Arnold Frank, Kleger Alexander
Abteilung für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Pathologe. 2021 Dec;42(Suppl 2):149-154. doi: 10.1007/s00292-021-00996-9. Epub 2021 Oct 8.
Over the last few decades, various models have been established within gastroenterological research that have significantly contributed to a better understanding of the (patho)physiological processes of various gastrointestinal (GI) diseases (inflammation, organ injuries, carcinomas). This review will focus on such models including genetically engineered mouse models (GEMMs), xenografts, and organoid-based culture systems. GEMMs laid the foundation for successful modeling of such diseases. These have the decisive advantage that diseases can be assessed in their physiological environment and thus allow the examination of cell-cell communications of various cell types (epithelium, fibroblast, immune cells). However, the discrepancy between the genetic background of mice and humans reflected a pivotal disadvantage that could at least partially be circumvented by transplanting human cells into immunocompromised host animals. The time-consuming and labor-intensive generation of such xenograft models, however, considerably limits their usefulness for timely preclinical drug screenings. Thus, novel organoid-based human cell culture systems from adult stem cells or pluripotent stem cells are a promising human tool for modeling GI diseases. The first results already show their usefulness in the regulation of adult tissue homeostasis, regeneration, and tumor development. In addition, this system can be easily established in clinical diagnostics and thus enables real-time ex vivo pharmacotyping to develop personalized therapy strategies, particularly for cancer patients.
在过去几十年中,胃肠病学研究建立了各种模型,这些模型对更好地理解各种胃肠道(GI)疾病(炎症、器官损伤、癌症)的(病理)生理过程做出了重大贡献。本综述将聚焦于此类模型,包括基因工程小鼠模型(GEMMs)、异种移植和基于类器官的培养系统。GEMMs为成功建立此类疾病模型奠定了基础。它们具有决定性优势,即可以在生理环境中评估疾病,从而能够研究各种细胞类型(上皮细胞、成纤维细胞、免疫细胞)之间的细胞间通讯。然而,小鼠和人类基因背景的差异反映了一个关键劣势,通过将人类细胞移植到免疫缺陷宿主动物中至少可以部分规避这一劣势。然而,此类异种移植模型的生成耗时且费力,这极大地限制了它们在及时进行临床前药物筛选方面的实用性。因此,源自成体干细胞或多能干细胞的新型基于类器官的人类细胞培养系统是一种有前景的用于模拟胃肠道疾病的人类工具。初步结果已经显示出它们在调节成体组织稳态、再生和肿瘤发展方面的有用性。此外,该系统可以在临床诊断中轻松建立,从而能够进行实时体外药物分型以制定个性化治疗策略,特别是对于癌症患者。