3D-Printed Multidrug-Eluting Stent from Graphene-Nanoplatelet-Doped Biodegradable Polymer Composite

Recent advances in implantable sensors and electronics using printable materials for advanced healthcare

This review article focuses on the recent printing technological progress in healthcare, underscoring the significant potential of implantable devices across diverse applications. Printing technologies have widespread use in developing health monitoring devices, diagnostic systems, and surgical devices. Recent years have witnessed remarkable progress in fabricating low-profile implantable devices, driven by advancements in printing technologies and nanomaterials. The importance of implantable biosensors and bioelectronics is highlighted, specifically exploring printing tools using bio-printable inks for practical applications, including a detailed examination of fabrication processes and essential parameters. This review also justifies the need for mechanical and electrical compatibility between bioelectronics and biological tissues. In addition to technological aspects, this article delves into the importance of appropriate packaging methods to enhance implantable devices' performance, compatibility, and longevity, which are made possible by integrating cutting-edge printing technology. Collectively, we aim to shed light on the holistic landscape of implantable biosensors and bioelectronics, showcasing their evolving role in advancing healthcare through innovative printing technologies.

Suitably Incorporated Hydrophobic, Redox-Active Drug in Poly Lactic Acid-Graphene Nanoplatelet Composite Generates 3D-Printed Medicinal Patch for Electrostimulatory Therapeutics

Polymer carbon composites have been reported for improved mechanical, thermal and electrical properties to provide reduced side effect by 3D printing personalized biomedical drug delivery devices. But control on homogeneity in loading and release of dopants like carbon allotropes and drugs, respectively, in the bulk and on the surface has always been a challenge. Herein, we are reporting a methodological cascade to achieve a model, customizable, 3D printed, homogeneously layered and electrically stimulatory, PLA-Graphene nanoplatelet (hl-PLGR) based drug delivery device, called 3D-est-MediPatch. The medicinal patch has been prepared by 3D-printing a Nic-hl-PLGR composite obtained by incorporating a redox active model drug, niclosamide (Nic) in hl-PLGR. The composite of Nic-hl-PLGR was characterized in three sequentially complex forms─composite film, hot melt extruded (HME) filament, and 3D printed (3DP) patches to understand the effect of filament extrusion and 3D-printing processes on Nic-hl-PLGR composite and overall drug incorporation efficiency and control. The incorporation of graphene was found to improve the homogeneity of the drug, and the hot melt extrusion improved the dispersion of drug and graphene fillers in the composite. The electroresponsive drug release from the Nic-hl-PLGR composite was found to be controllably accelerated compared to the drug release by diffusion, in simulated buffer condition. The released drug concentration was found to reach within the IC50 range for malignant melanoma cell (A375) and showed in vitro selectively, with reduced effects in noncancerous, fibroblast cells (NIH3T3). Further, the feasibility of application for this system was assessed in generating personalized 3D-est-MediPatch for skin, liver and spleen tissues in ex-vivo scenario. It showed excellent feasibility and efficacy of the 3D-est-MediPatch in controlled and personalized release of drugs during electrostimulation. Thus, a model platform, 3D-est-MediPatch, could be achieved by suitably incorporating a hydrophobic, redox-active drug (niclosamide) in poly lactic acid-graphene nanoplatelet composite for electrostimulatory therapeutics with reduced side effects.

Application of 3D, 4D, 5D, and 6D bioprinting in cancer research: what does the future look like?

The application of three- and four-dimensional (3D/4D) printing in cancer research represents a significant advancement in understanding and addressing the complexities of cancer biology. 3D/4D materials provide more physiologically relevant environments compared to traditional two-dimensional models, allowing for a more accurate representation of the tumor microenvironment that enables researchers to study tumor progression, drug responses, and interactions with surrounding tissues under conditions similar to in vivo conditions. The dynamic nature of 4D materials introduces the element of time, allowing for the observation of temporal changes in cancer behavior and response to therapeutic interventions. The use of 3D/4D printing in cancer research holds great promise for advancing our understanding of the disease and improving the translation of preclinical findings to clinical applications. Accordingly, this review aims to briefly discuss 3D and 4D printing and their advantages and limitations in the field of cancer. Moreover, new techniques such as 5D/6D printing and artificial intelligence (AI) are also introduced as methods that could be used to overcome the limitations of 3D/4D printing and opened promising ways for the fast and precise diagnosis and treatment of cancer.

Drug eluting protein and polysaccharides-based biofunctionalized fabric textiles- pioneering a new frontier in tissue engineering: An extensive review

In the ever-evolving landscape of tissue engineering, medicated biotextiles have emerged as a game-changer. These remarkable textiles have garnered significant attention for their ability to craft tissue scaffolds that closely mimic the properties of natural tissues. This comprehensive review delves into the realm of medicated protein and polysaccharide-based biotextiles, exploring a diverse array of fabric materials. We unravel the intricate web of fabrication methods, ranging from weft/warp knitting to plain/stain weaving and braiding, each lending its unique touch to the world of biotextiles creation. Fibre production techniques, such as melt spinning, wet/gel spinning, and multicomponent spinning, are demystified to shed light on the magic behind these ground-breaking textiles. The biotextiles thus crafted exhibit exceptional physical and chemical properties that hold immense promise in the field of tissue engineering (TE). Our review underscores the myriad applications of drug-eluting protein and polysaccharide-based textiles, including TE, tissue repair, regeneration, and wound healing. Additionally, we delve into commercially available products that harness the potential of medicated biotextiles, paving the way for a brighter future in healthcare and regenerative medicine. Step into the world of innovation with medicated biotextiles-where science meets the art of healing.

3D-Printed Shape Memory Poly(alkylene terephthalate) Scaffolds as Cardiovascular Stents Revealing Enhanced Endothelialization

Cardiovascular diseases are the leading cause of death and current treatments such as stents still suffer from disadvantages. Balloon expansion causes damage to the arterial wall and limited and delayed endothelialization gives rise to restenosis and thrombosis. New more performing materials that circumvent these disadvantages are required to improve the success rate of interventions. To this end, the use of a novel polymer, poly(hexamethylene terephthalate), is investigated for this application. The synthesis to obtain polymers with high molar masses up to 126.5 kg mol-1 is optimized and a thorough chemical and thermal analysis is performed. The polymers are 3D-printed into personalized cardiovascular stents using the state-of-the-art solvent-cast direct-writing technique, the potential of these stents to expand using their shape memory behavior is established, and it is shown that the stents are more resistant to compression than the poly(l-lactide) benchmark. Furthermore, the polymer's hydrolytic stability is demonstrated in an accelerated degradation study of 6 months. Finally, the stents are subjected to an in vitro biological evaluation, revealing that the polymer is non-hemolytic and supports significant endothelialization after only 7 days, demonstrating the enormous potential of these polymers to serve cardiovascular applications.

3D printing of biologics-what has been accomplished to date?

Three-dimensional (3D) printing is a promising approach for the stabilization and delivery of non-living biologics. This versatile tool builds complex structures and customized resolutions, and has significant potential in various industries, especially pharmaceutics and biopharmaceutics. Biologics have become increasingly prevalent in the field of medicine due to their diverse applications and benefits. Stability is the main attribute that must be achieved during the development of biologic formulations. 3D printing could help to stabilize biologics by entrapment, support binding, or crosslinking. Furthermore, gene fragments could be transited into cells during co-printing, when the pores on the membrane are enlarged. This review provides: (i) an introduction to 3D printing technologies and biologics, covering genetic elements, therapeutic proteins, antibodies, and bacteriophages; (ii) an overview of the applications of 3D printing of biologics, including regenerative medicine, gene therapy, and personalized treatments; (iii) information on how 3D printing could help to stabilize and deliver biologics; and (iv) discussion on regulations, challenges, and future directions, including microneedle vaccines, novel 3D printing technologies and artificial-intelligence-facilitated research and product development. Overall, the 3D printing of biologics holds great promise for enhancing human health by providing extended longevity and enhanced quality of life, making it an exciting area in the rapidly evolving field of biomedicine.

Clinical situations for which 3D Printing is considered an appropriate representation or extension of data contained in a medical imaging examination: vascular conditions

BACKGROUND

Medical three-dimensional (3D) printing has demonstrated utility and value in anatomic models for vascular conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (3DPSIG) provides appropriateness recommendations for vascular 3D printing indications.

METHODS

A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with vascular indications. Each study was vetted by the authors and strength of evidence was assessed according to published appropriateness ratings.

RESULTS

Evidence-based recommendations for when 3D printing is appropriate are provided for the following areas: aneurysm, dissection, extremity vascular disease, other arterial diseases, acute venous thromboembolic disease, venous disorders, lymphedema, congenital vascular malformations, vascular trauma, vascular tumors, visceral vasculature for surgical planning, dialysis access, vascular research/development and modeling, and other vasculopathy. Recommendations are provided in accordance with strength of evidence of publications corresponding to each vascular condition combined with expert opinion from members of the 3DPSIG.

CONCLUSION

This consensus appropriateness ratings document, created by the members of the 3DPSIG, provides an updated reference for clinical standards of 3D printing for the care of patients with vascular conditions.

Incorporation of Controlled Release Systems Improves the Functionality of Biodegradable 3D Printed Cardiovascular Implants

New horizons in cardiovascular research are opened by using 3D printing for biodegradable implants. This additive manufacturing approach allows the design and fabrication of complex structures according to the patient's imaging data in an accurate, reproducible, cost-effective, and quick manner. Acellular cardiovascular implants produced from biodegradable materials have the potential to provide enough support for in situ tissue regeneration while gradually being replaced by neo-autologous tissue. Subsequently, they have the potential to prevent long-term complications. In this Review, we discuss the current status of 3D printing applications in the development of biodegradable cardiovascular implants with a focus on design, biomaterial selection, fabrication methods, and advantages of implantable controlled release systems. Moreover, we delve into the intricate challenges that accompany the clinical translation of these groundbreaking innovations, presenting a glimpse of potential solutions poised to enable the realization of these technologies in the realm of cardiovascular medicine.

Advances in Fabrication Technologies for the Development of Next-Generation Cardiovascular Stents

Coronary artery disease is the most prevalent cardiovascular disease, claiming millions of lives annually around the world. The current treatment includes surgically inserting a tubular construct, called a stent, inside arteries to restore blood flow. However, due to lack of patient-specific design, the commercial products cannot be used with different vessel anatomies. In this review, we have summarized the drawbacks in existing commercial metal stents which face problems of restenosis and inflammatory responses, owing to the development of neointimal hyperplasia. Further, we have highlighted the fabrication of stents using biodegradable polymers, which can circumvent most of the existing limitations. In this regard, we elaborated on the utilization of new fabrication methodologies based on additive manufacturing such as three-dimensional printing to design patient-specific stents. Finally, we have discussed the functionalization of these stent surfaces with suitable bioactive molecules which can prove to enhance their properties in preventing thrombosis and better healing of injured blood vessel lining.

3D Printed Graphene and Graphene/Polymer Composites for Multifunctional Applications

Three-dimensional (3D) printing, alternatively known as additive manufacturing, is a transformative technology enabling precise, customized, and efficient manufacturing of components with complex structures. It revolutionizes traditional processes, allowing rapid prototyping, cost-effective production, and intricate designs. The 3D printed graphene-based materials combine graphene's exceptional properties with additive manufacturing's versatility, offering precise control over intricate structures with enhanced functionalities. To gain comprehensive insights into the development of 3D printed graphene and graphene/polymer composites, this review delves into their intricate fabrication methods, unique structural attributes, and multifaceted applications across various domains. Recent advances in printable materials, apparatus characteristics, and printed structures of typical 3D printing techniques for graphene and graphene/polymer composites are addressed, including extrusion methods (direct ink writing and fused deposition modeling), photopolymerization strategies (stereolithography and digital light processing) and powder-based techniques. Multifunctional applications in energy storage, physical sensor, stretchable conductor, electromagnetic interference shielding and wave absorption, as well as bio-applications are highlighted. Despite significant advancements in 3D printed graphene and its polymer composites, innovative studies are still necessary to fully unlock their inherent capabilities.

Additive manufacturing of sustainable biomaterials for biomedical applications

Biopolymers are promising environmentally benign materials applicable in multifarious applications. They are especially favorable in implantable biomedical devices thanks to their excellent unique properties, including bioactivity, renewability, bioresorbability, biocompatibility, biodegradability and hydrophilicity. Additive manufacturing (AM) is a flexible and intricate manufacturing technology, which is widely used to fabricate biopolymer-based customized products and structures for advanced healthcare systems. Three-dimensional (3D) printing of these sustainable materials is applied in functional clinical settings including wound dressing, drug delivery systems, medical implants and tissue engineering. The present review highlights recent advancements in different types of biopolymers, such as proteins and polysaccharides, which are employed to develop different biomedical products by using extrusion, vat polymerization, laser and inkjet 3D printing techniques in addition to normal bioprinting and four-dimensional (4D) bioprinting techniques. This review also incorporates the influence of nanoparticles on the biological and mechanical performances of 3D-printed tissue scaffolds. This work also addresses current challenges as well as future developments of environmentally friendly polymeric materials manufactured through the AM techniques. Ideally, there is a need for more focused research on the adequate blending of these biodegradable biopolymers for achieving useful results in targeted biomedical areas. We envision that biopolymer-based 3D-printed composites have the potential to revolutionize the biomedical sector in the near future.

A narrative review on the role of carbon nanoparticles in oncology

The lymphatic system is the first site of metastasis for most tumors and is a common reason for the failure of cancer therapy. The lymphatic system's anatomical properties make it difficult to deliver chemotherapy agents at therapeutic concentrations while avoiding systemic toxicity. Carbon nanoparticles offer a promising alternative for identifying and transporting therapeutic molecules. The larger diameter of lymphatic vessels compared to the diameter of blood vessels, allows carbon nanoparticles to selectively enter the lymphatic system once administered subcutaneously. Carbon nanoparticles stain tumor-draining lymph nodes black following intratumoral injection, making them useful in sentinel lymph node mapping. Drug-loaded carbon nanoparticles allow higher concentrations of chemotherapeutics to accumulate in regional lymph nodes while decreasing plasma drug accumulation. The use of carbon nanoparticles for chemotherapy delivery has been associated with lower mortality, fewer histopathology changes in vital organs, and lower serum concentrations of hepatocellular enzymes. This review will focus on the ability of carbon nanoparticles to target the lymphatics as well as their current and potential applications in sentinel lymph node mapping and oncology treatment regimens. This article is categorized under: Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery.

A Comparative Analysis of Chemical, Plasma and In Situ Modification of Graphene Nanoplateletes for Improved Performance of Fused Filament Fabricated Thermoplastic Polyurethane Composites Parts

The limited number of materials and mechanical weakness of fused deposition modeling (FDM) parts are deficiencies of FDM technology. The preparation of polymer composites parts with suitable filler is a promising method to improve the properties of the 3D printed parts. However, the agglomerate of filler makes its difficult disperse in the matrix. In this work, graphene nanoplatelets (GnPs) were surface modified with chemical, low-temperature plasma and in situ methods, in order to apply them as fillers for thermoplastic polyurethane (TPU). Following its modification, the surface chemical composition of GnPs was analyzed. Three wt% of surface-modified GnPs were incorporated into TPU to produce FDM filaments using a melting compounding process. Their effects on rheology properties and electrical conductivity on TPU/GnPs composites, as well as the dimensional accuracy and mechanical properties of FDM parts, are compared. The images of sample facture surfaces were examined by scanning electron microscope (SEM) to determine the dispersion of GnPs. Results indicate that chemical treatment of GnPs with zwitterionic surfactant is a good candidate to significantly enhance TPU filaments, when considering the FDM parts demonstrated the highest mechanical properties and lowest dimensional accuracy.

Development of Biodegradable Polymeric Stents for the Treatment of Cardiovascular Diseases

Cardiovascular disease has become the leading cause of death. A vascular stent is an effective means for the treatment of cardiovascular diseases. In recent years, biodegradable polymeric vascular stents have been widely investigated by researchers because of its degradability and clinical application potential for cardiovascular disease treatment. Compared to non-biodegradable stents, these stents are designed to degrade after vascular healing, leaving regenerated healthy arteries. This article reviews and summarizes the recent advanced methods for fabricating biodegradable polymeric stents, including injection molding, weaving, 3D printing, and laser cutting. Besides, the functional modification of biodegradable polymeric stents is also introduced, including visualization, anti-thrombus, endothelialization, and anti-inflammation. In the end, the challenges and future perspectives of biodegradable polymeric stents were discussed.

Three-Dimensional (3D) Printing in Cancer Therapy and Diagnostics: Current Status and Future Perspectives

Three-dimensional (3D) printing is a technique where the products are printed layer-by-layer via a series of cross-sectional slices with the exact deposition of different cell types and biomaterials based on computer-aided design software. Three-dimensional printing can be divided into several approaches, such as extrusion-based printing, laser-induced forward transfer-based printing systems, and so on. Bio-ink is a crucial tool necessary for the fabrication of the 3D construct of living tissue in order to mimic the native tissue/cells using 3D printing technology. The formation of 3D software helps in the development of novel drug delivery systems with drug screening potential, as well as 3D constructs of tumor models. Additionally, several complex structures of inner tissues like stroma and channels of different sizes are printed through 3D printing techniques. Three-dimensional printing technology could also be used to develop therapy training simulators for educational purposes so that learners can practice complex surgical procedures. The fabrication of implantable medical devices using 3D printing technology with less risk of infections is receiving increased attention recently. A Cancer-on-a-chip is a microfluidic device that recreates tumor physiology and allows for a continuous supply of nutrients or therapeutic compounds. In this review, based on the recent literature, we have discussed various printing methods for 3D printing and types of bio-inks, and provided information on how 3D printing plays a crucial role in cancer management.

What makes carbon nanoparticle a potent material for biological application?

Carbon materials are generally utilized in the form of carbon allotropes and their characteristics are exploited as such or for improving the thermal, electrical, optical, and mechanical properties of other biomaterials. This has now found a broader share in conventional biomaterial space with the generation of nanodiamond, carbon dot, carbon nanoparticles (CNPs), and so forth. With properties of better biocompatibility, intrinsic optical emission, aqueous suspendability, and easier surface conjugation possibilities made CNPs as one of the fore most choice for biological applications especially for use in intracellular spaces. There are various reports available presenting methods of preparing, characterizing, and using CNPs for various biological applications but a collection of information on what makes CNP a suitable biomaterial to achieve those biological activities is yet to be provided in a significant way. Herein, a series of correlations among synthesis, characterization, and mode of utilization of CNP have been incorporated along with the variations in its use as agent for sensing, imaging, and therapy of different diseases or conditions. It is ensembled that how simplified and optimized methods of synthesis is correlated with specific characteristics of CNPs which were found to be suitable in the specific biological applications. These comparisons and correlations among various CNPs, will surely provide a platform to generate new edition of this nanomaterial with improvised applications and newer methods of evaluating structural, physical, and functional properties. This may ensure the eventual use of CNPs for human being for specific need in near future. This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > Biosensing Diagnostic Tools > In Vitro Nanoparticle-Based Sensing Therapeutic Approaches and Drug Discovery > Emerging Technologies.

3D printing advances in the development of stents

3D printing technologies have found several applications within the biomedical sector including in the fabrication of medical devices, advanced visualization, diagnosis planning and simulation of surgical procedures. One of the areas in which of 3D printing is anticipated to revolutionised is the manufacturing of implantable bioresorbable drug-eluting scaffolds (stents). The ability to customize and create personalised tailor-made bioresorbable scaffolds has the potential to help solve many of the challenges associated with stenting, such as inappropriate stent sizing and design, abolish late stent thrombosis and help artery growth; 3D printing offers a rapid prototyping and effective method of producing stents making customization of designs feasible. This review provides an overview of the subjects and summarizes the latest research in the 3D printing technologies employed for the design and fabrication of bioresorbable stents including materials with the required printable and mechanical properties. Finally, we present a regulatory perspective on the development and engineering of 3D printed implantable stents.

Three-dimensional printed personalized drug devices with anatomical fit: a review

OBJECTIVES

Three-dimensional printing (3DP) has opened the era of drug personalization, promising to revolutionize the pharmaceutical field with improvements in efficacy, safety and compliance of the treatments. As a result of these investigations, a vast therapeutic field has opened for 3DP-loaded drug devices with an anatomical fit. Along these lines, innovative dosage forms, unimaginable until recently, can be obtained. This review explores 3DP-engineered drug devices described in recent research articles, as well as in patented inventions, and even devices already produced by 3DP with drug-loading potential.

KEY FINDINGS

3D drug-loaded stents, implants and prostheses are reviewed, along with devices produced to fit hard-to-attach body parts such as nasal masks, vaginal rings or mouthguards. The most promising 3DP techniques for such devices and the complementary technologies surrounding these inventions are also discussed, particularly the scanners useful for mapping body parts. Health regulatory concerns regarding the new use of such technology are also analysed.

SUMMARY

The scenario discussed in this review shows that for wearable 3DP drug devices to become a tangible reality to users, it will be necessary to overcome the existing regulatory barriers, create new interfaces with electronic systems and improve the mapping mechanisms of body surfaces.

Strategies toward development of antimicrobial biomaterials for dental healthcare applications

Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.

3D Printing of Pharmaceutical Application: Drug Screening and Drug Delivery

Advances in three-dimensional (3D) printing techniques and the development of tailored biomaterials have facilitated the precise fabrication of biological components and complex 3D geometrics over the past few decades. Moreover, the notable growth of 3D printing has facilitated pharmaceutical applications, enabling the development of customized drug screening and drug delivery systems for individual patients, breaking away from conventional approaches that primarily rely on transgenic animal experiments and mass production. This review provides an extensive overview of 3D printing research applied to drug screening and drug delivery systems that represent pharmaceutical applications. We classify several elements required by each application for advanced pharmaceutical techniques and briefly describe state-of-the-art 3D printing technology consisting of cells, bioinks, and printing strategies that satisfy requirements. Furthermore, we discuss the limitations of traditional approaches by providing concrete examples of drug screening (organoid, organ-on-a-chip, and tissue/organ equivalent) and drug delivery systems (oral/vaginal/rectal and transdermal/surgical drug delivery), followed by the introduction of recent pharmaceutical investigations using 3D printing-based strategies to overcome these challenges.

The Development of Design and Manufacture Techniques for Bioresorbable Coronary Artery Stents

Coronary artery disease (CAD) is the leading killer of humans worldwide. Bioresorbable polymeric stents have attracted a great deal of interest because they can treat CAD without producing long-term complications. Bioresorbable polymeric stents (BMSs) have undergone a sustainable revolution in terms of material processing, mechanical performance, biodegradability and manufacture techniques. Biodegradable polymers and copolymers have been widely studied as potential material candidates for bioresorbable stents. It is a great challenge to find a reasonable balance between the mechanical properties and degradation behavior of bioresorbable polymeric stents. Surface modification and drug-coating methods are generally used to improve biocompatibility and drug loading performance, which are decisive factors for the safety and efficacy of bioresorbable stents. Traditional stent manufacture techniques include etching, micro-electro discharge machining, electroforming, die-casting and laser cutting. The rapid development of 3D printing has brought continuous innovation and the wide application of biodegradable materials, which provides a novel technique for the additive manufacture of bioresorbable stents. This review aims to describe the problems regarding and the achievements of biodegradable stents from their birth to the present and discuss potential difficulties and challenges in the future.

Emerging 3D printing technologies for drug delivery devices: Current status and future perspective

The 'one-size-fits-all' approach followed by conventional drug delivery platforms often restricts its application in pharmaceutical industry, due to the incapability of adapting to individual pharmacokinetic traits. Driven by the development of additive manufacturing (AM) technology, three-dimensional (3D) printed drug delivery medical devices have gained increasing popularity, which offers key advantages over traditional drug delivery systems. The major benefits include the ability to fabricate 3D structures with customizable design and intricate architecture, and most importantly, ease of personalized medication. Furthermore, the emergence of multi-material printing and four-dimensional (4D) printing integrates the benefits of multiple functional materials, and thus provide widespread opportunities for the advancement of personalized drug delivery devices. Despite the remarkable progress made by AM techniques, concerns related to regulatory issues, scalability and cost-effectiveness remain major hurdles. Herein, we provide an overview on the latest accomplishments in 3D printed drug delivery devices as well as major challenges and future perspectives for AM enabled dosage forms and drug delivery systems.

Unlocking the power of optical imaging in the second biological window: Structuring near-infrared II materials from organic molecules to nanoparticles

Biomedical imaging techniques play a crucial role in clinical diagnosis, surgical intervention, and prognosis. Fluorescence imaging in the second biological window (second near-infrared [NIR-II]; 1000-1700 nm) has attracted attention recently. NIR-II fluorescence imaging offers unique advantages in terms of reduced photon scattering, deep tissue penetration, high sensitivity, and many others. A host of materials, including small organic molecules, single-walled carbon nanotubes, polymeric and rare-earth-doped nanoparticles, have been explored as NIR-II emitting fluorescent probes. Efficient and viable approaches to design and develop fluorescence probes with tunable photophysical properties without compromising other key features are of paramount importance. Various chemical strategies are explored to increase the quantum yield of these imaging agents without compromising their spatiotemporal resolution, specificity, and tissue penetration capabilities. This review summarizes the strategies implemented to design and synthesize NIR-II emitting nanoparticles and small organic molecule-based fluorescent probes for applications in the biomedical field. This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and Imaging Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery.

RNA-extraction-free nano-amplified colorimetric test for point-of-care clinical diagnosis of COVID-19

The global pandemic of coronavirus disease 2019 (COVID-19) highlights the shortcomings of the current testing paradigm for viral disease diagnostics. Here, we report a stepwise protocol for an RNA-extraction-free nano-amplified colorimetric test for rapid and naked-eye molecular diagnosis of COVID-19. The test employs a unique dual-prong approach that integrates nucleic acid (NA) amplification and plasmonic sensing for point-of-care detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with a sample-to-assay response time of <1 h. The RNA-extraction-free nano-amplified colorimetric test utilizes plasmonic gold nanoparticles capped with antisense oligonucleotides (ASOs) as a colorimetric reporter to detect the amplified nucleic acid from the COVID-19 causative virus, SARS-CoV-2. The ASOs are specific for the SARS-CoV-2 N-gene, and binding of the ASOs to their target sequence results in the aggregation of the plasmonic gold nanoparticles. This highly specific agglomeration step leads to a change in the plasmonic response of the nanoparticles. Furthermore, when tested using clinical samples, the accuracy, sensitivity and specificity of the test were found to be >98.4%, >96.6% and 100%, respectively, with a detection limit of 10 copies/μL. The test can easily be adapted to diagnose other viral infections with a simple modification of the ASOs and primer sequences. It also provides a low-cost, rapid approach requiring minimal instrumentation that can be used as a screening tool for the diagnosis of COVID-19 at point-of-care settings in resource-poor situations. The colorimetric readout of the test can even be monitored using a handheld optical reader to obtain a quantitative response. Therefore, we anticipate that this protocol will be widely useful for the development of biosensors for the molecular diagnostics of COVID-19 and other infectious diseases.

UV-trained and metal-enhanced fluorescence of biliverdin and biliverdin nanoparticles

Increasing the fluorescence quantum yield of fluorophores is of great interest for in vitro and in vivo biomedical imaging applications. At the same time, photobleaching and photodegradation resulting from continuous exposure to light are major considerations in the translation of fluorophores from research applications to industrial or healthcare applications. A number of tetrapyrrolic compounds, such as heme and its derivatives, are known to provide fluorescence contrast. In this work, we found that biliverdin (BV), a naturally-occurring tetrapyrrolic fluorophore, exhibits an increase in fluorescence quantum yield, without exhibiting photobleaching or degradation, in response to continuous ultraviolet (UV) irradiation. We attribute this increased fluorescence quantum yield to photoisomerization and conformational changes in BV in response to UV irradiation. This enhanced fluorescence can be further altered by chelating BV with metals. UV irradiation of BV led to an approximately 10-fold increase in its 365 nm fluorescence quantum yield, and the most favorable combination of UV irradiation and metal chelation led to an approximately 18.5-fold increase in its 365 nm fluorescence quantum yield. We also evaluated these stimuli-responsive behaviors in biliverdin nanoparticles (BVNPs) at the bulk-state and single-particle level. We determined that UV irradiation led to an approximately 2.4-fold increase in BVNP 365 nm quantum yield, and the combination of UV irradiation and metal chelation led to up to a 6.75-fold increase in BVNP 365 nm quantum yield. Altogether, these findings suggest that UV irradiation and metal chelation can be utilized alone or in combination to tailor the fluorescence behavior of imaging probes such as BV and BVNPs at selected wavelengths.

Recent advances in nanomaterials for therapy and diagnosis for atherosclerosis

Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation in arteries, leading to narrowing and thrombosis. It affects the heart, brain, and peripheral vessels and is the leading cause of mortality in the United States. Researchers have strived to design nanomaterials of various functions, ranging from non-invasive imaging contrast agents, targeted therapeutic delivery systems to multifunctional nanoagents able to target, diagnose, and treat atherosclerosis. Therefore, this review aims to summarize recent progress (2017-now) in the development of nanomaterials and their applications to improve atherosclerosis diagnosis and therapy during the preclinical and clinical stages of the disease.

A comparative analysis of solvent cast 3D printed carbonyl iron powder reinforced polycaprolactone polymeric stents for intravascular applications

In the present research, the effectiveness of developed methodology based on solvent cast 3D printing technique was investigated by printing the different geometries of the stents. The carbonyl iron powder (CIP) reinforced polycaprolactone (CIPC) was used to print three pre-existing stent designs such as ABBOTT BVS1.1, PALMAZ-SCHATZ, and ART18Z. The physicochemical behavior was analyzed by X-ray diffraction and scanning electron microscopy. The radial compression test, three-point bending test and stent deployment test were carried out to analyze the mechanical behavior. The degradation behavior of the stents was investigated in static as well as dynamic environment. To investigate the hemocompatible and cytocompatible behaviors of the stents, platelet adhesion test, hemolysis test, protein adsorption, in vitro cell viability test, and live/dead cell viability assay were performed. The results revealed that stents had the adequate mechanical properties to perform the necessary functions in the human coronary. The degradation studies showed slower degradation rate in the dynamic environment in comparison to static environment. in vitro biological analysis indicated that the stents represented excellent resistance to thrombosis, hemocompatible functions as well as cytocompatible nature. The results concluded that PALMAZ-SCHATZ stent represented better mechanical properties, cell viability, blood compatibility, and degradation behavior.

Big data and new information technology: what cardiologists need to know

Technological progress in medicine is constantly garnering pace, requiring that physicians constantly update their knowledge. The new wave of technologies breaking through into clinical practice includes the following: a) mHealth, which allows constant monitoring of biological parameters, anytime, anyplace, of hundreds of patients at the same time; b) artificial intelligence, which, powered by new deep learning techniques, are starting to beat human experts at their own game: diagnosis by imaging or electrocardiography; c) 3-dimensional printing, which may lead to patient-specific prostheses; d) systems medicine, which has arisen from big data, and which will open the way to personalized medicine by bringing together genetic, epigenetic, environmental, clinical and social data into complex integral mathematical models to design highly personalized therapies. This state-of-the-art review aims to summarize in a single document the most recent and most important technological trends that are being applied to cardiology, and to provide an overall view that will allow readers to discern at a glance the direction of cardiology in the next few years.

Advances in stent therapy for malignant biliary obstruction

Malignant biliary obstruction (MBO), result of pancreatobiliary diseases is a challenging condition. Most patients with MBO are inoperable at the time of diagnosis, and the disease is poorly controlled using external-beam radiotherapy and chemotherapy. Biliary stent therapy emerged as a promising strategy for alleviating MBO and prolonging life. However, physicians find it difficult to determine the optimal type of biliary stent for the palliation of MBO. Here, we review the safety and efficacy of available biliary stents, used alone or in combination with brachytherapy, photodynamic therapy and advanced chemotherapeutics, in patients with pancreatobiliary malignancies and put forward countermeasures involving stent obstruction. Furthermore, 3D-printing stents and nanoparticle-loaded stents have broad application prospects for fabricating tailor-made biliary stents.

In-vivo efficacy of biodegradable ultrahigh ductility Mg-Li-Zn alloy tracheal stents for pediatric airway obstruction

Pediatric laryngotracheal stenosis is a complex congenital or acquired airway injury that may manifest into a potentially life-threatening airway emergency condition. Depending on the severity of obstruction, treatment often requires a combination of endoscopic techniques, open surgical repair, intraluminal stenting, or tracheostomy. A balloon expandable biodegradable airway stent maintaining patency while safely degrading over time may address the complications and morbidity issues of existing treatments providing a less invasive and more effective management technique. Previous studies have focused on implementation of degradable polymeric scaffolds associated with potentially life-threatening pitfalls. The feasibility of an ultra-high ductility magnesium-alloy based biodegradable airway stents was demonstrated for the first time. The stents were highly corrosion resistant under in vitro flow environments, while safely degrading in vivo without affecting growth of the rabbit airway. The metallic matrix and degradation products were well tolerated by the airway tissue without exhibiting any noticeable local or systemic toxicity.

Personalized, Mechanically Strong, and Biodegradable Coronary Artery Stents via Melt Electrowriting

Biodegradable coronary artery stents are sought-after alternatives to permanent stents. These devices are designed to degrade after the blood vessel heals, leaving behind a regenerated artery. The original generation of clinically available biodegradable stents required significantly thicker struts (∼150 μm) than nondegradable ones to ensure sufficient mechanical strength. However, these thicker struts proved to be a key contributor to the clinical failure of the stents. A current challenge lies in the fabrication of stents that possess both thin struts and adequate mechanical strength. In this contribution, we describe a method for the bottom-up, additive manufacturing of biodegradable composite stents with ultrathin fibers and superior mechanical properties compared to the base polymer. Specifically, we illustrate that melt electrowriting (MEW) can be used to 3D print composite structures with thin struts (60-80 μm) and a high degree of geometric complexity required for stenting applications. Additionally, this technology allows additive manufacture of personalized stents that are customized to a patient's unique anatomy and disease state. Furthermore, we illustrate that polycaprolactone-reduced graphene oxide nanocomposites have superior mechanical properties compared to original polycaprolactone without detriment to the material's cytocompatibility and that customizable stent-like structures can be fabricated from these materials with struts as thin as 60 μm, well below the target value for clinical use of 80 μm.

A Smart Stent for Monitoring Eventual Restenosis: Computational Fluid Dynamic and Finite Element Analysis in Descending Thoracic Aorta

Even though scientific studies of smart stents are extensive, current smart stents focus on pressure sensors. This paper presents a novel implantable biocompatible smart stent for monitoring eventual restenosis. The device is comprised of a metal mesh structure, a biocompatible and adaptable envelope, and pair-operated ultrasonic sensors for restenosis monitoring through flow velocity. Aside from continuous monitoring of restenosis post-implantation, it is also important to evaluate whether the stent design itself causes complications such as restenosis or thrombosis. Therefore, computational fluid dynamic (CFD) analysis before and after stent implantation were carried out as well as finite element analysis (FEA). The proposed smart stent was put in the descending thoracic section of a virtually reconstructed aorta that comes from a computed tomography (CT) scan. Blood flow velocity showed that after stent implantation, there is not liquid retention or vortex generation. In addition, blood pressures after stent implantation were within the normal blood pressure values. The stress and the factor of safety (FOS) analysis showed that the stress values reached by the stent are very far from the yield strength limit of the materials and that the stent is stiff enough to support the applied loads exported from the CFD results.

Stimulus-Responsive Sequential Release Systems for Drug and Gene Delivery

In recent years, a range of studies have been conducted with the aim to design and characterize delivery systems that are able to release multiple therapeutic agents in controlled and programmed temporal sequences, or with spatial resolution inside the body. This sequential release occurs in response to different stimuli, including changes in pH, redox potential, enzyme activity, temperature gradients, light irradiation, and by applying external magnetic and electrical fields. Sequential release (SR)-based delivery systems, are often based on a range of different micro- or nanocarriers and may offer a silver bullet in the battle against various diseases, such as cancer. Their distinctive characteristic is the ability to release one or more drugs (or release drugs along with genes) in a controlled sequence at different times or at different sites. This approach can lengthen gene expression periods, reduce the side effects of drugs, enhance the efficacy of drugs, and induce an anti-proliferative effect on cancer cells due to the synergistic effects of genes and drugs. The key objective of this review is to summarize recent progress in SR-based drug/gene delivery systems for cancer and other diseases.

Biodegradable MRI Visible Drug Eluting Stent Reinforced by Metal Organic Frameworks

Metal-organic frameworks (MOFs) have applications in numerous fields. However, the development of MOF-based "theranostic" macroscale devices is not achieved. Here, heparin-coated biocompatible MOF/poly(ε-caprolactone) (PCL) "theranostic" stents are developed, where NH₂ -Materials of Institute Lavoisier (MIL)-101(Fe) encapsulates and releases rapamycin (an immunosuppressive drug). These stents also act as a remarkable source of contrast in ex vivo magnetic resonance imaging (MRI) compared to the invisible polymeric stent. The in vitro release patterns of heparin and rapamycin respectively can ensure a type of programmed model to prevent blood coagulation immediately after stent placement in the artery and stenosis over a longer term. Due to the presence of hydrolysable functionalities in MOFs, the stents are shown to be highly biodegradable in degradation tests under various conditions. Furthermore, there is no compromise of mechanical strength or flexibility with MOF compositing. The system described here promises many biomedical applications in macroscale theranostic devices. The use of MOF@PCL can render a medical device MRI-visible while simultaneously acting as a carrier for therapeutic agents.

Biological and mechanical characterization of biodegradable carbonyl iron powder/polycaprolactone composite material fabricated using three-dimensional printing for cardiovascular stent application

Biological and mechanical properties of biodegradable polymeric composite materials are strongly influenced by the choice of appropriate reinforcement in the polymer matrix. Non-compatibility of material in the vascular system could obstruct the way of the biological fluids. The concept of development of polymeric composite material for vascular implants is to provide enough support to the vessel and to restore the vessel in the natural state after degradation. In this research, the polycaprolactone composite materials (carbonyl iron powder/polycaprolactone) were developed by reinforcement of the 0%–2% of carbonyl iron powder using the solvent cast three-dimensional printing technique. The physicochemical properties of developed composites were characterized in conjunction with mechanical and biological properties. The mechanical characterizations were assessed by uniaxial tensile testing as well as flexibility testing. The results of mechanical testing assured that carbonyl iron powder/polycaprolactone composites have shown desirable properties for vascular implants. Besides the mechanical characterization, in vitro biological investigations of carbonyl iron powder/polycaprolactone were done for analyzing blood compatibility and cytocompatibility. The results revealed that the materials developed were biocompatible, less hemolytic, and having non-thrombogenic properties indicating the promising applications in the field of cardiovascular applications.

Development of 3D-Printed Sulfated Chitosan Modified Bioresorbable Stents for Coronary Artery Disease

Bioresorbable polymeric stents have attracted great interest for coronary artery disease because they can provide mechanical support first and then disappear within a desired time period. The conventional manufacturing process is laser cutting, and generally they are fabricated from tubular prototypes produced by injection molding or melt extrusion. The aim of this study is to fabricate and characterize a novel bioresorbable polymeric stent for treatment of coronary artery disease. Polycaprolactone (PCL) is investigated as suitable material for biomedical stents. A rotary 3D printing method is developed to fabricate the polymeric stents. Surface modification of polymeric stent is performed by immobilization of 2-N, 6-O-sulfated chitosan (26SCS). Physical and chemical characterization results showed that the surface microstructure of 3D-pinted PCL stents can be influenced by 26SCS modification, but no significant difference was observed for their mechanical behavior. Biocompatibility assessment results indicated that PCL and S-PCL stents possess good compatibility with blood and cells, and 26SCS modification can enhance cell proliferation. These results suggest that 3D printed PCL stent can be a potential candidate for coronary artery disease by modification of sulfated chitosan (CS).

Additive Manufacturing of Precision Biomaterials

Biomaterials play a critical role in modern medicine as surgical guides, implants for tissue repair, and as drug delivery systems. The emerging paradigm of precision medicine exploits individual patient information to tailor clinical therapy. While the main focus of precision medicine to date is the design of improved pharmaceutical treatments based on "-omics" data, the concept extends to all forms of customized medical care. This includes the design of precision biomaterials that are tailored to meet specific patient needs. Additive manufacturing (AM) enables free-form manufacturing and mass customization, and is a critical enabling technology for the clinical implementation of precision biomaterials. Materials scientists and engineers can contribute to the realization of precision biomaterials by developing new AM technologies, synthesizing advanced (bio)materials for AM, and improving medical-image-based digital design. As the field matures, AM is poised to provide patient-specific tissue and organ substitutes, reproducible microtissues for drug screening and disease modeling, personalized drug delivery systems, as well as customized medical devices.

Additive Manufacturing Technologies for Drug Delivery Applications

Patient to patient variability is one of the issues when administering medications to individuals with different health conditions, pharmacokinetic, age, fitness, gender, and race. This requires introducing smart and personalised drug delivery systems with controlled release profile manufactured using novel approaches. Additive manufacturing (AM) provides opportunities such as full customisation, design freedom, and on-site manufacturing, and materials recycling. As a result, the academic and industrial demand for additive manufacturing for drug delivery has been continuously increasing and showing impressive results for a wide range of products. This paper provides an extensive overview of AM technologies and their applications for drug delivery. The review discusses AM technologies including their working principles, processed materials, as well as current progress in drug delivery to produce personalized dosages for every patient with controlled release profile. AM potentials, industrial scale, and challenges are investigated with regards to practice and industrial applications. The paper covers novel possibilities of AM technologies and their pharmaceuticals applications, which indicate a promising healthcare future.

Three-dimensional printed 5-fluorouracil eluting polyurethane stents for the treatment of oesophageal cancers

3D printing is introduced as rapid and facile approach to prepare personalized drug-eluting stents for the treatment of oesophageal cancers.