Cited by 123D Printing in Biomedical ResearchSkin and Cellular Biology ResearchTissue Engineering and Regenerative Medicine

Diversity of human skin three-dimensional organotypic cultures

Open access
Jia, Yunlong Y, Atwood, Scott X·2024·Current Opinion in Genetics & Development

Abstract

Recently, significant strides have been made in the development of high-fidelity skin organoids, encompassing techniques such as 3D bioprinting, skin-on-a-chip systems, and models derived from pluripotent stem cells (PSCs), replicating appendage structures and diverse skin cell types. Despite the emergence of these state-of-the-art skin engineering models, human organotypic cultures (OTCs), initially proposed in the 1970s, continue to reign as the predominant in vitro cultured three-dimensional skin model in the field of tissue engineering. This enduring prevalence is owed to their cost-effectiveness, straight forward setup, time efficiency, and faithful representation of native human skin. In this review, we systematically delineate recent advances in skin OTC models, aiming to inform future efforts to enhance in vitro skin model fidelity and reproducibility.

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes recent advances in human skin organotypic cultures (OTCs), arguing that air–liquid interface OTCs remain the predominant in vitro 3D skin model despite newer organoid, bioprinting, and skin-on-a-chip approaches. It categorizes OTCs into human epidermal equivalents (HEEs), human skin equivalents (HSEs), and advanced human skin equivalents (aHSEs), and highlights single-cell omics, reproducibility challenges, and future directions.

Key findings

  • Human OTCs, initially proposed in the 1970s, remain the predominant in vitro cultured 3D skin model because of cost-effectiveness, straightforward setup, time efficiency, and faithful representation of native human skin; skin-related ailments rank as the fourth leading nonfatal disease burden globally, affecting approximately one-third of the population.
  • OTC models are categorized by structural complexity: HEEs (keratinocytes only), HSEs (epidermis and dermis, often collagen- or de-epidermized dermis-based), and aHSEs (incorporating endothelial cells, melanocytes, neuronal cells, lymphatic cells, immune cells, adipocytes, pluripotent stem cells, and/or appendages such as hair follicles or sweat glands).
  • Single-cell transcriptomics comparing HEEs, HSEs, xenograft HSEs, and in vivo epidermis indicates these systems resemble a fetal-like developmental state similar to PSC-based organoids; they contain all cellular states of their in vivo counterpart but may exhibit defects in basal and terminal differentiation depending on culture, and in vitro models show cellular stress.
  • hPSC-derived skin organoids can recapitulate stratified epidermis, fat-rich dermis, and pigmented hair follicles with sebaceous glands; WNT activation produces larger organoids without off-target cartilage differentiation, and hybrid PSC-derived organoid plus ALI culture can recapitulate multiple appendage structures and more adult-like skin.

Methods

  • Narrative review and synthesis of existing literature on human skin OTC models, with no primary experimental data reported.
  • Discusses model types and related technologies including HEEs, HSEs, aHSEs, skin spheroids, PSC-derived skin organoids, 3D bioprinting, and skin-on-a-chip systems, focusing on ALI-based OTCs.
  • Draws on cited single-cell omics studies, especially scRNA-seq, and other phenotypic/functional studies to assess model fidelity, applications, and reproducibility.

Limitations

  • The paper states that reproducibility is challenged by the absence of uniform standardized protocols, leading to variation in culture medium, ALI duration, fibroblast presence, cell seeding density, and passage number, which complicates cross-study comparison; which cell source provides the highest fidelity remains unclear.
  • The paper states that full-thickness HSE models lack vasculature, appendages, and an immune system, complicating simulation of systemic inflammation and appendage-associated pathogenesis; aHSE models are more time-consuming, complex, and costly, especially when using human or PSC-derived cells.
  • Evident from the text: as a narrative review, no systematic search strategy or quantitative synthesis is described, and single-cell research on in vitro skin models is described as relatively sparse and still in its early stages.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.gde.2024.102275

Cites

74 of 74 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

29 of 78 cited sources checked · 17 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    HEE models offer dependable substitutes for in vitro permeation testing studies.

    “For instance, the HEE models offer dependable substitutes for in vitro permeation testing studies, a domain historically plagued by the unpredictable availability and exorbitant cost associated with excised human skin [26].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [26] Salminen AT, Davis KJ, Felton RP, Nischal N, VonTungeln LS, Beland FA, Derr K, Brown PC, Ferrer M, Katz LM,: Parallel evaluation of alternative skin barrier models and excised human skin for dermal absorption studies in vitro. Toxicol In Vitro 2023, 91: 105630. 37315744 PMC10527924 source

      The Introduction (§2) says the tested alternative models differ greatly in their ability to model permeation through excised human skin. The Discussion (§5) concludes that alternative models require continued improvement before they can predict permeation across human skin, contrary to calling them dependable substitutes. The paper does support the separate point that excised human skin has limited availability and high cost. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    Animal use is limited by the imperative to adhere to the 3R strategy.

    “and the imperative to adhere to the 3R (replace, reduce, and refine) strategy [6] underscore the limitations of animal uses.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [6] Niehues H, Bouwstra JA, El Ghalbzouri A, Brandner JM, Zeeuwen PLJM, van den Bogaard EH: 3D skin models for 3R research: the potential of 3D reconstructed skin models to study skin barrier function. Exp Dermatol 2018, 27: 501– 511. 29518287 source
  • Premisecitation

    Animal models have interspecies variability.

    “However, challenges such as interspecies variability in animal models [5]”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [5] Gallagher, Kruger S, Josyula U, Rahul K, Gong A, Song A, Sweet R, Makled B, Parsey C, Norfleet J,: Thermally damaged porcine skin is not a surrogate mechanical model of human skin. Sci Rep 2022, 12: 4565. 35296755 PMC8927453 source
  • Premisecitation

    Pigmented HEE models can be used to assess the effect of melanin following ultraviolet irradiation.

    “Pigmented HEE models can be used to assess the effect of melanin following ultraviolet (UV) irradiation [31].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [31] Zamudio Díaz DF, Busch L, Kröger M, Klein AL, Lohan SB, Mewes KR, Vierkotten L, Witzel C, Rohn S, Meinke MC: Significance of melanin distribution in the epidermis for the protective effect against UV light. Sci Rep 2024, 14: 3488. 38347037 PMC10861496 source
  • Premisecitation

    aHSEs can integrate additional cell types including endothelial cells, melanocytes, neuronal cells, lymphatic cells, immune cells, adipocytes, pluripotent stem cells, and skin appendages.

    “These include endothelial cells to vascularize the dermis [46] and melanocytes to introduce pigmentation [47]. Furthermore, neuronal cells [48,49], lymphatic cells [50], immune cells (e.g. dermal dendritic cells [51], monocytes [52], T cells [53], and macrophages [54]), adipocytes and adipose tissue [49,55,56], pluripotent stem cells [22,36,57], and skin appendages such as hair follicles or sweat”
    Quote in the paperNot a substantial claim3 of 4 sources checked
    • cites [46] Zimoch J, Zielinska D, Michalak-Micka K, Rütsche D, Böni R, Biedermann T, Klar AS: Bio-engineering a prevascularized human tri-layered skin substitute containing a hypodermis. Acta Biomater 2021, 134: 215– 227. 34303011 source

      The cited paper supports the adipocyte and adipose-tissue portion: its Introduction describes generating a hypodermal layer from adipose-derived stem cells, and its Discussion describes the resulting tri-layered skin substitute. Citation [49] is also attached to neuronal cells in the citing sentence, but the paper does not report incorporating neuronal cells. The other listed cell types have separate citations and are not assessed here. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [47]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [18] Stanton DN, Ganguli-Indra G, Indra AK, Karande P: Bioengineered efficacy models of skin disease: advances in the last 10 years. Pharmaceutics 2022, 14: 319. 35214050 PMC8877988 source

      Section 7 (page unavailable) describes HSEs incorporating endothelial and lymphatic endothelial cells, neural components, immune cells, adipocytes, pluripotent stem cells, and skin appendages. The copy identifies melanocytes as pigment-producing cells in natural skin (Section 2), but the passages found do not establish their integration into HSEs; they also do not establish monocytes as a separately incorporated cell type. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [58] Abaci HE, Coffman A, Doucet Y, Chen J, Jacków J, Wang E, Guo Z, Shin JU, Jahoda CA, Christiano AM: Tissue engineering of human hair follicles using a biomimetic developmental approach. Nat Commun 2018, 9: 5301. 30546011 PMC6294003 source
  • Classified as probably not a substantial claim. 48
  • May combine two claims. 15
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MEK inhibition was shown as a potential targeted therapy strategy for Darier disease in a SERCA2-deficient HEE model.

    “Building upon the SERCA2-deficient HEE model, Mitogen activated protein kinase kinase (MEK) inhibition was shown as a potential targeted therapy strategy for DD [30].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [30] Zaver SA, Sarkar MK, Egolf S, Zou J, Tiwaa A, Capell BC, Gudjonsson JE, Simpson CL: Targeting SERCA2 in organotypic epidermis reveals MEK inhibition as a therapeutic strategy for Darier disease. JCI Insight 2023, 8: e170739. 37561594 PMC10561730 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The HEE model is implemented in hazard assessments and regenerative medicine and is commercially available from numerous companies.

    “Owing to its cost-effectiveness and reproducibility, the HEE model is also implemented in hazard assessments and regenerative medicine, where it is now commercially available from numerous companies [27,28].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [27] Hofmann E, Schwarz A, Fink J, Kamolz L-P, Kotzbeck P: Modelling the complexity of human skin in vitro. Biomedicines 2023, 11: 794. 36979772 PMC10045055 source

      Section 3 (Reconstructed Human Epidermis; page not provided) says reconstructed human epidermis models are commercially available from a number of companies for hazard assessments. It does not say these models are implemented in regenerative medicine. The cited passages also do not establish cost-effectiveness as the reason for their use. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [28] Zidarič T, Kleinschek KS, Maver U, Maver T: Commercial skin equivalents. In Function-Oriented Bioengineered Skin Equivalents: Continuous Development Towards Complete Skin Replication. Edited by Zidarič T, Kleinschek KS, Maver U, Maver T Springer International Publishing; 2023: 103– 122.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    scRNA-seq of human keratinocytes compared to holoclone signatures distinguished epidermal holoclone-forming cells from other epidermal cell states and identified a continuous hierarchical trajectory, showing that holoclone-forming cells generate meroclone- and paraclone-forming cells.

    “For instance, scRNA-seq of human KCs was compared to holoclone signatures, and the resulting analyses were able to clearly distinguish epidermal holoclone-forming cells from other epidermal cell states and identify a continuous hierarchical trajectory, showing that holoclone-forming cells generate meroclone- and paraclone-forming cells [67].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [67] Enzo E, Secone Seconetti A, Forcato M, Tenedini E, Polito MP, Sala I, Carulli S, Contin R, Peano C, Tagliafico E,: Single-keratinocyte transcriptomic analyses identify different clonal types and proliferative potential mediated by FOXM1 in human epidermal stem cells. Nat Commun 2021, 12: 2505. 33947848 PMC8097075 source
  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationcitation

    The versatile skin OTC-based platform is ideally suited for investigating a broad range of physiological and pathological scenarios, with significant potential for advancing understanding of skin developmental biology, disease modeling, and regenerative medicine.

    “The versatile skin OTC-based platform is ideally suited for investigating a broad range of physiological and pathological scenarios, presenting significant potential for advancing our understanding of skin developmental biology, disease modeling, and applications in regenerative medicine [69–71].”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [69] Cousin I, Misery L, de Vries P, Lebonvallet N: Emergence of new concepts in skin physiopathology through the use of in vitro human skin explants models. Dermatology 2023, 239: 849– 859. 37717565 source
    • cites [70] de Groot SC, Ulrich MMW, Gho CG, Huisman MA: Back to the future: from appendage development toward future human hair follicle neogenesis. Front Cell Dev Biol 2021, 9: 661787. 33912569 PMC8075059 source

      The Abstract (page unavailable) discusses human models for studying hair-follicle development and disease, and their potential clinical use. The Tissue Engineering section (page unavailable) discusses regeneration, but the paper does not identify or evaluate a skin OTC-based platform as ideally suited to a broad range of physiological and pathological scenarios. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [71] Kim J, Koo B-K, Knoblich JA: Human organoids: model systems for human biology and medicine. Nat Rev Mol Cell Biol 2020, 21: 571– 584. 32636524 PMC7339799 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Collagen- and DED-based HSEs are increasingly recognized as promising skin models owing to their supportive cellular environments and low antigenicity.

    “Significantly, collagen- and DED-based HSEs are increasingly recognized as promising skin models in skin bioengineering owing to their supportive cellular environments and low antigenicity [38,39].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [38] Zhang X, Chen X, Hong H, Hu R, Liu J, Liu C: Decellularized extracellular matrix scaffolds: recent trends and emerging strategies in tissue engineering. Bioact Mater 2022, 10: 15– 31. 34901526 PMC8637010 source

      The section on dECM scaffolds for skin tissue engineering (page not provided) describes decellularized dermal scaffolds that preserve features supporting cell adhesion and growth, and reports a vascularized skin equivalent. The Conclusions and outlooks (page not provided) say removal of immunogenic cellular components reduces potential immune responses. These passages support the claim for decellularized dermal materials, but do not establish the same advantages for collagen-based HSEs or specifically say that both types are increasingly recognized as skin models. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [39] Zheng W, Xu C-H: Innovative approaches and advances for hair follicle regeneration. ACS Biomater Sci Eng 2023, 9: 2251– 2276. 37036820 source
  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    scRNA-seq enables profiling of gene expression at single-cell resolution and identification of reliable cellular heterogeneity, allowing identification of previously unrecognized heterogeneity, revealing regulatory relationships between genes, and tracking trajectories of distinct cell lineages.

    “It enables both profiling of gene expression measurements at a single-cell resolution and identification of reliable cellular heterogeneity, allowing for the identification of previously unrecognized levels of cellular heterogeneity, revealing regulatory relationships between genes, and tracking the trajectories of distinct cell lineages in the same or different developmental stages [63–66].”
    Quote in the paperSubstantial claim3 of 4 sources checked
    • cites [63] Glover JD, Sudderick ZR, Shih BB-J, Batho-Samblas C, Charlton L, Krause AL, Anderson C, Riddell J, Balic A, Li J,: The developmental basis of fingerprint pattern formation and variation. Cell 2023, 186: 940– 956.e20. 36764291 source

      In “Single cell expression profiling delineates shared early but distinct late events,” the paper uses single-nucleus RNA-seq to characterize gene expression and identify distinct cell populations. The methods section also describes pseudotime trajectory analysis. It does not establish that this sequencing analysis revealed regulatory relationships between genes or tracked lineages across different developmental stages; the sequenced skin was from week 14. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [64]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [65] Ober-Reynolds B, Wang C, Ko JM, Rios EJ, Aasi SZ, Davis MM, Oro AE, Greenleaf WJ: Integrated single-cell chromatin and transcriptomic analyses of human scalp identify gene-regulatory programs and critical cell types for hair and skin diseases. Nat Genet 2023, 55: 1288– 1300. 37500727 PMC11190942 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [66] Wang S, Drummond ML, Guerrero-Juarez CF, Tarapore E, MacLean AL, Stabell AR, Wu SC, Gutierrez G, That BT, Benavente CA,: Single cell transcriptomics of human epidermis identifies basal stem cell transition states. Nat Commun 2020, 11: 4239. 32843640 PMC7447770 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • May combine two claims.

    Premisecitation

    The expansion of aHSEs enhances the application of OTC models for investigating therapeutic techniques, particularly in mimicking inflammatory skin diseases like psoriasis and atopic dermatitis, and in studying skin-related bacterial adhesion and infection.

    “This expansion enhances the application of OTC models for investigating potential therapeutic techniques [18,60], particularly in mimicking inflammatory skin diseases like psoriasis and atopic dermatitis [59], while also studying skin-related bacterial adhesion and infection [22,45].”
    Quote in the paperNot a substantial claim4 of 5 sources checked
    • cites [18] Stanton DN, Ganguli-Indra G, Indra AK, Karande P: Bioengineered efficacy models of skin disease: advances in the last 10 years. Pharmaceutics 2022, 14: 319. 35214050 PMC8877988 source
    • cites [60] Sanchez MM, Bagdasarian IA, Darch W, Morgan JT: Organotypic cultures as aging associated disease models. Aging 2022, 14: 9338– 9383. 36435511 PMC9740367 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [59] Scheurer J, Sauer B, Focken J, Giampetraglia M, Jäger A, Schürch CM, Weigelin B, Schittek B: Histological and functional characterization of 3D human skin models mimicking the inflammatory skin diseases psoriasis and atopic dermatitis. Dis Model Mech 2024, 17: dmm050541. 38251799 PMC10846593 source
    • cites [22]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [45] Reijnders CMA, van Lier A, Roffel S, Kramer D, Scheper RJ, Gibbs S: Development of a full-thickness human skin equivalent in vitro model derived from TERT-immortalized keratinocytes and fibroblasts. Tissue Eng Part A 2015, 21: 2448– 2459. 26135533 PMC4554934 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • May combine two claims.

    Premisecitation

    aHSE models offer high customization, facilitating control over organotypic cell populations, genotypes, and culture conditions, thereby enabling controlled studies on tissue-level biology.

    “aHSE models offer a high degree of customization, facilitating control over organotypic cell populations, genotypes, and culture conditions, thereby enabling meticulously controlled studies on tissue-level biology [59].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [59] Scheurer J, Sauer B, Focken J, Giampetraglia M, Jäger A, Schürch CM, Weigelin B, Schittek B: Histological and functional characterization of 3D human skin models mimicking the inflammatory skin diseases psoriasis and atopic dermatitis. Dis Model Mech 2024, 17: dmm050541. 38251799 PMC10846593 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    HSEs are used to investigate wound healing, aging, and various diseases.

    “HSEs are used to investigate various aspects of normal and abnormal skin biology, including wound healing [40,41], aging [42,43], and the study of various diseases [18].”
    Quote in the paperNot a substantial claim5 of 5 sources checked
    • cites [40] Hofmann E, Fink J, Pignet A-L, Schwarz A, Schellnegger M, Nischwitz SP, Holzer-Geissler JCJ, Kamolz L-P, Kotzbeck P: Human in vitro skin models for wound healing and wound healing disorders. Biomedicines 2023, 11: 1056. 37189674 PMC10135654 source
    • cites [41] Lee E-S, Ahn Y, Bae I-H, Min D, Park NH, Jung W, Kim S-H, Hong YD, Park WS, Lee CS: Synthetic retinoid seletinoid G improves skin barrier function through wound healing and collagen realignment in human skin equivalents. Int J Mol Sci 2020, 21: 3198. 32366052 PMC7247558 source
    • cites [42] Ahlers JMD, Falckenhayn C, Holzscheck N, Solé-Boldo L, Schütz S, Wenck H, Winnefeld M, Lyko F, Grönniger E, Siracusa A: Single-cell RNA profiling of human skin reveals age-related loss of dermal sheath cells and their contribution to a juvenile phenotype. Front Genet 2022, 12: 797747. 35069694 PMC8776708 source
    • cites [43] Weinmüllner R, Zbiral B, Becirovic A, Stelzer EM, Nagelreiter F, Schosserer M, Lämmermann I, Liendl L, Lang M, Terlecki-Zaniewicz L,: Organotypic human skin culture models constructed with senescent fibroblasts show hallmarks of skin aging. NPJ Aging Mech Dis 2020, 6: 4. 32194977 PMC7060247 source
    • cites [18] Stanton DN, Ganguli-Indra G, Indra AK, Karande P: Bioengineered efficacy models of skin disease: advances in the last 10 years. Pharmaceutics 2022, 14: 319. 35214050 PMC8877988 source
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Although complexity increases from HEE to aHSE models, their fidelity and consistency do not necessarily improve with increasing complexity.

    “Although the complexity increases from HEE to aHSE models, their fidelity and consistency do not necessarily improve with increasing complexity.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Two-dimensional monolayer cultures cannot replicate the stratified epidermis and lack 3D cell-to-cell and extracellular matrix interactions.

    “Moreover, 2D monolayer cultures are constrained by their inability to replicate the stratified epidermis and lack of 3D cell-to-cell/ECM (extracellular matrix) interactions [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Pampaloni F, Reynaud EG, Stelzer EHK: The third dimension bridges the gap between cell culture and live tissue. Nat Rev Mol Cell Biol 2007, 8: 839– 845. 17684528 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The ALI-based OTC model persists as a prevalent platform used in skin development research and in mitigating limitations associated with PSC-derived skin organoid cysts.

    “Despite the significant attention received by hPSC-derived skin organoids, the ALI-based OTC model persists as a prevalent platform extensively utilized not only in skin development research but also in mitigating the limitations associated with PSC-derived skin organoid cysts.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    RNA-seq facilitates comparison of gene expression or predicted biofunction profiles across different samples or experimental conditions.

    “This capability facilitates the comparison of gene expression or predicted biofunction profiles across different samples or experimental conditions.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    Single-cell RNA sequencing has become a routine method for studying human skin development.

    “In the wave of technological evolution from bulk to single-cell level omics, single-cell RNA sequencing (scRNA-seq) has become a routine method for studying human skin development.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The choice of appropriate cell sources for model development holds significant potential for enhancing the reproducibility of OTCs.

    “However, the choice of appropriate cell sources for model development holds significant potential for enhancing the reproducibility of OTCs.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    A major challenge in achieving reproducibility in skin culture systems stems from the absence of uniform, standardized protocols, which can lead to variations in culture medium, ALI duration, and key cellular parameters.

    “A major challenge in achieving reproducibility in skin culture systems stems from the absence of uniform, standardized protocols, which can lead to variations in factors such as culture medium, ALI duration, and key cellular parameters (e.g. fibroblast presence, cell seeding density, passage number, etc.).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The planar format and ample size of skin OTC models theoretically enable the adaptation and implementation of assessment approaches utilized on native human skin.

    “The planar format and ample size of skin OTC models theoretically enable the adaptation and implementation of assessment approaches utilized on native human skin.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Nagano et al. recently succeeded in generating semi-autologous skin in vivo through niche encroachment, paving the way for large-scale human skin graft production in livestock animals.

    “Addressing these challenges, Nagano et al. recently succeeded in generating semi-autologous skin in vivo through niche encroachment, paving the way for large-scale human skin graft production in livestock animals [74].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [74]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    Skin OTC models function as a crucial intermediary between animal models, traditional 2D cell cultures, and human skin biopsies.

    “Hence, skin OTC models function as a crucial intermediary between animal models, traditional 2D cell cultures, and human skin biopsies, highlighting their adaptability and versatility within the realm of skin biology.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Autologous skin grafting remains the gold standard for treating skin defects.

    “Within regenerative medicine, autologous skin grafting remains the gold standard for treating skin defects.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Numerous OTC-based cultured epidermis and skin substitute products have become commercially available.

    “In response to this pressing demand, numerous OTC-based cultured epidermis and skin substitute products have become commercially available (e.g. Commercially Available Skin Substitute Products [72]; Skin and Soft Tissue Substitutes [73]).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [72] Snyder D, Sullivan N, Margolis D, Schoelles K. Commercially available skin substitute products. In Skin Substitutes for Treating Chronic Wounds [Internet]. Agency for Healthcare Research and Quality (US); 2020. 32101391

      Not checked in the free run.

    • cites [73] United Healthcare. Skin and Soft Tissue Substitutes; 2024.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    RNA sequencing empowers researchers to simultaneously analyze the expression levels of all genes within a sample.

    “Unlike low-throughput methods such as quantitative polymerase chain reaction or immunofluorescence, highly sensitive RNA sequencing (RNA-seq) empowers researchers to simultaneously analyze the expression levels of all genes within a sample.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Humanized HSEs are grafted onto immunodeficient mice as hybrid models.

    “Additionally, they have been employed directly in studies and as ‘hybrid’ models, where humanized HSEs are grafted onto immunodeficient mice [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Using PSC-derived cells or immortalized cell lines may offer advantages over primary cell sources, which are susceptible to interdonor variability.

    “For example, using PSC-derived cells or immortalized cell lines may offer advantages over primary cell sources, which are susceptible to interdonor variability.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisenone given

    Autologous skin grafting has clinical limitations, particularly the restricted availability of donor sites.

    “However, its clinical limitations, particularly the restricted availability of donor sites, underscore the need for alternative strategies.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Comparison of HEEs, HSEs, xenograft HEEs, and in vivo epidermis indicates that these systems resemble a fetal-like developmental state similar to PSC-based organoids and contain all the cellular states as their in vivo counterpart but may exhibit defects in basal and terminal differentiation depending on how they are cultured.

    “Finally, a comparison of HEEs, HSEs, xenograft HEEs, and in vivo epidermis indicates that these systems also resemble a more fetal-like developmental state similar to the PSC-based organoids and contain all the cellular states as their in vivo counterpart but may exhibit defects in the basal and terminal differentiation programs depending on how they are cultured [44].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [44]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    No artificial skin substitute currently achieves full functional equivalence to autologous grafts.

    “Nevertheless, no artificial skin substitute currently achieves full functional equivalence to autologous grafts.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The two-layer design of HSEs allows optimal differentiation of the epidermis and replication of complex interactions between keratinocytes and fibroblasts, which are crucial for maintaining skin homeostasis.

    “This design allows for the optimal differentiation of the epidermis and the replication of the complex interactions between KCs and Fibs, which are crucial for maintaining skin homeostasis [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Jevtić M, Löwa A, Nováčková A, Kováčik A, Kaessmeyer S, Erdmann G, Vávrová K, Hedtrich S: Impact of intercellular crosstalk between epidermal keratinocytes and dermal fibroblasts on skin homeostasis. Biochim Biophys Acta Mol Cell Res 2020, 1867: 118722. 32302667 source
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    ALI-based planar OTC models for skin offer a robust platform enabling researchers to manipulate various types of skin cells and their microenvironments artificially.

    “ALI-based planar OTC models for skin offer a robust platform enabling researchers to manipulate various types of skin cells and their microenvironments artificially.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The produced rete ridges comprised rounded features of controlled geometry and periodicity in the dermal layer, advancing the HSE model to a more skin-like state.

    “The produced rete ridges comprised rounded features of controlled geometry and periodicity in the dermal layer, advancing the current HSE model to a more skin-like state.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Large-scale personalized edgeless wearable human skin grafts vascularized by skin-specific endothelial cells resulted in enhanced ECM deposition, improved mechanical properties, and site-specific differences in cellular and ECM organization.

    “Notably, the development of large-scale personalized edgeless wearable human skin grafts was further vascularized by skin-specific endothelial cells, resulting in enhanced deposition of the ECM, improved mechanical properties, and site-specific differences in cellular and ECM organization [61].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In investigations concerning skin development, skin is frequently delineated as an intricate network of four symbiotic barriers: the physical, chemical, immune, and microbiotic layers.

    “In investigations concerning skin development, skin is frequently delineated as an intricate network of four symbiotic barriers: the physical, chemical, immune, and microbiotic layers [75].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [75]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    The heightened complexity of aHSEs raises the specialty required for their widespread adoption and escalates costs, particularly when utilizing cells of human origin or PSC-derived cells.

    “The heightened complexity not only raises the specialty for their widespread adoption but also escalates costs, particularly when utilizing cells of human origin or PSC-derived cells.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    This paves the way for large-scale human skin graft production in livestock animals.

    “paving the way for large-scale human skin graft production in livestock animals.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 74.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stabell et al. conducted the first and only single-cell-based skin OTC modeling studies to date.

    “Stabell and colleagues conducted the first and only single-cell-based skin OTC modeling studies to date.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 44.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    Hybrid constructs amalgamating PSC-derived skin organoids with subsequent ALI culture methods emerge as a promising foundational approach for the assembly of integrated skin systems.

    “Hybrid constructs, amalgamating PSC-derived skin organoids with subsequent ALI culture methods, emerge as a promising foundational approach for the assembly of integrated skin systems.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The advancement of in vitro skin OTC models is steadfastly trending toward enhanced complexity and functionality.

    “To conclude, the advancement of in vitro skin OTC models is steadfastly trending toward enhanced complexity and functionality.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    AHR and TFAP2A axis regulates terminal differentiation of epidermal keratinocytes and formation of skin barrier.

    “the authors discovered a previously unrecognized axis involving AHR and TFAP2A that regulates the terminal differentiation of epidermal keratinocytes and the formation of the skin barrier.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 29.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Macrophages play a crucial role in early embryonic vascular development.

    “the authors demonstrated through experiments the crucial role of macrophages in early embryonic vascular development.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 64.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Vascularization by skin-specific endothelial cells leads to site-specific differences in cellular and ECM organization.

    “the skin graft was further vascularized by skin-specific endothelial cells, leading to enhanced deposition of the ECM, improved mechanical properties, and site-specific differences in cellular and ECM organization.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 61.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Contemporary research is channeling resources into enhancing skin models from simplistic bilayer constructs to elaborate systems that incorporate both immune cells and active surface microbiota.

    “Addressing these aspects, contemporary research is channeling resources into enhancing skin models from simplistic bilayer constructs to elaborate systems that incorporate both immune cells and active surface microbiota.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Activation of WNT signaling pathway in hPSC-derived skin organoids produces larger organoids without off-target cartilage differentiation.

    “through the activation of the WNT signaling pathway. This approach produced larger organoids without off-target cartilage differentiation.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 22.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Vascularization by skin-specific endothelial cells leads to improved mechanical properties.

    “the skin graft was further vascularized by skin-specific endothelial cells, leading to enhanced deposition of the ECM, improved mechanical properties, and site-specific differences in cellular and ECM organization.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 61.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    It was applied to study atopic dermatitis.

    “but was also applied to the study of atopic dermatitis.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 22.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Interpretationcitation

    This enhances HSE model toward more authentic skin-like configuration.

    “thereby enhancing the current HSE model toward a more authentic skin-like configuration.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 62.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Lewis team developed human skin models with distinct rete ridges using 3D-printed stamps and micromolding.

    “Lewis team developed human skin models featuring distinct rete ridges between the epidermal and dermal layers by employing 3D-printed stamps in conjunction with a micromolding technique.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 62.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Pappalardo et al. developed large-scale personalized edgeless wearable human skin grafts.

    “Pappalardo et al. reported the development of large-scale personalized edgeless wearable human skin grafts.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 61.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Rete ridges exhibited rounded attributes with controlled geometry and periodicity.

    “The resulting rete ridges exhibited rounded attributes with precisely controlled geometry and periodicity within the dermal layer”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 62.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    hPSC-derived skin organoid model has high fidelity in mimicking fetal skin and hair follicle development.

    “confirming its high fidelity in mimicking fetal skin and hair follicle development from early to late time points”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 64.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    ALI plays a critical role in promoting the differentiation of skin-relevant epithelial organoids.

    “it further illustrates the critical role of ALI in promoting the differentiation of skin-relevant epithelial organoids.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 23.•

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Conjunctiva organoids provide a versatile platform for studying conjunctival physiology.

    “and provide a versatile platform for studying conjunctival physiology.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 23.•

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In vitro models exhibit cellular stress.

    “while also highlighting cellular stress within in vitro models.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 44.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mouse and human conjunctiva organoids recapitulate key features of conjunctival epithelium.

    “It demonstrates that these organoids recapitulate key features of the conjunctival epithelium”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 23.•

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    This study is the first comprehensive multiomic reference atlas of human prenatal skin (7-16 PCW).

    “As the first comprehensive multiomic reference atlas of human prenatal skin (7–16 post-conception weeks)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 64.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The first hPSC-derived hair-bearing skin organoids were a breakthrough in 2020.

    “Following the breakthrough of the first hPSC-derived hair-bearing skin organoids in 2020”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 20.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Integrating an appropriate microbiota into an in vitro human skin model could significantly enhance its ability to replicate in vivo conditions more accurately.

    “integrating an appropriate microbiota into an in vitro human skin model could significantly enhance its ability to replicate in vivo conditions more accurately.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 75.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Vascularization by skin-specific endothelial cells leads to enhanced ECM deposition.

    “the skin graft was further vascularized by skin-specific endothelial cells, leading to enhanced deposition of the ECM, improved mechanical properties, and site-specific differences in cellular and ECM organization.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 61.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    This study provided the first imitation of skin's overall coordination and regional specificity.

    “This study provided the first imitation of the skin ’ s overall coordination and regional specificity”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 61.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Nagano et al. generated semi-autologous skin in vivo through niche encroachment.

    “Nagano et al. recently succeeded in generating semi-autologous skin in vivo through niche encroachment”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 74.••

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

59 of 59
  • The paper relies on this without support.

    The enduring prevalence of human OTCs is owed to their cost-effectiveness, straightforward setup, time efficiency, and faithful representation of native human skin.

    “This enduring prevalence is owed to their cost-effectiveness, straight forward setup, time efficiency, and faithful representation of native human skin.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Xenograft model is identified as both HEE and HSE

    Minor

    The discussion of reference 44 calls the xenograft models HEEs, but the paper's annotation of that same study calls them HSEs.

1 of 1

Cites

Flagged first, then by citations

Cited by

Still being checked.

Authors
Jia, Y. Y., & Atwood, S. X.
Affiliations
University of California, Irvine (US)
Corresponding author
Atwood, Scott X
Venue
Current Opinion in Genetics & Development
Publisher
Elsevier BV
Published
2024-12
Volume
89
Pages
102275
ISSN
0959-437X (ISSN-L)
OpenAlex
W4404293256
Cited by
12
References
74
Citations by year
2026: 10 · 2025: 2
FWCI
0.56
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Genetics & Development (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
Funders
National Science Foundation (CBET2134916)
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › 3D Printing in Biomedical Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Skin and Cellular Biology Research
  • Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
Keywords
organotypic culture, 3D skin model, in vitro skin model, skin organoids, skin-on-a-chip, 3D bioprinting, skin appendages, model reproducibility, skin tissue engineering
MeSH terms
Microphysiological Systems, Humans, Organoids, Skin, Tissue Engineering, Pluripotent Stem Cells, Bioprinting

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-22.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-22.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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