Dynamic Physiological Culture of Ex Vivo Human Tissue: A Systematic Review

SIMPLE SUMMARY: Within cancer research, a strong emphasis is placed on the development of models that accurately reproduce the conditions in which tumours develop and grow. A limitation of several models is that they fail to replicate the tumour’s blood supply. Our aim was to evaluate the concurrent literature regarding dynamic physiological culture techniques that have been used to successfully culture human tissue. We conducted a systematic review of the literature and identified 22 articles that described the use of different dynamic culture techniques in order to create a system that was physiologically representative. The most common method described was the use of perfusion culture. This article serves as a detailed reference of novel technologies that can be implemented within cancer research in order to improve the physiological conditions of current culture techniques. Realistic cancer models will translate into a greater understanding of the disease which will directly impact on patient outcomes. ABSTRACT: Conventional static culture fails to replicate the physiological conditions that exist in vivo. Recent advances in biomedical engineering have resulted in the creation of novel dynamic culturing systems that permit the recapitulation of normal physiological processes ex vivo. Whilst the physiological benefit for its use in the culture of two-dimensional cellular monolayer has been validated, its role in the context of primary human tissue culture has yet to be determined. This systematic review identified 22 articles that combined dynamic physiological culture techniques with primary human tissue culture. The most frequent method described (55%) utilised dynamic perfusion culture. A diverse range of primary human tissue was successfully cultured. The median duration of successful ex vivo culture of primary human tissue for all articles was eight days; however, a wide range was noted (5 h–60 days). Six articles (27%) reported successful culture of primary human tissue for greater than 20 days. This review illustrates the physiological benefit of combining dynamic culture with primary human tissue culture in both long-term culture success rates and preservation of native functionality of the tissue ex vivo. Further research efforts should focus on developing precise biochemical sensors that would allow for real-time monitoring and automated self-regulation of the culture system in order to maintain homeostasis. Combining these techniques allows the creation of an accurate system that can be used to gain a greater understanding of human physiology.