Design and Printing Strategies in 3D Bioprinting of Cell-Hydrogels: A Review

Regeneration of skeletal system with genipin crosslinked biomaterials

Natural biomaterials, such as collagen, gelatin, and chitosan, are considered as promising candidates for use in tissue regeneration treatment, given their similarity to natural tissues regarding components and structure. Nevertheless, only receiving a crosslinking process can these biomaterials exhibit sufficient strength to bear high tensile loads for use in skeletal system regeneration. Recently, genipin, a natural chemical compound extracted from gardenia fruits, has shown great potential as a reliable crosslinking reagent, which can reconcile the crosslinking effect and biosafety profile simultaneously. In this review, we briefly summarize the genipin extraction process, biosafety, and crosslinking mechanism. Subsequently, the applications of genipin regarding aiding skeletal system regeneration are discussed in detail, including the advances and technological strategies for reconstructing cartilage, bone, intervertebral disc, tendon, and skeletal muscle tissues. Finally, based on the specific pharmacological functions of genipin, its potential applications, such as its use in bioprinting and serving as an antioxidant and anti-tumor agent, and the challenges of genipin in the clinical applications in skeletal system regeneration are also presented.

3D printing of cell-laden electroconductive bioinks for tissue engineering applications

Bioprinting is an emerging powerful fabrication method, which enables the rapid assembly of 3D bioconstructs with dispensing cell-laden bioinks in pre-designed locations.

3D-printable zwitterionic nano-composite hydrogel system for biomedical applications

Herein, the cytotoxicity of a novel zwitterionic sulfobetaine hydrogel system with a nano-clay crosslinker has been investigated. We demonstrate that careful selection of the composition of the system (monomer to Laponite content) allows the material to be formed into controlled shapes using an extrusion based additive manufacturing technique with the ability to tune the mechanical properties of the product. Moreover, the printed structures can support their own weight without requiring curing during printing which enables the use of a printing-then-curing approach. Cell culture experiments were conducted to evaluate the neural cytotoxicity of the developed hydrogel system. Cytotoxicity evaluations were conducted on three different conditions; a control condition, an indirect condition (where the culture medium used had been in contact with the hydrogel to investigate leaching) and a direct condition (cells growing directly on the hydrogel). The result showed no significant difference in cell viability between the different conditions and cells were also found to be growing on the hydrogel surface with extended neurites present.

Recent Strategies in Fabrication of Gradient Hydrogels for Tissue Engineering Applications

Hydrogels are widely used as scaffold in tissue engineering field because of their ability to mimic the cellular microenvironment. However, mimicking a completely natural cellular environment is complicated due to the differences in various physical and chemical properties of cellular environments. Recently, gradient hydrogels provide excellent heterogeneous environment to mimic the different cellular microenvironments. To create hydrogels with an anisotropic distribution, gradient hydrogels have been widely developed by adopting several gradient generation techniques. Herein, the various gradient hydrogel fabrication techniques, including dual syringe pump systems, microfluidic device, photolithography, diffusion, and bio-printing are summarized. As the effects of gradient 3D hydrogels with stems have been reviewed elsewhere, this review focuses principally on gradient hydrogel fabrication for multi-model tissue regeneration. This review provides new insights into the key points for fabrication of gradient hydrogels for multi-model tissue regeneration.

Graphene oxide/alginate composites as novel bioinks for three-dimensional mesenchymal stem cell printing and bone regeneration applications

Three-dimensional (3D) cell printing is a versatile technique enabling the creation of 3D constructs containing hydrogel and cells in the desired shape or pattern. Bioinks exhibiting appropriate mechanical properties and biological activities to support cell growth and/or differentiation toward a specific lineage play critical roles in 3D cell printing and tissue engineering applications. Herein, we explored alginate/graphene oxide (GO) composites as bioinks for their potential to improve printability, structural stability, and osteogenic activities for osteogenic tissue engineering applications. The addition of GO (0.05-1.0 mg mL^-1) to 3% alginate significantly enhanced the printing performances of the alginate bioink. In addition, mesenchymal stem cells (MSCs) printed with alginate/GO showed good proliferation and higher survival in an oxidative stress environment. The 3D scaffolds printed with MSCs and alginate/GO demonstrated significantly enhanced osteogenic differentiation compared with those printed with MSCs and alginate. Overall, a bioink of 3% alginate and 0.5 mg mL^-1 GO showed the most balanced characteristics in terms of printability, structural stability, and osteogenic induction of the printed MSCs. Alginate/GO composite bioinks will be useful for bioprinting research for various tissue engineering applications.

Engineered 3D Polymer and Hydrogel Microenvironments for Cell Culture Applications

The realization of biomimetic microenvironments for cell biology applications such as organ-on-chip, in vitro drug screening, and tissue engineering is one of the most fascinating research areas in the field of bioengineering. The continuous evolution of additive manufacturing techniques provides the tools to engineer these architectures at different scales. Moreover, it is now possible to tailor their biomechanical and topological properties while taking inspiration from the characteristics of the extracellular matrix, the three-dimensional scaffold in which cells proliferate, migrate, and differentiate. In such context, there is therefore a continuous quest for synthetic and nature-derived composite materials that must hold biocompatible, biodegradable, bioactive features and also be compatible with the envisioned fabrication strategy. The structure of the current review is intended to provide to both micro-engineers and cell biologists a comparative overview of the characteristics, advantages, and drawbacks of the major 3D printing techniques, the most promising biomaterials candidates, and the trade-offs that must be considered in order to replicate the properties of natural microenvironments.

Pneumatic conveying printing technique for bioprinting applications

Droplet-based bio-printing (DBB) techniques have been extensively accepted due to their simplicity, flexibility and cost performance. However, the applicability of inkjet printing for bioprinting techniques still faces challenges, such as a narrow range of available bio-ink materials, cell damage due to the pressure strike and high shear rate during the printing process. Here, a new droplet-based printing technique, pneumatic conveying printing (PCP), is described. This new technique is successfully adopted for cell-printing purposes. The cells present in the bio-ink are not exposed to any significant pressure and therefore the PCP technique is gentle to the cells. Furthermore, PCP allows the usage of inks with viscosities higher than 1000 mPa s, enabling the usage of bio-inks with high cell concentrations (several tens of millions per millilitre). As a proof of concept, two different cell types were printed with this novel technique. To achieve a printing resolution of 400 to 600 μm, cells were encapsulated into a hydrogel containing calcium alginate. Deposition of the bio-ink drop containing sodium alginate on a surface pre-treated in CaCl2 solution, ensures a fast cross-linking reaction and the formation of gel drops. Cells encapsulated in the alginate gel survive and proliferate. Our novel PCP technique is highly suitable for 2D and 3D cell bio-printing.

Intrinsic Thermal Desorption in a 3D Printed Multifunctional Composite CO2 Sorbent with Embedded Heating Capability

Efficient removal of CO₂ from enclosed environments is a significant challenge, particularly in human space flight where strict restrictions on mass and volume are present. To address this issue, this study describes the use of a multimaterial, layer-by-layer, additive manufacturing technique to directly print a structured multifunctional composite for CO₂ sorption with embedded, intrinsic, heating capability to facilitate thermal desorption, removing the need for an external heat source from the system. This multifunctional composite is coprinted from an ink formulation based on zeolite 13X, and an electrically conductive sorbent ink formulation, which includes metal particles blended with the zeolite. The composites are characterized using analytical and imaging tools and then tested for CO₂ adsorption/desorption. The resistivity of the conductive sorbent is <2 mΩ m, providing a temperature increase up to 200 °C under 7 V applied bias, which is sufficient to trigger CO₂ desorption. The CO₂ adsorption capability of the conductive zeolite ink appears to be unaffected by the presence of the conductive particles, meaning a large fraction of the total mass of the structured composite device is functional.

Review of Advanced Hydrogel-Based Cell Encapsulation Systems for Insulin Delivery in Type 1 Diabetes Mellitus

: Type 1 Diabetes Mellitus (T1DM) is characterized by the autoimmune destruction of β-cells in the pancreatic islets. In this regard, islet transplantation aims for the replacement of the damaged β-cells through minimally invasive surgical procedures, thereby being the most suitable strategy to cure T1DM. Unfortunately, this procedure still has limitations for its widespread clinical application, including the need for long-term immunosuppression, the lack of pancreas donors and the loss of a large percentage of islets after transplantation. To overcome the aforementioned issues, islets can be encapsulated within hydrogel-like biomaterials to diminish the loss of islets, to protect the islets resulting in a reduction or elimination of immunosuppression and to enable the use of other insulin-producing cell sources. This review aims to provide an update on the different hydrogel-based encapsulation strategies of insulin-producing cells, highlighting the advantages and drawbacks for a successful clinical application.

Improving the Rate of Translation of Tissue Engineering Products

Over 100 000 research articles and 9000 patents have been published on tissue engineering (TE) in the past 20 years. Yet, very few TE products have made their way to the market during the same period. Experts have proposed a variety of strategies to address the lack of translation of TE products. However, since these proposals are guided by qualitative insights, they are limited in scope and impact. Machine learning is utilized in the current study to analyze the entire body of patents that have been published over the past twenty years and understand patenting trends, topics, areas of application, and exemplifications. This analysis yields surprising and little-known insights about the differences in research priorities and perceptions of innovativeness of tissue engineers in academia and industry, as well as aids to chart true advances in the field during the past twenty years. It is hoped that this analysis and subsequent proposal to improve translational rates of TE products will spur much needed dialogue about this important pursuit.

[Current concepts and new developments of 3D printing in trauma surgery]

The use of 3D printing (synonyms "rapid prototyping" and "additive manufacturing") has played an increasing role in the industry for many years and finds more and more interest and application in musculoskeletal surgery, especially orthopedic trauma surgery.In this article the current literature is systematically reviewed, presented and evaluated in a condensed and comprehensive way according to anatomical (upper and lower extremities) and functional aspects. As many of the publications analyzed were feasibility studies, the degree of evidence is low and methodological weaknesses are obvious and numerous; however, this pioneering work is extremely stimulating and important for further development because the technical, medical and economic potential of this technology is huge and interesting for all those involved in the treatment of musculoskeletal problems.

iPSC Bioprinting: Where are We at?

Here, we present a concise review of current 3D bioprinting technologies applied to induced pluripotent stem cells (iPSC). iPSC have recently received a great deal of attention from the scientific and clinical communities for their unique properties, which include abundant adult cell sources, ability to indefinitely self-renew and differentiate into any tissue of the body. Bioprinting of iPSC and iPSC derived cells combined with natural or synthetic biomaterials to fabricate tissue mimicked constructs, has emerged as a technology that might revolutionize regenerative medicine and patient-specific treatment. This review covers the advantages and disadvantages of bioprinting techniques, influence of bioprinting parameters and printing condition on cell viability, and commonly used iPSC sources, and bioinks. A clear distinction is made for bioprinting techniques used for iPSC at their undifferentiated stage or when used as adult stem cells or terminally differentiated cells. This review presents state of the art data obtained from major searching engines, including Pubmed/MEDLINE, Google Scholar, and Scopus, concerning iPSC generation, undifferentiated iPSC, iPSC bioprinting, bioprinting techniques, cartilage, bone, heart, neural tissue, skin, and hepatic tissue cells derived from iPSC.

Experimental characterization and computational modeling of hydrogel cross-linking for bioprinting applications

Alginate-based hydrogels are extensively used to create bioinks for bioprinting, due to their biocompatibility, low toxicity, low costs, and slight gelling. Modeling of bioprinting process can boost experimental design reducing trial-and-error tests. To this aim, the cross-linking kinetics for the chemical gelation of sodium alginate hydrogels via calcium chloride diffusion is analyzed. Experimental measurements on the absorbed volume of calcium chloride in the hydrogel are obtained at different times. Moreover, a reaction-diffusion model is developed, accounting for the dependence of diffusive properties on the gelation degree. The coupled chemical system is solved using finite element discretizations which include the inhomogeneous evolution of hydrogel state in time and space. Experimental results are fitted within the proposed modeling framework, which is thereby calibrated and validated. Moreover, the importance of accounting for cross-linking-dependent diffusive properties is highlighted, showing that, if a constant diffusivity property is employed, the model does not properly capture the experimental evidence. Since the analyzed mechanisms highly affect the evolution of the front of the solidified gel in the final bioprinted structure, the present study is a step towards the development of reliable computational tools for the in silico optimization of protocols and post-printing treatments for bioprinting applications.

Scaffolding Strategies for Tissue Engineering and Regenerative Medicine Applications

During the past two decades, tissue engineering and the regenerative medicine field have invested in the regeneration and reconstruction of pathologically altered tissues, such as cartilage, bone, skin, heart valves, nerves and tendons, and many others. The 3D structured scaffolds and hydrogels alone or combined with bioactive molecules or genes and cells are able to guide the development of functional engineered tissues, and provide mechanical support during in vivo implantation. Naturally derived and synthetic polymers, bioresorbable inorganic materials, and respective hybrids, and decellularized tissue have been considered as scaffolding biomaterials, owing to their boosted structural, mechanical, and biological properties. A diversity of biomaterials, current treatment strategies, and emergent technologies used for 3D scaffolds and hydrogel processing, and the tissue-specific considerations for scaffolding for Tissue engineering (TE) purposes are herein highlighted and discussed in depth. The newest procedures focusing on the 3D behavior and multi-cellular interactions of native tissues for further use for in vitro model processing are also outlined. Completed and ongoing preclinical research trials for TE applications using scaffolds and hydrogels, challenges, and future prospects of research in the regenerative medicine field are also presented.

Mesenchymal Stem Cells for Spinal Cord Injury: Current Options, Limitations, and Future of Cell Therapy

Spinal cord injury (SCI) constitutes an inestimable public health issue. The most crucial phase in the pathophysiological process of SCI concerns the well-known secondary injury, which is the uncontrolled and destructive cascade occurring later with aberrant molecular signaling, inflammation, vascular changes, and secondary cellular dysfunctions. The use of mesenchymal stem cells (MSCs) represents one of the most important and promising tested strategies. Their appeal, among the other sources and types of stem cells, increased because of their ease of isolation/preservation and their properties. Nevertheless, encouraging promise from preclinical studies was followed by weak and conflicting results in clinical trials. In this review, the therapeutic role of MSCs is discussed, together with their properties, application, limitations, and future perspectives.

Recent Advances in Scaffold Design and Material for Vascularized Tissue-Engineered Bone Regeneration

Bone tissue is a highly vascularized tissue and concomitant development of the vascular system and mineralized matrix requires a synergistic interaction between osteogenesis and angioblasts. Several strategies have been applied to achieve vascularized tissue-engineered bone, including the addition of cytokines as well as pre-vascularization strategies and co-culture systems. However, the scaffold is another extremely important component to consider, and development of vascularized bone scaffolds remains one of the greatest challenges for engineering clinically relevant bone substitutes. Here, this review highlights the biomaterial selection, preparation of pre-vascularized scaffolds, composition modification of the scaffold, structural design, and the comprehensive use of the above synergistic modifications of scaffold materials for vascular scaffolds in bone tissue engineering. Moreover, a strategy is proposed for the design of future scaffold structures, in which promoting the regeneration of vascularized bone by regulating the microenvironment should be the main focus. This overview can help illuminate progress in this field and identify the most recently developed scaffolds that show the greatest potential for achieving clinically vascularized bone.

Advancing Frontiers in Bone Bioprinting

Three-dimensional (3D) bioprinting of cell-laden biomaterials is used to fabricate constructs that can mimic the structure of native tissues. The main techniques used for 3D bioprinting include microextrusion, inkjet, and laser-assisted bioprinting. Bioinks used for bone bioprinting include hydrogels loaded with bioactive ceramics, cells, and growth factors. In this review, a critical overview of the recent literature on various types of bioinks used for bone bioprinting is presented. Major challenges, such as the vascularity, clinically relevant size, and mechanical properties of 3D printed structures, that need to be addressed to successfully use the technology in clinical settings, are discussed. Emerging approaches to solve these problems are reviewed, and future strategies to design customized 3D printed structures are proposed.

3D models in the new era of immune oncology: focus on T cells, CAF and ECM

Immune checkpoint inhibitor therapy has changed clinical practice for patients with different cancers, since these agents have demonstrated a significant improvement of overall survival and are effective in many patients. However, an intrinsic or acquired resistance frequently occur and biomarkers predictive of responsiveness should help in patient selection and in defining the adequate treatment options. A deep analysis of the complexity of the tumor microenvironment is likely to further advance the field and hopefully identify more effective combined immunotherapeutic strategies. Here we review the current knowledge on tumor microenvironment, focusing on T cells, cancer associated fibroblasts and extracellular matrix. The use of 3D cell culture models to resemble tumor microenvironment landscape and to screen immunomodulatory drugs is also reviewed.

Gellan Fluid Gel as a Versatile Support Bath Material for Fluid Extrusion Bioprinting

Biomedical applications of three-dimensional (3D) printing demand complex hydrogel-based constructs laden with living cells. Advanced support materials facilitate the fabrication of such constructs. This work demonstrates the versatility and utility of a gellan fluid gel as a support bath material for fabricating freeform 3D hydrogel constructs from a variety of materials. Notably, the gellan fluid gel support bath can supply sensitive biological cross-linking agents such as enzymes to printed fluid hydrogel precursors for mild covalent hydrogel cross-linking. This mild fabrication approach is suitable for fabricating cell-laden gelatin-based constructs in which mammalian cells can form intercellular contacts within hours of fabrication; cellular activity is observed over several days within printed constructs. In addition, gellan is compatible with a wide range of ionic and thermal conditions, which makes it a suitable support material for ionically cross-linked structures generated by printing alginate-based ink formulations as well as thermosensitive hydrogel constructs formed from gelatin. Ultraviolet irradiation of printed structures within the support bath is also demonstrated for photoinitiated cross-linking of acrylated ink materials. Furthermore, gellan support material performance in terms of printed filament stability and residual support material on constructs is found to be comparable and superior, respectively, to previously reported support materials.

Skin bioprinting: the future of burn wound reconstruction?

Burns are a significant cause of trauma, and over the years, the focus of patient care has shifted from just survival to facilitation of improved functional outcomes. Typically, burn treatment, especially in the case of extensive burn injuries, involves surgical excision of injured skin and reconstruction of the burn injury with the aid of skin substitutes. Conventional skin substitutes do not contain all skin cell types and do not facilitate recapitulation of native skin physiology. Three-dimensional (3D) bioprinting for reconstruction of burn injuries involves layer-by-layer deposition of cells along with scaffolding materials over the injured areas. Skin bioprinting can be done either in situ or in vitro. Both these approaches are similar except for the site of printing and tissue maturation. There are technological and regulatory challenges that need to be overcome for clinical translation of bioprinted skin for burn reconstruction. However, the use of bioprinting for skin reconstruction following burns is promising; bioprinting will enable accurate placement of cell types and precise and reproducible fabrication of constructs to replace the injured or damaged sites. Overall, 3D bioprinting is a very transformative technology, and its use for wound reconstruction will lead to a paradigm shift in patient outcomes. In this review, we aim to introduce bioprinting, the different stages involved, in vitro and in vivo skin bioprinting, and the various clinical and regulatory challenges in adoption of this technology.

Scanningless and continuous 3D bioprinting of human tissues with decellularized extracellular matrix

Decellularized extracellular matrices (dECMs) have demonstrated excellent utility as bioscaffolds in recapitulating the complex biochemical microenvironment, however, their use as bioinks in 3D bioprinting to generate functional biomimetic tissues has been limited by their printability and lack of tunable physical properties. Here, we describe a method to produce photocrosslinkable tissue-specific dECM bioinks for fabricating patient-specific tissues with high control over complex microarchitecture and mechanical properties using a digital light processing (DLP)-based scanningless and continuous 3D bioprinter. We demonstrated that tissue-matched dECM bioinks provided a conducive environment for maintaining high viability and maturation of human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes and hepatocytes. Microscale patterning also guided spontaneous cellular reorganization into predesigned striated heart and lobular liver structures through biophysical cues. Our methodology enables a light-based approach to rapidly bioprint dECM bioinks with accurate tissue-scale design to engineer physiologically-relevant functional human tissues for applications in biology, regenerative medicine, and diagnostics.

Poly(alkyl glycidyl ether) hydrogels for harnessing the bioactivity of engineered microbes

Herein, we describe a method to produce yeast-laden hydrogel inks for the direct-write 3D printing of cuboidal lattices for immobilized whole-cell catalysis.

Modulating physical, chemical, and biological properties in 3D printing for tissue engineering applications

Over the years, 3D printing technologies have transformed the field of tissue engineering and regenerative medicine by providing a tool that enables unprecedented flexibility, speed, control, and precision over conventional manufacturing methods. As a result, there has been a growing body of research focused on the development of complex biomimetic tissues and organs produced via 3D printing to serve in various applications ranging from models for drug development to translational research and biological studies. With the eventual goal to produce functional tissues, an important feature in 3D printing is the ability to tune and modulate the microenvironment to better mimic in vivo conditions to improve tissue maturation and performance. This paper reviews various strategies and techniques employed in 3D printing from the perspective of achieving control over physical, chemical, and biological properties to provide a conducive microenvironment for the development of physiologically relevant tissues. We will also highlight the current limitations associated with attaining each of these properties in addition to introducing challenges that need to be addressed for advancing future 3D printing approaches.

Bio-Based Polymers for 3D Printing of Bioscaffolds

Three-dimensional (3D) printing technologies enable not only faster bioconstructs development but also on-demand and customized manufacturing, offering patients a personalized biomedical solution. This emerging technique has a great potential for fabricating bioscaffolds with complex architectures and geometries and specifically tailored for use in regenerative medicine. The next major innovation in this area will be the development of biocompatible and histiogenic 3D printing materials with bio-based printable polymers. This review will briefly discuss 3D printing techniques and their current limitations, with a focus on novel bio-based polymers as 3D printing feedstock for clinical medicine and tissue regeneration.

Addressing Unmet Clinical Needs with 3D Printing Technologies

Recent advances in 3D printing have enabled the creation of novel 3D constructs and devices with an unprecedented level of complexity, properties, and functionalities. In contrast to manufacturing techniques developed for mass production, 3D printing encompasses a broad class of fabrication technologies that can enable 1) the creation of highly customized and optimized 3D physical architectures from digital designs; 2) the synergistic integration of properties and functionalities of distinct classes of materials to create novel hybrid devices; and 3) a biocompatible fabrication approach that facilitates the creation and cointegration of biological constructs and systems. This progress report describes how these capabilities can potentially address a myriad of unmet clinical needs. First, the creation of 3D-printed prosthetics to regain lost functionalities by providing structural support for skeletal and tubular organs is highlighted. Second, novel drug delivery strategies aided by 3D-printed devices are described. Third, the advancement of medical research heralded by 3D-printed tissue/organ-on-chips systems is discussed. Fourth, the developments of 3D-printed tissue and organ regeneration are explored. Finally, the potential for seamless integration of engineered organs with active devices by leveraging the versatility of multimaterial 3D printing is envisioned.

3D bioprinting of functional tissue models for personalized drug screening and in vitro disease modeling

3D bioprinting is emerging as a promising technology for fabricating complex tissue constructs with tailored biological components and mechanical properties. Recent advances have enabled scientists to precisely position materials and cells to build functional tissue models for in vitro drug screening and disease modeling. This review presents state-of-the-art 3D bioprinting techniques and discusses the choice of cell source and biomaterials for building functional tissue models that can be used for personalized drug screening and disease modeling. In particular, we focus on 3D-bioprinted liver models, cardiac tissues, vascularized constructs, and cancer models for their promising applications in medical research, drug discovery, toxicology, and other pre-clinical studies.

Essential steps in bioprinting: From pre- to post-bioprinting

An increasing demand for directed assembly of biomaterials has inspired the development of bioprinting, which facilitates the assembling of both cellular and acellular inks into well-arranged three-dimensional (3D) structures for tissue fabrication. Although great advances have been achieved in the recent decade, there still exist issues to be addressed. Herein, a review has been systematically performed to discuss the considerations in the entire procedure of bioprinting. Though bioprinting is advancing at a rapid pace, it is seen that the whole process of obtaining tissue constructs from this technique involves multiple-stages, cutting across various technology domains. These stages can be divided into three broad categories: pre-bioprinting, bioprinting and post-bioprinting. Each stage can influence others and has a bearing on the performance of fabricated constructs. For example, in pre-bioprinting, tissue biopsy and cell expansion techniques are essential to ensure a large number of cells are available for mass organ production. Similarly, medical imaging is needed to provide high resolution designs, which can be faithfully bioprinted. In the bioprinting stage, compatibility of biomaterials is needed to be matched with solidification kinetics to ensure constructs with high cell viability and fidelity are obtained. On the other hand, there is a need to develop bioprinters, which have high degrees of freedom of movement, perform without failure concerns for several hours and are compact, and affordable. Finally, maturation of bioprinted cells are governed by conditions provided during the post-bioprinting process. This review, for the first time, puts all the bioprinting stages in perspective of the whole process of bioprinting, and analyzes their current state-of-the art. It is concluded that bioprinting community will recognize the relative importance and optimize the parameter of each stage to obtain the desired outcomes.

Engineering innervated secretory epithelial organoids by magnetic three-dimensional bioprinting for stimulating epithelial growth in salivary glands

Current saliva-based stimulation therapies for radiotherapy-induced xerostomia are not fully effective due to the presence of damaged secretory epithelia and nerves in the salivary gland (SG). Hence, three-dimensional bio-engineered organoids are essential to regenerate the damaged SG. Herein, a recently validated three-dimensional (3D) biofabrication system, the magnetic 3D bioprinting (M3DB), is tested to generate innervated secretory epithelial organoids from a neural crest-derived mesenchymal stem cell, the human dental pulp stem cell (hDPSC). Cells are tagged with magnetic nanoparticles (MNP) and spatially arranged with magnet dots to generate 3D spheroids. Next, a SG epithelial differentiation stage was completed with fibroblast growth factor 10 (4-400 ng/ml) to recapitulate SG epithelial morphogenesis and neurogenesis. The SG organoids were then transplanted into ex vivo model to evaluate their epithelial growth and innervation. M3DB-formed spheroids exhibited both high cell viability rate (>90%) and stable ATP intracellular activity compared to MNP-free spheroids. After differentiation, spheroids expressed SG epithelial compartments including secretory epithelial, ductal, myoepithelial, and neuronal. Fabricated organoids also produced salivary α-amylase upon FGF10 stimulation, and intracellular calcium mobilization and trans-epithelial resistance was elicited upon neurostimulation with different neurotransmitters. After transplantation, the SG-like organoids significantly stimulated epithelial and neuronal growth in damaged SG. It is the first time bio-functional innervated SG-like organoids are bioprinted. Thus, this is an important step towards SG regeneration and the treatment of radiotherapy-induced xerostomia.

3D Printing of Thermoresponsive Polyisocyanide (PIC) Hydrogels as Bioink and Fugitive Material for Tissue Engineering

Despite the rapid and great developments in the field of 3D hydrogel printing, a major ongoing challenge is represented by the development of new processable materials that can be effectively used for bioink formulation. In this work, we present an approach to 3D deposit, a new class of fully-synthetic, biocompatible PolyIsoCyanide (PIC) hydrogels that exhibit a reverse gelation temperature close to physiological conditions (37 °C). Being fully-synthetic, PIC hydrogels are particularly attractive for tissue engineering, as their properties—such as hydrogel stiffness, polymer solubility, and gelation kinetics—can be precisely tailored according to process requirements. Here, for the first time, we demonstrate the feasibility of both 3D printing PIC hydrogels and of creating dual PIC-Gelatin MethAcrylate (GelMA) hydrogel systems. Furthermore, we propose the use of PIC as fugitive hydrogel to template structures within GelMA hydrogels. The presented approach represents a robust and valid alternative to other commercial thermosensitive systems—such as those based on Pluronic F127—for the fabrication of 3D hydrogels through additive manufacturing technologies to be used as advanced platforms in tissue engineering.

Three-Dimensional Printing and Cell Therapy for Wound Repair

Significance: Skin tissue damage is a major challenge and a burden on healthcare systems, from burns and other trauma to diabetes and vascular disease. Although the biological complexities are relatively well understood, appropriate repair mechanisms are scarce. Three-dimensional bioprinting is a layer-based approach to regenerative medicine, whereby cells and cell-based materials can be dispensed in fine spatial arrangements to mimic native tissue. Recent Advances: Various bioprinting techniques have been employed in wound repair-based skin tissue engineering, from laser-induced forward transfer to extrusion-based methods, and with the investigation of the benefits and shortcomings of each, with emphasis on biological compatibility and cell proliferation, migration, and vitality. Critical issues: Development of appropriate biological inks and the vascularization of newly developed tissues remain a challenge within the field of skin tissue engineering. Future Directions: Progress within bioprinting requires close interactions between material scientists, tissue engineers, and clinicians. Microvascularization, integration of multiple cell types, and skin appendages will be essential for creation of complex skin tissue constructs.

Additive Manufacturing of Catalytically Active Living Materials

Living materials, which are composites of living cells residing in a polymeric matrix, are designed to utilize the innate functionalities of the cells to address a broad range of applications such as fermentation and biosensing. Herein, we demonstrate the additive manufacturing of catalytically active living materials (AMCALM) for continuous fermentation. A multi-stimuli-responsive yeast-laden hydrogel ink, based on F127-dimethacrylate, was developed and printed using a direct-write 3D printer. The reversible stimuli-responsive behaviors of the polymer hydrogel inks to temperature and pressure are critical, as they enabled the facile incorporation of yeast cells and subsequent fabrication of 3D lattice constructs. Subsequent photo-cross-linking of the printed polymer hydrogel afforded a robust elastic material. These yeast-laden living materials were metabolically active in the fermentation of glucose into ethanol for 2 weeks in a continuous batch process without significant reduction in efficiency (∼90% yield of ethanol). This cell immobilization platform may potentially be applicable toward other genetically modified yeast strains to produce other high-value chemicals in a continuous biofermentation process.

Three-dimensional extrusion bioprinting of single- and double-network hydrogels containing dynamic covalent crosslinks

The fabrication of three-dimensional (3D) scaffolds is indispensable to tissue engineering and 3D printing is emerging as an important approach towards this. Hydrogels are often used as inks in extrusion-based 3D printing, including with encapsulated cells; however, numerous challenging requirements exist, including appropriate viscosity, the ability to stabilize after extrusion, and cytocompatibility. Here, we present a shear-thinning and self-healing hydrogel crosslinked through dynamic covalent chemistry for 3D bioprinting. Specifically, hyaluronic acid was modified with either hydrazide or aldehyde groups and mixed to form hydrogels containing a dynamic hydrazone bond. Due to their shear-thinning and self-healing properties, the hydrogels could be extruded for 3D printing of structures with high shape fidelity, stability to relaxation, and cytocompatibility with encapsulated fibroblasts (>80% viability). Forces for extrusion and filament sizes were dependent on parameters such as material concentration and needle gauge. To increase scaffold functionality, a second photocrosslinkable interpenetrating network was included that was used for orthogonal photostiffening and photopatterning through a thiol-ene reaction. Photostiffening increased the scaffold's modulus (∼300%) while significantly decreasing erosion (∼70%), whereas photopatterning allowed for spatial modification of scaffolds with dyes. Overall, this work introduces a simple approach to both fabricate and modify 3D printed scaffolds. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 865-875, 2018.

3D printing of photopolymers

Recent progress in the photoinitiators and monomers/oligomers of photopolymers for 3D printing is presented in the review.

A highly printable and biocompatible hydrogel composite for direct printing of soft and perfusable vasculature-like structures

Vascularization is one major obstacle in bioprinting and tissue engineering. In order to create thick tissues or organs that can function like original body parts, the presence of a perfusable vascular system is essential. However, it is challenging to bioprint a hydrogel-based three-dimensional vasculature-like structure in a single step. In this paper, we report a new hydrogel-based composite that offers impressive printability, shape integrity, and biocompatibility for 3D bioprinting of a perfusable complex vasculature-like structure. The hydrogel composite can be used on a non-liquid platform and is printable at human body temperature. Moreover, the hydrogel composite supports both cell proliferation and cell differentiation. Our results represent a potentially new vascularization strategy for 3D bioprinting and tissue engineering.

3D neural tissue models: From spheroids to bioprinting

Three-dimensional (3D) in vitro neural tissue models provide a better recapitulation of in vivo cell-cell and cell-extracellular matrix interactions than conventional two-dimensional (2D) cultures. Therefore, the former is believed to have great potential for both mechanistic and translational studies. In this paper, we review the recent developments in 3D in vitro neural tissue models, with a particular focus on the emerging bioprinted tissue structures. We draw on specific examples to describe the merits and limitations of each model, in terms of different applications. Bioprinting offers a revolutionary approach for constructing repeatable and controllable 3D in vitro neural tissues with diverse cell types, complex microscale features and tissue level responses. Further advances in bioprinting research would likely consolidate existing models and generate complex neural tissue structures bearing higher fidelity, which is ultimately useful for probing disease-specific mechanisms, facilitating development of novel therapeutics and promoting neural regeneration.

Fabrication and characterization of a 3D bioprinted nanoparticle-hydrogel hybrid device for biomimetic detoxification

A biomimetic micro/nanodevice is 3D bioprinted using polyethylene glycol (PEG) hydrogel as the supporting platform, along with the red blood cell (RBC) membrane-coated nanoparticles (RBC-NPs) encapsulated in the hydrogel as the detoxification mechanism. RBC-NPs are prepared through a nanoprecipitation and coating method and then mixed into the poly(ethylene glycol) diacrylate (PEGDA) monomer solution for 3D bioprinting through photopolymerization. This resulting detoxification device is engineered with multiple inner channels for the RBC-NPs to nonspecifically soak up the various toxins flowing through the channels. Different shapes (i.e. star or triangle) of the channel are fabricated, each with a larger surface area than the generic circle shape. The device is characterized for microstructure, nanoparticle encapsulation and function, and its detoxification ability. Overall, the strategy of incorporating functional nanoparticles into a biocompatible hydrogel as the supporting platform may enable localized, patient specific controlled therapeutics for detoxification, drug delivery, and other precision medicine application.

Fabrication of complex-shaped hydrogels by diffusion controlled gelation of nanocellulose crystallites

In this study we investigated the fabrication of small hydrogel objects by the coordination-driven assembly of supramolecular rod-like crystallites of nanocellulose, using ionotropic gelation as a methodological approach and Ca²⁺ as a gelling agent. We proved that the gelation process is diffusion-mediated and fitting the equations modelling this process to the profile of the Ca²⁺ front, a Ca²⁺ diffusion coefficient in the incipient hydrogel of (4.5 ± 1.1) × 10^-6 cm² s^-1 was calculated. At the steady-state a spatially homogeneous distribution of Ca²⁺-crosslinked sites in the hydrogel network was observed. External ionotropic gelation produced beads, wires or disks, while core-shell capsules were obtained by inverse ionotropic gelation. We demonstrated that equilibrium and dynamics of the distribution of Ca²⁺ offer the opportunity to design precisely the size and shape of these small hydrogel objects. In particular, the core size and the shell thickness of the capsules can be tailored under kinetic controlled conditions. The proposed approach, with supramolecular structures of the natural source as assembling components and the water-in-water fabrication process, is fast, simple, and requires only sustainable chemistry and is easily implementable in automatic microfluidic platforms.