Background/Aim: Cholangiocarcinoma (CCA) is a stem cell-based cancer. The in vivo tumor microenvironment is not present in two-dimensional (2D) cultures, which is one of the limitations in cancer stem cell (CSC) research. Thus, we aimed to establish three-dimensional (3D) culture mimicking extracellular matrix (ECM) that could serve as a niche for CSC enrichment in CCA. Materials and Methods: Silk fibroin-gelatin/hyaluronic acid/heparan sulfate (SF-GHHs) scaffolds were fabricated by lyophilization in various ratios and compared to silk fibroin (SF) scaffold. The physical and biological characteristics of the scaffolds were investigated. Results: The SF-GHHs 1:2 scaffold with pore size of 350±102 μm harbored optimal porosity, good water uptake, and stable beta-sheet that supported the increase in KKU-213A cell proliferation and aggregation. The CSC and the epithelial-mesenchymal transition (EMT) markers were significantly upregulated in this scaffold compared to 2D. Moreover, drug sensitivity against cisplatin and gemcitabine in 3D culture was significantly higher than that in 2D culture.
Conclusion:The SF-GHHs 1:2 scaffold could simulate ECM that may serve as a CSC niche of CCA, and reinforce stemness and EMT properties, suggesting its suitability for 3D CCA model, which supports CSC and new targeting drug research in CCA.Cholangiocarcinoma (CCA) is an aggressive cancer that arises from the epithelium of bile ducts with the highest incidence in Northeastern Thailand where liver flukes are endemic (1). The only curative treatment is surgery but is not effective in patients with late-stage cancer (2). Many lines of evidence indicated the implication of cancer stem cells (CSCs) in CCA (3-9). CSCs are a tumor cell subpopulation that is capable of self-renewal and differentiation. CSCs are related to cancer initiation, progression, and resistance to chemo-and radio-therapies (9). Although the traditional twodimensional (2D) culture has long been used in cancer research, it cannot mimic tumor microenvironment, which plays crucial roles in cell-cell and cell-matrix interactions giving rise to the differences in cancer morphology, proliferation, invasion, metastasis, signaling pathways and other biological functions when compared to in vivo conditions (10,11). Three-dimensional (3D) cell culture was established to mimic tumor-like in vivo conditions providing more predictive data for in vivo tests of CSCs in cancer research (12). There are two main types of 3D cancer models for CSC enrichment including scaffold-free and scaffoldbased methods (12).Most 3D CCA models are scaffold-free methods and organoid models (13,14). However, the tumor microenvironment is not represented in scaffold-free applications, whereas organoid generation is difficult, expensive, and time-consuming ( 14). The 3D porous scaffold 1155