Airways-on-chip models to advance pathology treatment of respiratory organs

By miniaturizing functional tissue units and recreating physiological-like microenvironments with dynamic stimuli, organ-on-chip (OOC) technology has emerged as a powerful platform for in vitro disease modeling and therapeutic screening. These microfluidic systems are increasingly applied to address major global health challenges, including cancer, owing to their ability to replicate complex tumor microenvironments and metastatic processes. By offering controlled, reproducible conditions for preclinical evaluation, OOCs are accelerating drug discovery and assessment thus they hold great promise for advancing personalized and precision medicine across diverse organ systems, including the airways. This review summarizes recent progress in OOC models for lower and upper airway diseases, spanning lung, trachea and nose, with a key focus on respiratory tract tumors. Here we highlight innovative strategies for recreating pathological airway tissue microenvironments, enabling reliable investigation of respiratory conditions, real-time monitoring of inflammatory responses, as well as evaluation of drug efficacy. Furthermore, we examine how platform design and cell type selection influence the specificity and fidelity of disease modeling, underscoring their critical roles in the development of accurate in vitro systems for studying respiratory diseases and cancer.