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<journal-id journal-id-type="publisher-id">Front. Cell Dev. Biol.</journal-id>
<journal-title>Frontiers in Cell and Developmental Biology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell Dev. Biol.</abbrev-journal-title>
<issn pub-type="epub">2296-634X</issn>
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<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-id pub-id-type="publisher-id">1268540</article-id>
<article-id pub-id-type="doi">10.3389/fcell.2023.1268540</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cell and Developmental Biology</subject>
<subj-group>
<subject>Mini Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Organoids as complex (bio)systems</article-title>
<alt-title alt-title-type="left-running-head">Fernandes</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fcell.2023.1268540">10.3389/fcell.2023.1268540</ext-link>
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<contrib contrib-type="author" corresp="yes">
<name>
<surname>Fernandes</surname>
<given-names>Tiago G.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/684253/overview"/>
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<role content-type="https://credit.niso.org/contributor-roles/Writing - review &#x26; editing/"/>
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<aff id="aff1">
<sup>1</sup>
<institution>Department of Bioengineering and iBB&#x2014;Institute for Bioengineering and Biosciences</institution>, <institution>Instituto Superior T&#xe9;cnico</institution>, <institution>Universidade de Lisboa</institution>, <addr-line>Lisbon</addr-line>, <country>Portugal</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Associate Laboratory i4HB&#x2014;Institute for Health and Bioeconomy</institution>, <institution>Instituto Superior T&#xe9;cnico</institution>, <institution>Universidade de Lisboa</institution>, <addr-line>Lisbon</addr-line>, <country>Portugal</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1778887/overview">Laralynne Przybyla</ext-link>, University of California, San Francisco, United States</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/2355064/overview">Yuyao Tian</ext-link>, The Chinese University of Hong Kong, China</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Tiago G. Fernandes, <email>tfernandes@tecnico.ulisboa.pt</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>25</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>11</volume>
<elocation-id>1268540</elocation-id>
<history>
<date date-type="received">
<day>28</day>
<month>07</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>14</day>
<month>08</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Fernandes.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Fernandes</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Organoids are three-dimensional structures derived from stem cells that mimic the organization and function of specific organs, making them valuable tools for studying complex systems in biology. This paper explores the application of complex systems theory to understand and characterize organoids as exemplars of intricate biological systems. By identifying and analyzing common design principles observed across diverse natural, technological, and social complex systems, we can gain insights into the underlying mechanisms governing organoid behavior and function. This review outlines general design principles found in complex systems and demonstrates how these principles manifest within organoids. By acknowledging organoids as representations of complex systems, we can illuminate our understanding of their normal physiological behavior and gain valuable insights into the alterations that can lead to disease. Therefore, incorporating complex systems theory into the study of organoids may foster novel perspectives in biology and pave the way for new avenues of research and therapeutic interventions to improve human health and wellbeing.</p>
</abstract>
<kwd-group>
<kwd>complex systems</kwd>
<kwd>organoids</kwd>
<kwd>stem cells</kwd>
<kwd>systems biology</kwd>
<kwd>disease modeling</kwd>
</kwd-group>
<contract-num rid="cn001">UIDB/04565/2020 UIDP/04565/2020 LA/P/0140/2020</contract-num>
<contract-sponsor id="cn001">Funda&#xe7;&#xe3;o para a Ci&#xea;ncia e a Tecnologia<named-content content-type="fundref-id">10.13039/501100001871</named-content>
</contract-sponsor>
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<meta-name>section-at-acceptance</meta-name>
<meta-value>Stem Cell Research</meta-value>
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</front>
<body>
<sec id="s1">
<title>1 An overview of complex systems theory</title>
<p>Complex systems can be found in the natural world and in many different man-made inventions, including finance, economics, and social organizations (<xref ref-type="bibr" rid="B79">Waldrop, 1993</xref>). The study of such systems is interdisciplinary and focuses on the examination of non-intuitive, adaptive, and dynamic properties. The roots of complex systems theory can be traced back to various scientific fields, including mathematics, physics, biology, ecology, economics, and social sciences. One of the earliest pioneers of complex systems theory was the mathematician Norbert Wiener, who developed the field of cybernetics in the 1940s and 1950s, seeking to understand the feedback mechanisms that govern the behavior of systems (<xref ref-type="bibr" rid="B83">Wiener, 1948</xref>; <xref ref-type="bibr" rid="B59">Shannon et al., 1950</xref>). Another influential figure was the physicist Murray Gell-Mann, who proposed the concept of &#x201c;complex adaptive systems&#x201d; in the 1960s to describe systems that exhibit emergent behavior (<xref ref-type="bibr" rid="B27">Holland, 1992</xref>; <xref ref-type="bibr" rid="B17">Gell-Mann, 1995</xref>). In the 1970s, the Santa Fe Institute was established as a center for the study of complex systems, and many of the key figures in the field today, including Stuart Kauffman, John Holland, and Brian Arthur, were associated with the institute. Kauffman, in particular, made significant contributions to the field with his work on complex systems in biology (<xref ref-type="bibr" rid="B19">Glass and Kauffman, 1972</xref>; <xref ref-type="bibr" rid="B30">Kauffman, 1984</xref>). The 1980s and 1990s saw the development of new mathematical and computational tools for the study of complex systems, including chaos theory, fractals, and cellular automata (<xref ref-type="bibr" rid="B43">Mandelbrot and Aizenman, 1979</xref>; <xref ref-type="bibr" rid="B52">Pippard, 1982</xref>; <xref ref-type="bibr" rid="B85">Wolfram, 1984</xref>; <xref ref-type="bibr" rid="B35">Langton, 1986</xref>). These tools allowed researchers to simulate and model complex systems and study the emergence of patterns and behaviors (<xref ref-type="bibr" rid="B2">Axelrod and Hamilton, 1981</xref>; <xref ref-type="bibr" rid="B16">Forrest, 1990</xref>).</p>
<p>Today, complex systems theory continues to be a thriving field of research with applications in a wide range of disciplines. Some of the key challenges facing the field include developing new mathematical and computational models that can capture the complexity of real-world systems and understanding the relationship between individual behavior and system-level outcomes (<xref ref-type="bibr" rid="B63">Siegenfeld and Bar-Yam, 2020</xref>). Almost 70&#xa0;years of research have culminated in the Nobel Prize in Physics, 2021, which was awarded &#x201c;for groundbreaking contributions to our understanding of complex physical systems&#x201d; with one-half jointly to Syukuro Manabe and Klaus Hasselmann &#x201c;for the physical modelling of Earth&#x2019;s climate, quantifying variability and reliably predicting global warming&#x201d; and the other half to Giorgio Parisi &#x201c;for the discovery of the interplay of disorder and fluctuations in physical systems from atomic to planetary scales&#x201d; (<xref ref-type="bibr" rid="B55">Press release. NobelPrize.org., 2021</xref>). Parisi, in particular, became known for his work on the collective behavior of animals such as flocks of birds (<xref ref-type="bibr" rid="B3">Ballerini et al., 2008</xref>). Focusing on the collective behavior of starlings, he explored the idea that the movements of individual animals in a group can be influenced by the behavior of neighboring animals. As can be seen by this example, complex systems theory has many different applications in the study of natural systems, as well as in the design of artificial systems, like computer networks and transportation structures (<xref ref-type="fig" rid="F1">Figure 1A</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Complex systems. <bold>(A)</bold> Examples of complex systems include natural systems, such as the human body, the climate system, and the collective behavior of flocks of birds, as well as man-made inventions, like computer networks, the financial system, transport systems, and cities. <bold>(B)</bold> Key characteristics, or principles, that define complex systems include emergence, self-organization, feedback, nonlinearity, and adaptation.</p>
</caption>
<graphic xlink:href="fcell-11-1268540-g001.tif"/>
</fig>
<p>In fact, the aforementioned examples share key characteristics, or principles, that make them complex systems. These include emergence, nonlinearity, self-organization, feedback, and adaptation (<xref ref-type="fig" rid="F1">Figure 1B</xref>) (<xref ref-type="bibr" rid="B42">Ma&#x2019;ayan, 2017</xref>). These principles help to explain why complex systems can exhibit such diverse and often unpredictable behaviors. One of such principles is emergence, which refers to the phenomenon where complex behavior arises from interactions among simple components. Emergent properties are often difficult to predict or explain based solely on the properties of the individual components. Furthermore, feedback loops, which are cycles of interaction between components that can lead to self-organization and adaptation, create non-linear dynamics, which means that small changes in one part of the system can have large and unpredictable effects on the system as a whole. Depending on the context, feedback can be positive (amplifying) or negative (dampening). From this complex framework, typically emerges self-organization and adaptation. Self-organization refers to the ability of complex systems to spontaneously form structures or patterns without external direction or control. This phenomenon arises from the interactions between components of the system and can lead to new properties or behaviors. On the other hand, adaptation refers to the ability of complex systems to adjust and evolve in response to changing environments or conditions. While facing external disturbances, adaptive systems can exhibit resilience and robustness.</p>
<p>By understanding the behavior of complex systems, researchers can gain insights into the underlying mechanisms that drive their dynamics, and develop strategies for controlling or optimizing their behavior (<xref ref-type="bibr" rid="B10">Cohen et al., 2022</xref>; <xref ref-type="bibr" rid="B57">San Miguel, 2023</xref>). In this review, I argue that three-dimensional (3D) organoids derived from stem cells develop the characteristics that make them complex (bio) systems. These organoids offer opportunities to explore complex genetic conditions, and model human development, organogenesis, and pathology (<xref ref-type="bibr" rid="B56">Quadrato and Arlotta, 2017</xref>; <xref ref-type="bibr" rid="B31">Kim et al., 2020</xref>). However, several limitations exist due to the variability and lack of consistent anatomical organization attained in different organoid systems. This text presents the fundamental principles of &#x201c;<italic>in vitro</italic> organogenesis&#x201d; and explores the biological aspects that can be effectively modeled with current methods. Additionally, the text also discusses potential improvements that could make organoids reliable tools for investigating the emergent properties displayed by complex (bio) systems.</p>
</sec>
<sec id="s2">
<title>2 Characterization of organoids as complex (bio)systems</title>
<p>Organoids, which are three-dimensional <italic>in vitro</italic> cultures that mimic the structure and function of organs (<xref ref-type="bibr" rid="B66">Simian and Bissell, 2017</xref>), can indeed be considered complex systems. They meet the criteria of complex systems in a way that they display, if not all, most of the key characteristics or principles that make up such structures (<xref ref-type="fig" rid="F2">Figure 2A</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Organoids as complex (bio)systems. <bold>(A)</bold> Organoids demonstrate self-organization, where components within the system arrange themselves into ordered structures. Stem cells can break symmetry and differentiate, giving rise to tissue-specific architecture and functionality. Organoids also show polarization, with cells differentiating along an axis to form structures featuring distinct apical and basal regions. <bold>(B)</bold> Different methods can be used to analyze organoids using a systems-based perspective. These include experimental techniques, like scRNA-seq, various 3D imaging and tomography methods, together with predictive mathematical models, complemented by machine learning algorithms capable of capturing the molecular complexity within living systems. <bold>(C)</bold> Genome editing, using CRISPR-Cas9, for example, can be applied to introduce specific genetic modifications into cells, to investigate the roles of genes, signaling pathways, or cellular behaviors in organoid development and functionality. This capability opens up a range of possibilities for studying organoids and manipulating emergent properties. By selectively editing genes associated with specific pathways or signaling cascades, researchers can program organoid development, behavior, and function.</p>
</caption>
<graphic xlink:href="fcell-11-1268540-g002.tif"/>
</fig>
<p>Firstly, organoids demonstrate self-organization, where the components within the system arrange themselves into ordered structures without external guidance. In the case of organoids, stem cells can break symmetry and differentiate, giving rise to tissue-specific architecture and functionality (<xref ref-type="bibr" rid="B40">Lou and Leung, 2018</xref>). This process is driven by complex signaling pathways and cellular interactions (<xref ref-type="bibr" rid="B88">Yin et al., 2016</xref>). Additionally, organoids exhibit emergent behavior, where complex patterns and functionalities arise from the interactions among their constituent cells. Many organoids also show polarization, with cells differentiating along an axis to form structures featuring distinct apical and basal regions. For example, in cerebral organoids, cells self-organize into neural networks displaying cortical layering with distinct neuronal populations arranged in characteristic laminar patterns (<xref ref-type="bibr" rid="B13">Eiraku et al., 2008</xref>). These cerebral organoids typically develop and exhibit spontaneous electrical activity, resembling firing patterns seen in the developing brain (<xref ref-type="bibr" rid="B60">Sharf et al., 2022</xref>). Likewise, kidney organoids demonstrate differentiation into proximal and distal tubules with specific apical and basal domains (<xref ref-type="bibr" rid="B41">Low et al., 2019</xref>). Similarly, intestinal organoids display emergent properties (<xref ref-type="bibr" rid="B76">Tsai et al., 2017</xref>), including the formation of crypt-like structures, villi-like protrusions, and the presence of various specialized cell types (<xref ref-type="bibr" rid="B86">Workman et al., 2017</xref>).</p>
<p>In fact, embryonic development serves as a classic example of self-organization in biological systems. Cells communicate and coordinate their behaviors to create complex structures and organs. Patterns arise from interactions among cells, including differential gene expression, cell-cell signaling, and mechanical forces (<xref ref-type="bibr" rid="B38">Li et al., 2014</xref>). This communication occurs through signaling molecules (<italic>e.g.</italic>, WNT, BMP, NOTCH) that regulate their fate and spatial organization. Furthermore, differential adhesion properties between cells also contribute to the segregation and patterning observed during development (<xref ref-type="bibr" rid="B22">Gumbiner, 1996</xref>). Tissue polarity, in particular, emerges from coordinated cell signaling, cell-cell interactions, and cytoskeletal rearrangements. Signaling pathways, such as planar cell polarity (PCP), regulate the establishment and maintenance of tissue polarity (<xref ref-type="bibr" rid="B28">Jones and Chen, 2007</xref>).</p>
<p>In organoids, external stimuli such as growth factors, cytokines, or mechanical cues can be added to modulate pattern formation (<xref ref-type="bibr" rid="B29">Karzbrun et al., 2021</xref>) and contribute to the orientation and alignment of cells within the organoids (<xref ref-type="bibr" rid="B65">Silva et al., 2021</xref>). Studying tissue polarity in organoids could be useful for deciphering the mechanisms underlying tissue morphogenesis, cell differentiation, and cell polarity establishment. Therefore, manipulating the culture environment, modifying the composition of the culture medium, or applying physical forces can be employed to influence the organization and patterning of cells within organoids. Particularly, modulating signaling pathways or providing specific biochemical or mechanical cues can direct the establishment of tissue polarity in engineered organoids (<xref ref-type="bibr" rid="B64">Silva et al., 2019</xref>). Understanding pattern formation in organoids provides insights into the fundamental principles of organ development, including cell fate specification, tissue morphogenesis, and spatial organization. It can also shed light on developmental disorders (<xref ref-type="bibr" rid="B33">Lancaster et al., 2013</xref>) and facilitate the engineering of functional tissues or organs for regenerative medicine applications (<xref ref-type="bibr" rid="B40">Lou and Leung, 2018</xref>). This research could have implications for modeling diseases related to tissue polarity defects, like polycystic kidney disease (<xref ref-type="bibr" rid="B84">Wilson, 2011</xref>).</p>
<p>Organoids also exhibit non-linear dynamics, where small changes in the system can have disproportionately large effects on the overall behavior. For instance, altering culture conditions or genetic features can lead to dramatic changes in organoid development, morphology, and functionality (<xref ref-type="bibr" rid="B77">Velazquez et al., 2021</xref>). The responses of organoids to external stimuli can also exhibit non-linear behaviors, such as threshold effects and positive feedback loops (<xref ref-type="bibr" rid="B23">Hannezo and Heisenberg, 2019</xref>; <xref ref-type="bibr" rid="B36">Lewis et al., 2021</xref>). By comparison, non-linearity is also observed in various biological systems, such as gene regulatory networks, where small changes in gene expression levels can result in significant changes in cellular behavior (<xref ref-type="bibr" rid="B70">Steinacher et al., 2016</xref>; <xref ref-type="bibr" rid="B44">Manicka et al., 2023</xref>).</p>
<p>Considering organoids as complex systems also offers the opportunity to model complex diseases in a more physiologically relevant context. It has already been shown that they can recapitulate disease-specific phenotypes [<italic>e.g.</italic>, abnormal neural activity in cerebral organoids derived from patients with neurological disorders (<xref ref-type="bibr" rid="B20">Gomes et al., 2020</xref>)]. In fact, disease-related emergent behaviors in organoids often result from genetic or environmental factors influencing cell behavior, signaling pathways, or cellular responses. Disease-associated mutations or environmental triggers can disrupt normal cellular processes, leading to aberrant behaviors or disease-specific phenotypes (<xref ref-type="bibr" rid="B45">Maranga et al., 2020</xref>). Therefore, the inclusion of disease-relevant genetic mutations, exposure to disease-associated factors, or manipulation of culture conditions can influence the emergence of disease-specific behaviors in organoids. As a result, they offer a means to investigate disease processes that are challenging to study in animal models or traditional cell culture systems, potentially leading to improved diagnostics, targeted therapies, and advancements in regenerative medicine (<xref ref-type="bibr" rid="B58">Sasai, 2013</xref>).</p>
<p>In conclusion, organoids exemplify the characteristics of complex systems by displaying emergent behavior, self-organization, and non-linearity. Notably, pattern formation and tissue polarity are among the emergent behaviors observed, arising from intricate cell-cell communication, cell adhesion, and mechanical forces. External stimuli, including growth factors, chemical gradients, or disease-associated factors, can influence these phenomena. Understanding organoid emergent behaviors has implications for elucidating developmental principles, studying disease mechanisms, and advancing regenerative medicine and personalized therapeutics.</p>
</sec>
<sec id="s3">
<title>3 Methods for studying organoids as complex (bio)systems</title>
<p>This contemporary era underlines the necessity to explore novel methodologies for comprehending the intricacies present in both natural and man-made (bio)systems. This imperative aligns with addressing pressing social and economic issues through scientific advancements. Therefore, a seamless fusion of experimental life sciences with computational sciences and other advanced technologies becomes essential for gaining deeper insights into the complexity of biological phenomena (<xref ref-type="bibr" rid="B39">Linshiz et al., 2012</xref>). Central to this effort is the identification of underlying patterns governing intricate physiological or pathological processes, in which organoids can be seen as convenient experimental models (<xref ref-type="bibr" rid="B67">Soares et al., 2023</xref>; <xref ref-type="bibr" rid="B71">Tenreiro et al., 2023</xref>). Achieving this goal entails the production of advanced experimental techniques, together with predictive mathematical models, complemented by machine learning algorithms capable of capturing the molecular complexity within living systems (<xref ref-type="fig" rid="F2">Figure 2B</xref>). An overview of experimental and computational methods used for characterizing complex systems, and their application to organoids is provided bellow.</p>
<p>Firstly, examples of experimental techniques used to study organoids as complex systems, include single-cell RNA sequencing, live imaging, and an assortment of functional assays. Single-cell RNA sequencing (scRNA-seq) and other single-cell omics techniques, in particular, enable the characterization of gene expression profiles and molecular heterogeneity within organoids at a single-cell resolution (<xref ref-type="bibr" rid="B6">Brazovskaja et al., 2019</xref>). This allows researchers to identify distinct cell populations, track cellular trajectories during development, and investigate cellular responses to perturbations or environmental cues (<xref ref-type="bibr" rid="B15">Fleck et al., 2022</xref>). However, mapping developmental dynamics with organoids is particularly challenging using standard single-cell omics techniques, particularly because spatial and temporal information of the system is lost when processing samples (<xref ref-type="bibr" rid="B78">Wahle et al., 2023</xref>).</p>
<p>Indeed, various 3D imaging and tomography methods, such as confocal microscopy, live-cell imaging, light-sheet microscopy, and electron microscopy, allow researchers to visualize the structural organization and dynamics of organoids at cellular and subcellular levels (<xref ref-type="bibr" rid="B49">Nowzari et al., 2021</xref>). These high-resolution 3D images of organoids provide insights into cellular behaviors, cell-cell interactions, and the spatial distribution of specific markers or molecules within organoids (<xref ref-type="bibr" rid="B11">D&#x2019;Imprima et al., 2023</xref>). Such capabilities allow researchers to investigate spatial organization, cellular architectures, and complex tissue morphologies. Combining single-cell transcriptomics with spatial imaging has already been tested to explore clonality and lineage dynamics during cerebral organoid development (<xref ref-type="bibr" rid="B24">He et al., 2022</xref>). He and coworkers used cellular barcoding, scRNA-seq, and light-sheet microscopy to achieve spatial lineage recordings in cerebral organoids and confirm regional clonality in the developing neuroepithelium. Additional organoid-specific functional assays have also been developed for studying organoids. For example, in brain organoids, electrophysiological measurements, calcium imaging, or multi-electrode array recordings can assess neuronal activity and network properties (<xref ref-type="bibr" rid="B51">Passaro and Stice, 2021</xref>; <xref ref-type="bibr" rid="B60">Sharf et al., 2022</xref>). Additionally, in intestinal organoids, functional assays can measure barrier function, nutrient absorption, or drug response, providing insights into physiological activities (<xref ref-type="bibr" rid="B89">Zietek et al., 2020</xref>).</p>
<p>Moreover, computational modeling approaches, including ordinary differential equations (ODEs), partial differential equations (PDEs), agent-based models, and network modeling, can simulate and predict the behaviors of complex systems like organoids (<xref ref-type="bibr" rid="B21">Gon&#xe7;alves and Garc&#xed;a-Aznar, 2023</xref>; <xref ref-type="bibr" rid="B53">Pleyer and Fleck, 2023</xref>; <xref ref-type="bibr" rid="B82">Wen and Chaolu, 2023</xref>). These models integrate known biological mechanisms and parameters to study emergent properties, test hypotheses, and explore the effects of perturbations on organoid development, functionality, and response to external factors (<xref ref-type="bibr" rid="B47">Montes-Olivas et al., 2019</xref>). For example, models of intestinal organoids have been developed to investigate the distribution of cell populations and growth patterns in response to signaling dynamics (<xref ref-type="bibr" rid="B7">Buske et al., 2012</xref>; <xref ref-type="bibr" rid="B74">Thalheim et al., 2018</xref>), to study the biomechanical interactions between cells in crypts (<xref ref-type="bibr" rid="B34">Langlands et al., 2016</xref>; <xref ref-type="bibr" rid="B1">Almet et al., 2018</xref>), and to evaluate the effect of exogenous substances in the growth pattern of colon cancer organoids (<xref ref-type="bibr" rid="B87">Yan et al., 2018</xref>). Additionally, mass transport models have also been used to simulate oxygen and nutrient consumption in cerebral organoids (<xref ref-type="bibr" rid="B46">McMurtrey, 2016</xref>; <xref ref-type="bibr" rid="B4">Berger et al., 2018</xref>). Finally, reaction-diffusion models have been useful to simulate and predict fate patterning expression in gastruloids (<xref ref-type="bibr" rid="B14">Etoc et al., 2016</xref>; <xref ref-type="bibr" rid="B73">Tewary et al., 2017</xref>). The generated simulations show signaling expression similar to experimental observations, and accurately predict pattern formation <italic>in vitro</italic> models of gastrulation.</p>
<p>Computational methods for analyzing large-scale omics datasets, such as scRNA-seq data, enable the identification of gene regulatory networks, cell type classification, trajectory analysis, and the detection of emergent patterns and states within biological systems (<xref ref-type="bibr" rid="B69">Stanojevic et al., 2022</xref>). Bioinformatics tools also assist in integrating diverse datasets, performing statistical analyses, and generating comprehensive visualizations (<xref ref-type="bibr" rid="B25">Hie et al., 2019</xref>; <xref ref-type="bibr" rid="B32">Krassowski et al., 2020</xref>; <xref ref-type="bibr" rid="B12">Dries et al., 2021</xref>). Presently, machine learning algorithms and artificial intelligence techniques can also be employed to analyze complex and high-dimensional data (<xref ref-type="bibr" rid="B81">Webb, 2018</xref>; <xref ref-type="bibr" rid="B5">Bhardwaj et al., 2022</xref>). These approaches aid in pattern recognition, clustering, prediction, and classification tasks. In the future, they will help uncover hidden relationships, identify novel biomarkers, and predict organoid behaviors or responses to specific conditions or interventions (<xref ref-type="bibr" rid="B62">Shoji et al., 2023</xref>).</p>
<p>Both experimental and computational methods have been widely applied to study organoids as complex systems (<xref ref-type="bibr" rid="B54">Poli et al., 2019</xref>). These approaches provide insights into organoid development, functionality, disease modeling, and drug discovery (<xref ref-type="bibr" rid="B80">Wang and Hummon, 2021</xref>). For instance, single-cell analysis has revealed cellular heterogeneity, identified key signaling pathways, and uncovered novel cell populations within organoids. Mathematical models and computational simulations have aided in understanding emergent behaviors, optimizing culture conditions, and predicting the response of organoids to different stimuli. Machine learning techniques have been used to analyze complex datasets, classify organoid types, and predict drug responses. Overall, the combination of experimental and computational methods enables a comprehensive characterization and understanding of organoids as complex systems, providing valuable insights into their biology, functionality, and translational applications.</p>
</sec>
<sec id="s4">
<title>4 Genome editing and manipulation of organoid (bio)systems</title>
<p>Genetic engineering techniques, such as CRISPR-Cas9, can be applied to introduce specific genetic modifications or reporter genes into cells (<xref ref-type="fig" rid="F2">Figure 2C</xref>). This technology allows researchers to investigate the roles of specific genes, signaling pathways, or cellular behaviors in organoid development, functionality, or disease modeling (<xref ref-type="bibr" rid="B72">Teriyapirom et al., 2021</xref>). This capability opens up a range of possibilities in studying organoid behavior and manipulating emergent properties.</p>
<p>For example, by selectively editing genes associated with specific pathways or signaling cascades, researchers can study the effects of these genetic changes on organoid development, behavior, and function. This helps uncover the underlying genetic mechanisms controlling emergent behavior. Eventually, genome editing can also be employed to promote the generation of specific cell types within organoids and spatially organizing them (<xref ref-type="bibr" rid="B77">Velazquez et al., 2021</xref>). This manipulation can recreate tissue-like structures, leading to the development of more sophisticated and accurate models that better mimic the complexity of developing organs (<xref ref-type="bibr" rid="B26">Ho and Morsut, 2021</xref>). For example, Cakir and coworkers have engineered human pluripotent stem cells to ectopically express <italic>ETV2</italic> and generate complex vascular-like networks in cerebral organoids (<xref ref-type="bibr" rid="B9">Cakir et al., 2019</xref>). Similarly, forced expression of transcription factor <italic>PU.1</italic> also induced the generation of microglia-like cells (<xref ref-type="bibr" rid="B8">Cakir et al., 2022</xref>). Overall, the presence of vasculature and microglia enhanced the functional properties of organoids (<xref ref-type="bibr" rid="B9">Cakir et al., 2019</xref>; <xref ref-type="bibr" rid="B8">Cakir et al., 2022</xref>; <xref ref-type="bibr" rid="B68">Speicher et al., 2022</xref>). This cell programming strategy was also used to direct differentiation of human pluripotent stem cells into hepatocytes <italic>in vitro</italic> (<xref ref-type="bibr" rid="B75">Tomaz et al., 2022</xref>). The overexpression of three nuclear factors (<italic>HNF1A</italic>, <italic>HNF6</italic>, and <italic>FOXA3</italic>) resulted in the rapid production of hepatocytes with enhanced functional characteristics.</p>
<p>Moreover, by introducing disease-associated mutations into organoids, researchers can study how specific genetic alterations contribute to the development of diseases (<xref ref-type="bibr" rid="B48">Nie and Hashino, 2017</xref>). Organoids with such mutations can serve as disease models for testing potential treatments and understanding disease progression (<xref ref-type="bibr" rid="B20">Gomes et al., 2020</xref>; <xref ref-type="bibr" rid="B45">Maranga et al., 2020</xref>). Organoids can also be derived from individual patients, and genome editing allows for the introduction of specific mutations associated with the patient disease (<xref ref-type="bibr" rid="B37">Li et al., 2020</xref>). This personalized approach enables the testing of various drug treatments on patient organoids, potentially leading to more effective and tailored therapies (<xref ref-type="bibr" rid="B61">Shiihara et al., 2021</xref>).</p>
<p>Nevertheless, it is important to note that the complexity of emergent behavior in organoids means that controlling it solely through genome editing might not be straightforward, and other factors, such as environmental cues and cellular interactions, also play essential roles. As research in genome editing continues to evolve, further developments into controlling emergent behavior in organoids are expected.</p>
</sec>
<sec id="s5">
<title>5 Future directions and conclusion</title>
<p>As discussed in previous sections, organoids have proven to be powerful tools, replicating the structural and functional complexity of organs <italic>in vitro</italic> (<xref ref-type="bibr" rid="B50">Pa&#x219;ca, 2018</xref>). However, future developments are not without obstacles. Reproducibility, scalability, and physiological relevance are key challenges that must be addressed to maximize the impact of organoids in various applications. To overcome these limitations, researchers need to embrace cutting-edge technologies (<xref ref-type="bibr" rid="B18">Gjorevski et al., 2022</xref>), such as microfluidics, and advanced imaging techniques. Moreover, involving experts from diverse fields, including biology, engineering, and computational science, can enrich our understanding of organoid development and function.</p>
<p>In this review, I have examined how organoids have the potential to revolutionize our understanding of development, disease, and regenerative medicine. Their ability to recapitulate complex phenomena offers unique opportunities to study human biology in unprecedented ways. From modeling diseases and drug responses, to paving the way for personalized medicine, organoids hold immense promise for the future of healthcare. As we conquer the challenges of reproducibility, scalability, and physiological relevance, the impact of organoids on medical research will undoubtedly flourish. By embracing this technology, we can usher in an era of precise and personalized medicine, ultimately improving the lives of countless individuals worldwide.</p>
</sec>
</body>
<back>
<sec id="s6">
<title>Author contributions</title>
<p>TF: Writing&#x2013;original draft, Writing&#x2013;review and editing, Conceptualization, Funding acquisition, Project administration, Validation.</p>
</sec>
<sec id="s7">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding was received from Funda&#xe7;&#xe3;o para a Ci&#xea;ncia e a Tecnologia, I. P. (FCT) financed by national funds, in the scope of the project UIDB/04565/2020 and UIDP/04565/2020 of the Research Unit Institute for Bioengineering and Biosciences&#x2014;iBB, and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy&#x2014;i4HB.</p>
</sec>
<ack>
<p>The author would like to acknowledge the members of his research unit for helpful discussions that have led to the preparation of this manuscript.</p>
</ack>
<sec sec-type="COI-statement" id="s8">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
<p>The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.</p>
</sec>
<sec sec-type="disclaimer" id="s9">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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