Advantages, Disadvantages and Limitations of the System

TNO has 10 units of TIM-2 available, allowing multiple parameters to be tested in parallel. In contrast to other multi-compartmental in vitro models, experiments are quick (usually three test days or less), yet still physiological and predictive. The advantages over other models are the presence of peristaltics and a dialysis system, the latter of which allows production of physiological concentrations of metabolites, and a highly active microbiota of normal density to be used. Another advantage is that a single parameter in the system can be changed, and the effect of that single parameter on microbiota activity can be studied. This has been done e.g., when studying the effect of different pH's on fermentation of carbohydrates (unpublished). Naturally, in vitro models have their limitations. As with every other in vitro model that mimics the colon, TIM-2 does not have epithelial or immune cells. However, as discussed in Sect. 26.4, samples can be incubated with these cells for even better predictability. Another limitation is that the model has been developed on the basis of literature data of mostly health individuals. Due to this, it is unclear exactly which parameters to simulate when simulating patient populations as discussed in van Nuenen et al. (2004). Another limitation is that (apart from volume and pH) there are no feed-back mechanisms in the system. Therefore, the experiments in such in vitro models will always be at most an indication of what may occur in real life, and the results need to be interpreted with care.

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