Researchers can now create miniature versions of your organs to tailor the best treatment

"Organoids are the tool we have been missing until now," says Associate Professor and PhD Thomas Lykke-Møller Sørensen, peering down his microscope. Under the lens, countless cells have clustered together into what looks most like a large balloon with a hollow centre. The cells are attempting to mimic a real intestine and develop into what is known as an organoid.

"Instead of growing flat, as they do in traditional cell cultures, organoids are grown in a gel, allowing them to form a three-dimensional structure. This creates something that resembles the folds of an intestine," explains Thomas Lykke-Møller Sørensen, who heads the newly established Section for Molecular & Cellular Biotechnology at Aarhus University.

Researchers there are currently developing a model that could form the foundation of personalised medicine in the Danish healthcare system, helping to ensure that each patient receives treatment tailored to their individual needs. This has been a declared political objective for many years, and Denmark is among the world's leading countries when it comes to data and infrastructure for personalised medicine. The challenge is that the country still lags behind in making it a routine part of treatment for ordinary patients. Organoids - essentially miniature three-dimensional organs - may help address this gap.

"Although we can read a person's DNA, we do not always know how their genes affect the body in practice. By growing organoids from a patient's own cells, however, we can test medicines and gain a more accurate understanding of how that particular patient is likely to respond," says Thomas Lykke-Møller Sørensen, emphasising that while this represents a major technological breakthrough, further development is still required.

The first trial gut organoids

The next stage of development is currently being undertaken through a close collaboration between the newly established Section for Molecular & Cellular Biotechnology and the Department of Hepatology and Gastroenterology at Aarhus University Hospital. The first eight trial participants have now been recruited. All are living with ulcerative colitis, a chronic inflammatory disease of the colon and rectum in which the intestinal lining becomes irritated and develops ulcers. The condition most commonly affects younger people and often persists throughout life.

At present, only around 20-30 per cent of patients respond to the first treatment they receive. As a result, doctors are often forced to try different therapies one after another until they find one that works. This process can take considerable time and may lead to serious side effects, explains physician and assistant professor Sidsel Støy, who is involved in collecting tissue samples from the intestines of the eight participants.

The patients' stem cells are then isolated and grown into miniature intestines. Once the organoids are ready, researchers can test medications and tailor treatment to the individual patient from the outset.

"Organoids have the potential to make an enormous difference for the approximately 70,000 people in Denmark living with chronic inflammatory bowel diseases. However, before the technology can be introduced as a routine treatment in hospitals, we need to conduct large-scale clinical trials involving many more participants," she says.

Better decision-making in healthcare

As part of their research project, Sidsel Støy and Thomas Lykke-Møller Sørensen are also investigating liver cirrhosis, a chronic and potentially fatal condition commonly known as scarring of the liver. The disease cannot be cured because the scar tissue in the liver is permanent. Treatment therefore focuses on slowing disease progression, managing complications and, in some cases, considering liver transplantation.

The liver and the intestine are biologically closely connected, and liver cirrhosis has a significant impact on intestinal function. By growing intestinal organoids from patients' duodenal tissue in the laboratory, the researchers hope to understand how interactions between the liver and the intestine contribute to the progression of the disease-and to identify far more personalised treatment approaches.

"This is not a miracle cure," says Thomas Lykke-Møller Sørensen, before continuing:

"But organoids can help ensure that patients experience less overtreatment, fewer side effects, and that better decisions are made across the healthcare system. They can provide us with functional insight into how each individual patient responds."

He expects organoid research to become a major focus area in the coming years within Aarhus University's new Section for Molecular & Cellular Biotechnology.