycle of the parasite cryptosporidium, which causes the diarrheal disease commonly called “Crypto”. Organoids are proving to be very helpful in discovering many different aspects of human development and disease. 

The future of organoids in research and medicine

Organoids and regenerative medicine

There currently are organoids that resemble over a dozen different organs of the body. However, it must be remembered that the ability to create organoids is relatively new. Researchers are still developing methods to create organoids for numerous other tissues and organs. This effort will take time. 

In parallel to this research scientists are constantly trying to make established organoids more representative of real organ tissue. The more accurately organoids represent real organ tissues, the more accurate researchers’ data becomes. 

Organoids are thought to be the first step towards growing tissue and organs for transplant. If lab-grown tissues are to be used for medicine, proving that they closely match (or better yet, exactly match) real organs is essential. 

As of 2023, clinical trials are ongoing involving transplantation of gut organoids for treatment of colitis and of salivary gland organoids for dry mouth disease. Researchers are currently examining the safety and reliability of transplanting organoid-generated tissue in animals. It will be many years before growing functioning organs as research tools, much less for transplant, becomes a possibility. 

Scientists point out that one of the major benefits of lab-grown tissue is that genetic tools can be used to alter cells and remove genetic mutations that caused a patient’s disease in the first place. Obviously, there are ethical issues about altering the genetic code, but it could provide individuals with long-lasting medical solutions.  

Organoids and cancer research

Cancer research is another area where organoids are being used. Many types of cancer have cells that act like stem cells. Researchers are using these cells to grow cancer organoids. Researchers collect from different cancer patients to grow organoids that develop tumours in the lab, such as prostate cancer. 

Being able to grow mini-tumours that model various cancers allows researchers to study tumour growth in detail. Researchers hope to learn about the genes, proteins and signalling pathways cancer cells use and find new way to stop cancers from growing or metastasising (spreading throughout the body). 

In a slightly different approach, researchers are also studying what gene mutations cause healthy organoids to get tumours. This helps to identify what genes and signalling pathways are important for cancers to grow. It can also suggest what genes are important for protecting organs from cancer and what might be malfunctioning in cancer patients. 

Organoids as a screening tool

One last area that researchers are using organoids is to speed up research in general. Most organoids are small, which allows researchers to easily grow many of them at a time. At the same time, modern screening technologies allows researchers to test and compare hundreds of samples at the same time. Since organoids can model healthy and diseased organs as well as cancers, these high-throughput studies could become a very powerful tool for researchers to rapidly test new drugs, medical treatments and more. 

There are likely many other ways that organoids will impact research and medicine, some of which remain to be discovered.

Find out more

The Ethics of Brain Organoids - interview with bio-ethicist Sarah Chan 

Sanger Institute - Organoids: Cancer in 3D – a YouTube video on cancer organoids 

ISSCR – Organoids: What is the Science and What are the Clinical Applications? – a YouTube video of a lecture on brain organoids 

TEDx Talk – How We Are Growing Organs in the Lab? – a YouTube video by Dr Jim Wells 

ASCB – What’s it all about? Organoids – an article on organoids by the American Society for Cell Biology 

HSC – Organoids: A new window into disease, development and discovery – an article on organoids by Harvard Stem Cell Institute 

Use and application of 3D-organoid technology – A short review of scientific literature that discusses organoids and their use in research and medicine 

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