Will Organs on Chips Revolutionize Drug Trials?

Bret S. Stetka, MD

Disclosures

October 12, 2016

Getting Personal

Organs-on-chips could also help clinicians realize an eagerly anticipated healthcare Holy Grail: personalized medicine, or catering therapies to a person's unique genetic and biological profile.

By fabricating chips for patient subgroups using stem cells from specific individuals, Ingber feels that personalized drug therapies can be developed far more effectively.

"Pharma companies often run these huge clinical trials that are unsuccessful," he says. "But then they'll crunch the numbers and realize that a genetic subgroup of people did respond. They will then go back and redesign a trial just for that subgroup."

Dr Clive Svendsen, director of the Cedars-Sinai Regenerative Medicine Institute in Los Angeles, has partnered with Emulate and Ingber's group, among others, to help customize organs-on-chips. Rather than using generic cell line models, Svendsen—whose group is working on chip-based models of the blood/brain barrier, amyotrophic lateral sclerosis, and the gut (complete with its own microbiome)—is using induced pluripotent stem cell technology to reprogram cells from individual patients into specific organ tissues that are then implanted into chips.

Svendsen's blood/brain barrier model, for example, involves seeding neurons and astrocytes on one side of a chip membrane and endothelial cells on the other. Blood infused with candidate medications can be channeled through vessel to see which compounds can cross the notoriously impermeable barricade.

"How drugs cross, or don't cross, the blood/brain barrier is specific to the patient. It depends in part on which transporters they have," explains Svendsen.

"We envision this could be very useful in deciding on, for example, a chemotherapy for a tumor or an antidepressant for certain neurologic and psychiatric disorders. Maybe certain drugs get past the barrier in one patient but not another," he says.

Medscape editor-in-chief Eric Topol, MD, also sees chip technology as a means toward personalizing healthcare.

"In the continuing movement to digitize the medical essence of human beings, the organ-on-a-chip progress is striking," he comments. "It's a terrific way to push individualized medicine forward."

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