Recent advances in 3D models of the nervous system for neural regeneration research and drug development.

The development of drugs for nervous diseases poses distinctive difficulties owing to the incomplete understanding of the physiology and complex pathogenesis of the multifaceted central (CNS) and peripheral (PNS) nervous systems. Conventional animal tests and in vitro two-dimensional (2D) cell cultures fail to reproduce the sophisticated structure of natural human tissues, hindering the new drug discovery process. The emerging three-dimensional (3D) neural tissue models, including organoids, organ-on-chip and 3D-printed neural scaffolds, can provide an improved reproduction of the critical features, structural complexity, biological functions, dynamic circulation micro-environment and cell-matrix/cell interactions of the nervous systems. This review examines state-of-the-art 3D models for neural physiology/pathology, emphasizing their drug development applications. Fundamental advantages of various in vitro 3D neural models for investigating the mechanisms of nerve regeneration and disorders in both the CNS and PNS are compared in terms of the different modeling techniques. In addition, the applications of 3D neural models in drug development are summarized covering a range of areas such as disease modeling for basic research, pharmacokinetic and pharmacodynamic testing for drug screening and drug safety evaluation. Furthermore, current challenges and future outlook of biomimetic models and the existing bottlenecks hindering their successful translation into clinical use are discussed. STATEMENT OF SIGNIFICANCE: This review highlights the groundbreaking potential of 3D neural models-organoids, organ-on-chip, and 3D-printed scaffolds-to revolutionize neurological research and drug development. Unlike conventional methods, these models replicate the intricate structure and function of the human nervous system, enabling precise study of diseases like Alzheimer's, spinal injuries, and brain tumors. By summarizing and discussing recent advancements, the review compares techniques, their applications in drug screening and personalized medicine, and addresses challenges in model accuracy and scalability. Bridging neuroscience, engineering, and pharmacology, this work provides a roadmap for researchers to innovate therapies. The insights presented are critical for accelerating drug discovery and improving treatment outcomes, making 3D neural models essential for scientists and clinicians tackling neurological disorders.