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Agrawal P, Tiwari A, Chowdhury SK, Vohra M, Gour A, Waghmare N, Bhutani U, Kamalnath S, Sangwan B, Rajput J, Raj R, Rajendran NP, Kamath AV, Haddadin R, Chandru A, Sangwan VS, Bhowmick T. Kuragel: A biomimetic hydrogel scaffold designed to promote corneal regeneration. iScience 2024; 27:109641. [PMID: 38646166 PMCID: PMC11031829 DOI: 10.1016/j.isci.2024.109641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/30/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Cornea-related injuries are the most common cause of blindness worldwide. Transplantation remains the primary approach for addressing corneal blindness, though the demand for donor corneas outmatches the supply by millions. Tissue adhesives employed to seal corneal wounds have shown inefficient healing and incomplete vision restoration. We have developed a biodegradable hydrogel - Kuragel, with the ability to promote corneal regeneration. Functionalized gelatin and hyaluronic acid form photo-crosslinkable hydrogel with transparency and compressive modulus similar to healthy human cornea. Kuragel composition was tuned to achieve sufficient adhesive strength for sutureless integration to host tissue, with minimal swelling post-administration. Studies in the New Zealand rabbit mechanical injury model affecting corneal epithelium and stroma demonstrate that Kuragel efficiently promotes re-epithelialization within 1 month of administration, while stroma and sub-basal nerve plexus regenerate within 3 months. We propose Kuragel as a regenerative treatment for patients suffering from corneal defects including thinning, by restoration of transparency and thickness.
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Affiliation(s)
| | - Anil Tiwari
- Pandorum Technologies Pvt., Ltd, Bangalore, India
- Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | | | - Mehak Vohra
- Pandorum Technologies Pvt., Ltd, Bangalore, India
| | - Abha Gour
- Pandorum Technologies Pvt., Ltd, Bangalore, India
- Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | | | | | - S. Kamalnath
- Pandorum Technologies Pvt., Ltd, Bangalore, India
| | | | - Jyoti Rajput
- Pandorum Technologies Pvt., Ltd, Bangalore, India
| | - Ritu Raj
- Pandorum Technologies Pvt., Ltd, Bangalore, India
| | | | | | - Ramez Haddadin
- Feinberg School of Medicine Northwestern University, Chicago, IL, USA
| | - Arun Chandru
- Pandorum Technologies Pvt., Ltd, Bangalore, India
| | | | - Tuhin Bhowmick
- Pandorum Technologies Pvt., Ltd, Bangalore, India
- Pandorum International Inc, San Francisco, CA, USA
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2
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Lee GW, Chandrasekharan A, Roy S, Thamarappalli A, Mahaling B, Lee H, Seong KY, Ghosh S, Yang SY. 3D bioprinting of stromal cells-laden artificial cornea based on visible light-crosslinkable bioinks forming multilength networks. Biofabrication 2024; 16:035002. [PMID: 38507802 DOI: 10.1088/1758-5090/ad35eb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/20/2024] [Indexed: 03/22/2024]
Abstract
3D bioprinting has the potential for the rapid and precise engineering of hydrogel constructs that can mimic the structural and optical complexity of a healthy cornea. However, the use of existing light-activated bioinks for corneal printing is limited by their poor cytocompatibility, use of cytotoxic photoinitiators (PIs), low photo-crosslinking efficiency, and opaque/colored surface of the printed material. Herein, we report a fast-curable, non-cytotoxic, optically transparent bioprinting system using a new water-soluble benzoyl phosphinate-based PI and photocrosslinkable methacrylated hyaluronic acid (HAMA). Compared with commercially available PIs, the newly developed PI, lithium benzoyl (phenyl) phosphinate (BP), demonstrated increased photoinitiation efficiency under visible light and low cytotoxicity. Using a catalytic amount of BP, the HA-based bioinks quickly formed 3D hydrogel constructs under low-energy visible-light irradiation (405 nm, <1 J cm-2). The mechanical properties and printability of photocurable bioinks were further improved by blending low (10 kDa) and high (100 kDa) molecular weight (MW) HAMA by forming multilength networks. For potential applications as corneal scaffolds, stromal cell-laden dome-shaped constructs were fabricated using MW-blended HAMA/BP bioink and a digital light processing printer. The HA-based photocurable bioinks exhibited good cytocompatibility (80%-95%), fast curing kinetics (<5 s), and excellent optical transparency (>90% in the visible range), potentially making them suitable for corneal tissue engineering.
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Affiliation(s)
- Gyeong Won Lee
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Ajeesh Chandrasekharan
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Subhadeep Roy
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Akash Thamarappalli
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Binapani Mahaling
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Hyeseon Lee
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Keum-Yong Seong
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Sourabh Ghosh
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Seung Yun Yang
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
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Bhutani U, Dey N, Chowdhury SK, Waghmare N, Mahapatra RD, Selvakumar K, Chandru A, Bhowmick T, Agrawal P. Biopolymeric corneal lenticules by digital light processing based bioprinting: a dynamic substitute for corneal transplant. Biomed Mater 2024; 19:035017. [PMID: 38471165 DOI: 10.1088/1748-605x/ad3312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/12/2024] [Indexed: 03/14/2024]
Abstract
Digital light processing (DLP) technology has gained significant attention for its ability to construct intricate structures for various applications in tissue modeling and regeneration. In this study, we aimed to design corneal lenticules using DLP bioprinting technology, utilizing dual network bioinks to mimic the characteristics of the human cornea. The bioink was prepared using methacrylated hyaluronic acid and methacrylated gelatin, where ruthenium salt and sodium persulfate were included for mediating photo-crosslinking while tartrazine was used as a photoabsorber. The bioprinted lenticules were optically transparent (85.45% ± 0.14%), exhibited adhesive strength (58.67 ± 17.5 kPa), and compressive modulus (535.42 ± 29.05 kPa) sufficient for supporting corneal tissue integration and regeneration. Puncture resistance tests and drag force analysis further confirmed the excellent mechanical performance of the lenticules enabling their application as potential corneal implants. Additionally, the lenticules demonstrated outstanding support for re-epithelialization and stromal regeneration when assessed with human corneal stromal cells. We generated implant ready corneal lenticules while optimizing bioink and bioprinting parameters, providing valuable solution for individuals suffering from various corneal defects and waiting for corneal transplants.
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Affiliation(s)
- Utkarsh Bhutani
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Namit Dey
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Suvro Kanti Chowdhury
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Neha Waghmare
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Rita Das Mahapatra
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Kamalnath Selvakumar
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Arun Chandru
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
| | - Tuhin Bhowmick
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
- Pandorum International Inc., San Francisco, CA, United States of America
| | - Parinita Agrawal
- Pandorum Technologies Private Limited, Bangalore Bioinnovation Centre, Helix Biotech Park, Electronic City, Phase 1, Bengaluru 560100, India
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Gingras AA, Jansen PA, Smith C, Zhang X, Niu Y, Zhao Y, Roberts CJ, Herderick ED, Swindle-Reilly KE. 3D Bioprinting of Acellular Corneal Stromal Scaffolds with a Low Cost Modified 3D Printer: A Feasibility Study. Curr Eye Res 2023; 48:1112-1121. [PMID: 37669915 DOI: 10.1080/02713683.2023.2251172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 08/20/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE Loss of corneal transparency is one of the major causes of visual loss, generating a considerable health and economic burden globally. Corneal transplantation is the leading treatment procedure, where the diseased cornea is replaced by donated corneal tissue. Despite the rise of cornea donations in the past decade, there is still a huge gap between cornea supply and demand worldwide. 3D bioprinting is an emerging technology that can be used to fabricate tissue equivalents that resemble the native tissue, which holds great potential for corneal tissue engineering application. This study evaluates the manufacturability of 3D bioprinted acellular corneal grafts using low-cost equipment and software, not necessarily designed for bioprinting applications. This approach allows access to 3D printed structures where commercial 3D bioprinters are cost prohibitive and not readily accessible to researchers and clinicians. METHODS Two extrusion-based methods were used to 3D print acellular corneal stromal scaffolds with collagen, alginate, and alginate-gelatin composite bioinks from a digital corneal model. Compression testing was used to determine moduli. RESULTS The printed model was visually transparent with tunable mechanical properties. The model had central radius of curvature of 7.4 mm, diameter of 13.2 mm, and central thickness of 0.4 mm. The compressive secant modulus of the material was 23.7 ± 1.7 kPa at 20% strain. 3D printing into a concave mold had reliability advantages over printing into a convex mold. CONCLUSIONS The printed corneal models exhibited visible transparency and a dome shape, demonstrating the potential of this process for the preparation of acellular partial thickness corneal replacements. The modified printing process presented a low-cost option for corneal bioprinting.
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Affiliation(s)
- Amelia A Gingras
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Peter A Jansen
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Caroline Smith
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Xu Zhang
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
| | - Ye Niu
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA
| | - Yi Zhao
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Edward D Herderick
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA
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Joshi VP, Chatterjee S, Basu S. Relationship of Density, Depth, and Surface Irregularity of Superficial Corneal Opacification with Visual Acuity. Curr Eye Res 2023; 48:536-545. [PMID: 36724802 DOI: 10.1080/02713683.2023.2173786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To explore the relationship between the density, depth, and surface irregularity of superficial corneal opacities and vision. METHODS This prospective imaging study included 19 patients with unilateral superficial corneal opacification due to scarring post-microbial keratitis. Each eye underwent an assessment of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contact lens corrected visual acuity (CLCVA), and Scheimpflug and anterior segment optical tomography imaging. Regression analysis was performed to detect the association between density, depth of scarring, and the surface irregularity in terms of higher order aberrations (HOA), and keratometry and UCVA, CLCVA, and the difference between BSCVA and CLCVA. RESULTS The mean logMAR UCVA, BSCVA, and CLCVA were 0.76, 0.35, and 0.28, respectively. The corneal scars had a mean thickness of 158.7 ± 61 µ and density of 65.73 ± 24.46 GSU. Bivariate analysis model for UCVA showed an association with Z42 secondary astigmatism (p = 0.02), Z44 quadrafoil (p = 0.01), combined coma Z3 ± 1(p = 0.03), and combined HOA Z3-Z6 (p = 0.045), out of which Z44 Quadrafoil (p = 0.04) was most significant with multivariate analysis. Bivariate analysis for BCVA-CLVA showed association with Z31 coma horizontal (p = 0.04), Z33 oblique trefoil (p = 0.02), Z40 primary spherical aberration (p = 0.008), and Z5 - 5 (p = 0.007), out of which Z31 horizontal coma (p = 0.04) and Z40 spherical aberration (p = 0.009) were significant on multivariate analysis. Change in densitometry, corneal thickness, epithelial:stromal reflectivity ratio, scar depth, and keratometry did not show any significant association with UCVA, BSCVA-CLCVA, or CLCVA. CONCLUSION In superficial corneal stromal scarring, deranged surface irregularity parameters like higher-order aberrations affect the final visual acuity more than the depth or density of the opacity.
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Affiliation(s)
- Vineet Pramod Joshi
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India.,Professor Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Subhajit Chatterjee
- Cataract, Refractive Surgery and Contact Lens Services, LV Prasad Eye Institute, Hyderabad, India
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India.,Professor Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
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Patient-specific 3D bioprinting for in situ tissue engineering and regenerative medicine. 3D Print Med 2023. [DOI: 10.1016/b978-0-323-89831-7.00003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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7
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Orash Mahmoud Salehi A, Heidari-Keshel S, Poursamar SA, Zarrabi A, Sefat F, Mamidi N, Behrouz MJ, Rafienia M. Bioprinted Membranes for Corneal Tissue Engineering: A Review. Pharmaceutics 2022; 14:pharmaceutics14122797. [PMID: 36559289 PMCID: PMC9784133 DOI: 10.3390/pharmaceutics14122797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Corneal transplantation is considered a convenient strategy for various types of corneal disease needs. Even though it has been applied as a suitable solution for most corneal disorders, patients still face several issues due to a lack of healthy donor corneas, and rejection is another unknown risk of corneal transplant tissue. Corneal tissue engineering (CTE) has gained significant consideration as an efficient approach to developing tissue-engineered scaffolds for corneal healing and regeneration. Several approaches are tested to develop a substrate with equal transmittance and mechanical properties to improve the regeneration of cornea tissue. In this regard, bioprinted scaffolds have recently received sufficient attention in simulating corneal structure, owing to their spectacular spatial control which produces a three-cell-loaded-dimensional corneal structure. In this review, the anatomy and function of different layers of corneal tissue are highlighted, and then the potential of the 3D bioprinting technique for promoting corneal regeneration is also discussed.
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Affiliation(s)
- Amin Orash Mahmoud Salehi
- Department of Chemistry and Nanotechnology, School of Engineering and Science, Tecnologico de Monterrey, Monterrey 64849, NL, Mexico
| | - Saeed Heidari-Keshel
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1434875451, Iran
| | - Seyed Ali Poursamar
- Biosensor Research Center, Isfahan University of Medical Sciences, Isfahan 8174673441, Iran
| | - Ali Zarrabi
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul 34396, Turkey
| | - Farshid Sefat
- Department of Biomedical and Electronics Engineering, School of Engineering, University of Bradford, Bradford BD7 1DP, UK
- Interdisciplinary Research Centre in Polymer Science & Technology (Polymer IRC), University of Bradford, Bradford BD7 1DP, UK
| | - Narsimha Mamidi
- Department of Chemistry and Nanotechnology, School of Engineering and Science, Tecnologico de Monterrey, Monterrey 64849, NL, Mexico
- Correspondence: or (N.M.); (M.R.)
| | - Mahmoud Jabbarvand Behrouz
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1985717443, Iran
| | - Mohammad Rafienia
- Biosensor Research Center, Isfahan University of Medical Sciences, Isfahan 8174673441, Iran
- Correspondence: or (N.M.); (M.R.)
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Tafti MF, Aghamollaei H, Moghaddam MM, Jadidi K, Alio JL, Faghihi S. Emerging tissue engineering strategies for the corneal regeneration. J Tissue Eng Regen Med 2022; 16:683-706. [PMID: 35585479 DOI: 10.1002/term.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Cornea as the outermost layer of the eye is at risk of various genetic and environmental diseases that can damage the cornea and impair vision. Corneal transplantation is among the most applicable surgical procedures for repairing the defected tissue. However, the scarcity of healthy tissue donations as well as transplantation failure has remained as the biggest challenges in confront of corneal grafting. Therefore, alternative approaches based on stem-cell transplantation and classic regenerative medicine have been developed for corneal regeneration. In this review, the application and limitation of the recently-used advanced approaches for regeneration of cornea are discussed. Additionally, other emerging powerful techniques such as 5D printing as a new branch of scaffold-based technologies for construction of tissues other than the cornea are highlighted and suggested as alternatives for corneal reconstruction. The introduced novel techniques may have great potential for clinical applications in corneal repair including disease modeling, 3D pattern scheming, and personalized medicine.
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Affiliation(s)
- Mahsa Fallah Tafti
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Jorge L Alio
- Department of Research and Development, VISSUM, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Department of Pathology and Surgery, Division of Ophthalmology, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
| | - Shahab Faghihi
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
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