Abstract Background Organoid technology has emerged as a pivotal tool in IBD research, offering unparalleled insights into disease mechanisms, mechanisms-of-action, and host-microbiota interactions. Advances in these models enable the establishment of co-cultures in dynamic and IBD-specific intestinal environments. Methods Intestinal crypts from biopsies of IBD patients were isolated, adult stem cells expanded into 3D organoids and differentiated to reflect epithelial subtypes. To enable easy basolateral and apical access, organoid-derived epithelial cells were cultured in Transwells. For enhanced physiological relevance, organoids were integrated into gut-on-a-chip platforms featuring microfluidic flow and peristalsis, and prolonged co-cultures with stimuli and cell types of interest. Advanced imaging techniques, including high-resolution microscopy, were used to evaluate epithelial dynamics, barrier integrity, and inflammatory responses. These models were utilized to test therapeutic compounds and assess personalized responses based on patient-specific profiles (Figure 1). Results Organoid-based models replicated key features of IBD pathology, including inflammation-induced epithelial dysfunction and barrier loss. Imaging provided critical insights into cell-cell interactions and mucus expression under inflammatory conditions and therapeutic interventions. Barrier integrity was rigorously assessed using transepithelial electrical resistance in Transwells, confirming functional disruptions associated with inflammation or ER-stress. Transcriptomic analyses revealed patient- and disease-specific responses to cytokines, microbial metabolites, and environmental stressors, demonstrating the relevance for personalized therapeutic strategies. Early gut-on-a-chip experiments validated the integration of intact (Papp) organoid-derived epithelial monolayers with stromal components and dynamic flow. Conclusion The convergence of organoid technology and gut-on-a-chip systems heralds a new era in IBD translational research. These platforms provide complementary strengths, enabling researchers to tailor models to specific investigative needs. Gut-on-a-chip models integrate organoid-derived epithelial layers with stromal, vascular, and/or immune components under dynamic flow conditions, offering unparalleled insight into the spatial and functional complexities of the gut environment. Together, these systems support personalized exploration of disease pathways and (preclinical) therapeutic efficacy, bridging the gap between in vitro modeling and clinical application. This convergence establishes a versatile foundation for precision medicine, addressing individual variability and driving transformative advances in patient care.
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