3D-Printing of Functional Biomedical Microdevices via Light- and Extrusion-Based Approaches

A Novel Triad of Bio-Inspired Design, Digital Fabrication, and Bio-Derived Materials for Personalised Bone Repair

The emerging paradigm of personalised bone repair embodies a transformative triad comprising bio-inspired design, digital fabrication, and the exploration of innovative materials. The increasing average age of the population, alongside the rising incidence of fractures associated with age-related conditions such as osteoporosis, necessitates the development of customised, efficient, and minimally invasive treatment modalities as alternatives to conventional methods (e.g., autografts, allografts, Ilizarov distraction, and bone fixators) typically employed to promote bone regeneration. A promising innovative technique involves the use of cellularised scaffolds incorporating mesenchymal stem cells (MSCs). The selection of materials-ranging from metals and ceramics to synthetic or natural bio-derived polymers-combined with a design inspired by natural sources (including bone, corals, algae, shells, silk, and plants) facilitates the replication of geometries, architectures, porosities, biodegradation capabilities, and mechanical properties conducive to physiological bone regeneration. To mimic internal structures and geometries for construct customisation, scaffolds can be designed using Computer-aided Design (CAD) and fabricated via 3D-printing techniques. This approach not only enables precise control over external shapes and internal architectures but also accommodates the use of diverse materials that improve biological performance and provide economic advantages. Finally, advanced numerical models are employed to simulate, analyse, and optimise the complex processes involved in personalised bone regeneration, with computational predictions validated against experimental data and in vivo studies to ascertain the model's ability to predict the recovery of bone shape and function.

Pharmaceutical applications and requirements of resins for printing by digital light processing (DLP)

The digital light processing (DLP) printer has proven to be effective in biomedical and pharmaceutical applications, as its printing method does not induce shear and a strong temperature on the resin. In addition, the DLP printer has good resolution and print quality, which makes it possible to print complex structures with a customized shape, being used for various purposes ranging from jewelry application to biomedical and pharmaceutical areas. The big disadvantage of DLP is the lack of a biocompatible and non-toxic resin on the market. To overcome this limitation, an ideal resin for biomedical and pharmaceutical use is needed. The resin must have appropriate properties, so that the desired format is printed when with a determined wavelength is applied. Thus, the aim of this work is to bring the basic characteristics of the resins used by this printing method and the minimum requirements to start printing by DLP for pharmaceutical and biomedical applications. The DLP method has proven to be effective in obtaining pharmaceutical devices such as drug delivery systems. Furthermore, this technology allows the printing of devices of ideal size, shape and dosage, providing the patient with personalized treatment.

Direct laser writing-enabled 3D printing strategies for microfluidic applications

Over the past decade, additive manufacturing-or "three-dimensional (3D) printing"-has attracted increasing attention in the Lab on a Chip community as a pathway to achieve sophisticated system architectures that are difficult or infeasible to fabricate via conventional means. One particularly promising 3D manufacturing technology is "direct laser writing (DLW)", which leverages two-photon (or multi-photon) polymerization (2PP) phenomena to enable high geometric versatility, print speeds, and precision at length scales down to the 100 nm range. Although researchers have demonstrated the potential of using DLW for microfluidic applications ranging from organ on a chip and drug delivery to micro/nanoparticle processing and soft microrobotics, such scenarios present unique challenges for DLW. Specifically, microfluidic systems typically require macro-to-micro fluidic interfaces (e.g., inlet and outlet ports) to facilitate fluidic loading, control, and retrieval operations; however, DLW-based 3D printing relies on a micron-to-submicron-sized 2PP volume element (i.e., "voxel") that is poorly suited for manufacturing these larger-scale fluidic interfaces. In this Tutorial Review, we highlight and discuss the four most prominent strategies that researchers have developed to circumvent this trade-off and realize macro-to-micro interfaces for DLW-enabled microfluidic components and systems. In addition, we consider the possibility that-with the advent of next-generation commercial DLW printers equipped with new dynamic voxel tuning, print field, and laser power capabilities-the overall utility of DLW strategies for Lab on a Chip fields may soon expand dramatically.

Biofabrication Directions in Recapitulating the Immune System-on-a-Chip

Ever since the implementation of microfluidics in the biomedical field, in vitro models have experienced unprecedented progress that has led to a new generation of highly complex miniaturized cell culture platforms, known as Organs-on-a-Chip (OoC). These devices aim to emulate biologically relevant environments, encompassing perfusion and other mechanical and/or biochemical stimuli, to recapitulate key physiological events. While OoCs excel in simulating diverse organ functions, the integration of the immune organs and immune cells, though recent and challenging, is pivotal for a more comprehensive representation of human physiology. This comprehensive review covers the state of the art in the intricate landscape of immune OoC models, shedding light on the pivotal role of biofabrication technologies in bridging the gap between conceptual design and physiological relevance. The multifaceted aspects of immune cell behavior, crosstalk, and immune responses that are aimed to be replicated within microfluidic environments, emphasizing the need for precise biomimicry are explored. Furthermore, the latest breakthroughs and challenges of biofabrication technologies in immune OoC platforms are described, guiding researchers toward a deeper understanding of immune physiology and the development of more accurate and human predictive models for a.o., immune-related disorders, immune development, immune programming, and immune regulation.

Recent Developments in Bio-Ink Formulations Using Marine-Derived Biomaterials for Three-Dimensional (3D) Bioprinting

3D bioprinting is a disruptive, computer-aided, and additive manufacturing technology that allows the obtention, layer-by-layer, of 3D complex structures. This technology is believed to offer tremendous opportunities in several fields including biomedical, pharmaceutical, and food industries. Several bioprinting processes and bio-ink materials have emerged recently. However, there is still a pressing need to develop low-cost sustainable bio-ink materials with superior qualities (excellent mechanical, viscoelastic and thermal properties, biocompatibility, and biodegradability). Marine-derived biomaterials, including polysaccharides and proteins, represent a viable and renewable source for bio-ink formulations. Therefore, the focus of this review centers around the use of marine-derived biomaterials in the formulations of bio-ink. It starts with a general overview of 3D bioprinting processes followed by a description of the most commonly used marine-derived biomaterials for 3D bioprinting, with a special attention paid to chitosan, glycosaminoglycans, alginate, carrageenan, collagen, and gelatin. The challenges facing the application of marine-derived biomaterials in 3D bioprinting within the biomedical and pharmaceutical fields along with future directions are also discussed.

Photocuring 3D printing technology as an advanced tool for promoting angiogenesis in hypoxia-related diseases

Three-dimensional (3D) bioprinting has emerged as a promising strategy for fabricating complex tissue analogs with intricate architectures, such as vascular networks. Achieving this necessitates bioink formulations that possess highly printable properties and provide a cell-friendly microenvironment mimicking the native extracellular matrix. Rapid advancements in printing techniques continue to expand the capabilities of researchers, enabling them to overcome existing biological barriers. This review offers a comprehensive examination of ultraviolet-based 3D bioprinting, renowned for its exceptional precision compared to other techniques, and explores its applications in inducing angiogenesis across diverse tissue models related to hypoxia. The high-precision and rapid photocuring capabilities of 3D bioprinting are essential for accurately replicating the intricate complexity of vascular networks and extending the diffusion limits for nutrients and gases. Addressing the lack of vascular structure is crucial in hypoxia-related diseases, as it can significantly improve oxygen delivery and overall tissue health. Consequently, high-resolution 3D bioprinting facilitates the creation of vascular structures within three-dimensional engineered tissues, offering a potential solution for addressing hypoxia-related diseases. Emphasis is placed on fundamental components essential for successful 3D bioprinting, including cell types, bioink compositions, and growth factors highlighted in recent studies. The insights provided in this review underscore the promising prospects of leveraging 3D printing technologies for addressing hypoxia-related diseases through the stimulation of angiogenesis, complementing the therapeutic efficacy of cell therapy.

Computer numerical control (CNC) carving as an on-demand point-of-care manufacturing of solid dosage form: A digital alternative method for 3D printing

Computer numerical control (CNC) carving is a widely used method of industrial subtractive manufacturing of wood, plastics, and metal products. However, there have been no previous reports of applying this approach to manufacture medicines. In this work, the novel method of tablet production using CNC carving is introduced for the first time. This report provides a proof-of-concept for applying subtractive manufacturing as an alternative to formative (powder compression) and additive (3D printing) manufacturing for the on-demand production of solid dosage forms. This exemplar manufacturing approach was employed to produce patient-specific hydrocortisone (HC) tablets for the treatment of children with congenital adrenal hyperplasia. A specially made drug-polymer cast based on polyethene glycol (PEG 6,000) and hydroxypropyl cellulose was produced using thermal casting. The cast was used as a workpiece and digitally carved using a small-scale 3-dimensional (3D) CNC carving. To establish the ability of this new approach to provide an accurate dose of HC, four different sizes of CNC carved tablet were manufactured to achieve HC doses of 2.5, 5, 7.5 and 10 mg with a relative standard deviation of the tablet weight in the range of 3.69-4.79%. In addition, batches of 2.5 and 5 mg HC tablets met the British Pharmacopeia standards for weight uniformity. Thermal analysis and X-ray powder diffraction indicated that the model drug was in amorphous form. In addition, HPLC analysis indicated a level of purity of 96.5 ± 1.1% of HC. In addition, the process yielded mechanically strong cylindrical tablets with tensile strength ranging from 0.49 to 1.6 MPa and friability values of <1%, whilst maintaining an aesthetic look. In vitro, HC release from the CNC-carved tablets was slower with larger tablet sizes and higher binder contents. This is the first report on applying CNC carving in the pharmaceutical context of producing solid dosage forms. The work showed the potential of this technology as an alternative method for the on-demand manufacturing of patient-specific dosage forms.

Micropatterning of functional lipid bilayer assays for quantitative bioanalysis

Interactions of the cell with its environment are mediated by the cell membrane and membrane-localized molecules. Supported lipid bilayers have enabled the recapitulation of the basic properties of cell membranes and have been broadly used to further our understanding of cellular behavior. Coupled with micropatterning techniques, lipid bilayer platforms have allowed for high throughput assays capable of performing quantitative analysis at a high spatiotemporal resolution. Here, an overview of the current methods of the lipid membrane patterning is presented. The fabrication and pattern characteristics are briefly described to present an idea of the quality and notable features of the methods, their utilizations for quantitative bioanalysis, as well as to highlight possible directions for the advanced micropatterning lipid membrane assays.

3D printed electronics with nanomaterials

A large variety of printing, deposition and writing techniques have been incorporated to fabricate electronic devices in the last decades. This approach, printed electronics, has gained great interest in research and practical applications and is successfully fuelling the growth in materials science and technology. On the other hand, a new player is emerging, additive manufacturing, called 3D printing, introducing a new capability to create geometrically complex constructs with low cost and minimal material waste. Having such tremendous technology in our hands, it was just a matter of time to combine advances of printed electronics technology for the fabrication of unique 3D structural electronics. Nanomaterial patterning with additive manufacturing techniques can enable harnessing their nanoscale properties and the fabrication of active structures with unique electrical, mechanical, optical, thermal, magnetic and biological properties. In this paper, we will briefly review the properties of selected nanomaterials suitable for electronic applications and look closer at the current achievements in the synergistic integration of nanomaterials with additive manufacturing technologies to fabricate 3D printed structural electronics. The focus is fixed strictly on techniques allowing as much as possible fabrication of spatial 3D objects, or at least conformal ones on 3D printed substrates, while only selected techniques are adaptable for 3D printing of electronics. Advances in the fabrication of conductive paths and circuits, passive components, antennas, active and photonic components, energy devices, microelectromechanical systems and sensors are presented. Finally, perspectives for development with new nanomaterials, multimaterial and hybrid techniques, bioelectronics, integration with discrete components and 4D-printing are briefly discussed.

3D-Printed Microinjection Needle Arrays via a Hybrid DLP-Direct Laser Writing Strategy

Microinjection protocols are ubiquitous throughout biomedical fields, with hollow microneedle arrays (MNAs) offering distinctive benefits in both research and clinical settings. Unfortunately, manufacturing-associated barriers remain a critical impediment to emerging applications that demand high-density arrays of hollow, high-aspect-ratio microneedles. To address such challenges, here, a hybrid additive manufacturing approach that combines digital light processing (DLP) 3D printing with "ex situ direct laser writing (esDLW)" is presented to enable new classes of MNAs for fluidic microinjections. Experimental results for esDLW-based 3D printing of arrays of high-aspect-ratio microneedles-with 30 μm inner diameters, 50 μm outer diameters, and 550 μm heights, and arrayed with 100 μm needle-to-needle spacing-directly onto DLP-printed capillaries reveal uncompromised fluidic integrity at the MNA-capillary interface during microfluidic cyclic burst-pressure testing for input pressures in excess of 250 kPa (n = 100 cycles). Ex vivo experiments perform using excised mouse brains reveal that the MNAs not only physically withstand penetration into and retraction from brain tissue but also yield effective and distributed microinjection of surrogate fluids and nanoparticle suspensions directly into the brains. In combination, the results suggest that the presented strategy for fabricating high-aspect-ratio, high-density, hollow MNAs could hold unique promise for biomedical microinjection applications.

High cell density and high-resolution 3D bioprinting for fabricating vascularized tissues

Three-dimensional (3D) bioprinting techniques have emerged as the most popular methods to fabricate 3D-engineered tissues; however, there are challenges in simultaneously satisfying the requirements of high cell density (HCD), high cell viability, and fine fabrication resolution. In particular, bioprinting resolution of digital light processing-based 3D bioprinting suffers with increasing bioink cell density due to light scattering. We developed a novel approach to mitigate this scattering-induced deterioration of bioprinting resolution. The inclusion of iodixanol in the bioink enables a 10-fold reduction in light scattering and a substantial improvement in fabrication resolution for bioinks with an HCD. Fifty-micrometer fabrication resolution was achieved for a bioink with 0.1 billion per milliliter cell density. To showcase the potential application in tissue/organ 3D bioprinting, HCD thick tissues with fine vascular networks were fabricated. The tissues were viable in a perfusion culture system, with endothelialization and angiogenesis observed after 14 days of culture.

To infinity and beyond: Strategies for fabricating medicines in outer space

Recent advancements in next generation spacecrafts have reignited public excitement over life beyond Earth. However, to safeguard the health and safety of humans in the hostile environment of space, innovation in pharmaceutical manufacturing and drug delivery deserves urgent attention. In this review/commentary, the current state of medicines provision in space is explored, accompanied by a forward look on the future of pharmaceutical manufacturing in outer space. The hazards associated with spaceflight, and their corresponding medical problems, are first briefly discussed. Subsequently, the infeasibility of present-day medicines provision systems for supporting deep space exploration is examined. The existing knowledge gaps on the altered clinical effects of medicines in space are evaluated, and suggestions are provided on how clinical trials in space might be conducted. An envisioned model of on-site production and delivery of medicines in space is proposed, referencing emerging technologies (e.g. Chemputing, synthetic biology, and 3D printing) being developed on Earth that may be adapted for extra-terrestrial use. This review concludes with a critical analysis on the regulatory considerations necessary to facilitate the adoption of these technologies and proposes a framework by which these may be enforced. In doing so, this commentary aims to instigate discussions on the pharmaceutical needs of deep space exploration, and strategies on how these may be met.

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Space is a hostile environment that threatens human health and drug stability.

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Data on the behaviour of medicines in space is critical but lacking.

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Novel drug manufacturing and delivery strategies are needed to safeguard crewmembers’ safety.

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Chemputing, synthetic biology, and 3D printing are examples of such emerging technologies.

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A regulatory framework for space medicines must be implemented to assure quality.

Soft nano and microstructures for the photomodulation of cellular signaling and behavior

Photoresponsive soft materials are everywhere in the nature, from human's retina tissues to plants, and have been the inspiration for engineers in the development of modern biomedical materials. Light as an external stimulus is particularly attractive because it is relatively cheap, noninvasive to superficial biological tissues, can be delivered contactless and offers high spatiotemporal control. In the biomedical field, soft materials that respond to long wavelength or that incorporate a photon upconversion mechanism are desired to overcome the limited UV-visible light penetration into biological tissues. Upon light exposure, photosensitive soft materials respond through mechanisms of isomerization, crosslinking or cleavage, hyperthermia, photoreactions, electrical current generation, among others. In this review, we discuss the most recent applications of photosensitive soft materials in the modulation of cellular behavior, for tissue engineering and regenerative medicine, in drug delivery and for phototherapies.

Advances in Concentration Gradient Generation Approaches in a Microfluidic Device for Toxicity Analysis

This systematic review aimed to analyze the development and functionality of microfluidic concentration gradient generators (CGGs) for toxicological evaluation of different biological organisms. We searched articles using the keywords: concentration gradient generator, toxicity, and microfluidic device. Only 33 of the 352 articles found were included and examined regarding the fabrication of the microdevices, the characteristics of the CGG, the biological model, and the desired results. The main fabrication method was soft lithography, using polydimethylsiloxane (PDMS) material (91%) and SU-8 as the mold (58.3%). New technologies were applied to minimize shear and bubble problems, reduce costs, and accelerate prototyping. The Christmas tree CGG design and its variations were the most reported in the studies, as well as the convective method of generation (61%). Biological models included bacteria and nematodes for antibiotic screening, microalgae for pollutant toxicity, tumor and normal cells for, primarily, chemotherapy screening, and Zebrafish embryos for drug and metal developmental toxicity. The toxic effects of each concentration generated were evaluated mostly with imaging and microscopy techniques. This study showed an advantage of CGGs over other techniques and their applicability for several biological models. Even with soft lithography, PDMS, and Christmas tree being more popular in their respective categories, current studies aim to apply new technologies and intricate architectures to improve testing effectiveness and reduce common microfluidics problems, allowing for high applicability of toxicity tests in different medical and environmental models.

Design Aspects of Additive Manufacturing at Microscale: A Review

Additive manufacturing (AM) technology has been researched and developed for almost three decades. Microscale AM is one of the fastest-growing fields of research within the AM area. Considerable progress has been made in the development and commercialization of new and innovative microscale AM processes, as well as several practical applications in a variety of fields. However, there are still significant challenges that exist in terms of design, available materials, processes, and the ability to fabricate true three-dimensional structures and systems at a microscale. For instance, microscale AM fabrication technologies are associated with certain limitations and constraints due to the scale aspect, which may require the establishment and use of specialized design methodologies in order to overcome them. The aim of this paper is to review the main processes, materials, and applications of the current microscale AM technology, to present future research needs for this technology, and to discuss the need for the introduction of a design methodology. Thus, one of the primary concerns of the current paper is to present the design aspects describing the comparative advantages and AM limitations at the microscale, as well as the selection of processes and materials.

Digital Light Processing Bioprinting Advances for Microtissue Models

Digital light processing (DLP) bioprinting has been widely introduced as a fast and robust biofabrication method in tissue engineering. The technique holds a great promise for creating tissue models because it can replicate the resolution and complexity of natural tissues and constructs. A DLP system projects 2D images onto layers of bioink using a digital photomask. The resolution of DLP bioprinting strongly depends on the characteristics of the projected light and the photo-cross-linking response of the bioink microenvironment. In this review, we present a summary of DLP fundamentals with a focus on bioink properties, photoinitiator selection, and light characteristics in resolution of bioprinted constructs. A simple guideline is provided for bioengineers interested in using DLP platforms and customizing technical specifications for its design. The literature review reveals the promising future of DLP bioprinting for disease modeling and biofabrication.

Photoacoustic imaging of 3D-printed vascular networks

Thrombosis in the circulation system can lead to major myocardial infarction and cardiovascular deaths. Understanding thrombosis formation is necessary for developing safe and effective treatments. In this work, using digital light processing (DLP)-based 3D printing, we fabricated sophisticatedin vitromodels of blood vessels with internal microchannels that can be used for thrombosis studies. In this regard, photoacoustic microscopy (PAM) offers a unique advantage for label-free visualization of the 3D-printed vessel models, with large penetration depth and functional sensitivity. We compared the imaging performances of two PAM implementations: optical-resolution PAM and acoustic-resolution PAM, and investigated 3D-printed vessel structures with different patterns of microchannels. Our results show that PAM can provide clear microchannel structures at depths up to 3.6 mm. We further quantified the blood oxygenation in the 3D-printed vascular models, showing that thrombi had lower oxygenation than the normal blood. We expect that PAM can find broad applications in 3D printing and bioprinting forin vitrostudies of various vascular and other diseases.

Engineering 3D Printed Microfluidic Chips for the Fabrication of Nanomedicines

Currently, there is an unmet need to manufacture nanomedicines in a continuous and controlled manner. Three-dimensional (3D) printed microfluidic chips are an alternative to conventional PDMS chips as they can be easily designed and manufactured to allow for customized designs that are able to reproducibly manufacture nanomedicines at an affordable cost. The manufacturing of microfluidic chips using existing 3D printing technologies remains very challenging because of the intricate geometry of the channels. Here, we demonstrate the manufacture and characterization of nifedipine (NFD) polymeric nanoparticles based on Eudragit L-100 using 3D printed microfluidic chips with 1 mm diameter channels produced with two 3D printing techniques that are widely available, stereolithography (SLA) and fuse deposition modeling (FDM). Fabricated polymeric nanoparticles showed good encapsulation efficiencies and particle sizes in the range of 50-100 nm. SLA chips possessed better channel resolution and smoother channel surfaces, leading to smaller particle sizes similar to those obtained by conventional manufacturing methods based on solvent evaporation, while SLA manufactured nanoparticles showed a minimal burst effect in acid media compared to nanoparticles fabricated with FDM chips. Three-dimensional printed microfluidic chips are a novel and easily amenable cost-effective strategy to allow for customization of the design process for continuous manufacture of nanomedicines under controlled conditions, enabling easy scale-up and reducing nanomedicine development times, while maintaining high-quality standards.

Emerging Technologies in Multi-Material Bioprinting

Bioprinting, within the emerging field of biofabrication, aims at the fabrication of functional biomimetic constructs. Different 3D bioprinting techniques have been adapted to bioprint cell-laden bioinks. However, single-material bioprinting techniques oftentimes fail to reproduce the complex compositions and diversity of native tissues. Multi-material bioprinting as an emerging approach enables the fabrication of heterogeneous multi-cellular constructs that replicate their host microenvironments better than single-material approaches. Here, bioprinting modalities are reviewed, their being adapted to multi-material bioprinting is discussed, and their advantages and challenges, encompassing both custom-designed and commercially available technologies are analyzed. A perspective of how multi-material bioprinting opens up new opportunities for tissue engineering, tissue model engineering, therapeutics development, and personalized medicine is offered.

Stereolithography 3D printing technology in pharmaceuticals: a review

Three-dimensional printing (3DP) technology is an innovative tool used in manufacturing medical devices, producing alloys, replacing biological tissues, producing customized dosage forms and so on. Stereolithography (SLA), a 3D printing technique, is very rapid and highly accurate and produces finished products of uniform quality. 3D formulations have been optimized with a perfect tool of artificial intelligence learning techniques. Complex designs/shapes can be fabricated through SLA using the photopolymerization principle. Different 3DP technologies are introduced and the most promising of these, SLA, and its commercial applications, are focused on. The high speed and effectiveness of SLA are highlighted. The working principle of SLA, the materials used and applications of the technique in a wide range of different sectors are highlighted in this review. An innovative idea of 3D printing customized pharmaceutical dosage forms is also presented. SLA compromises several advantages over other methods, such as cost effectiveness, controlled integrity of materials and greater speed. The development of SLA has allowed the development of printed pharmaceutical devices. Considering the present trends, it is expected that SLA will be used along with conventional methods of manufacturing of 3D model. This 3D printing technology may be utilized as a novel tool for delivering drugs on demand. This review will be useful for researchers working on 3D printing technologies.

Fused filament fabrication 3D printed polylactic acid electroosmotic pumps

Additive manufacturing (3D printing) offers a flexible approach for the production of bespoke microfluidic structures such as the electroosmotic pump. Here a readily accessible fused filament fabrication (FFF) 3D printing technique has been employed for the first time to produce microcapillary structures using low cost thermoplastics in a scalable electroosmotic pump application. Capillary structures were formed using a negative space 3D printing approach to deposit longitudinal filament arrangements with polylactic acid (PLA) in either "face-centre cubic" or "body-centre cubic" arrangements, where the voids deliberately formed within the deposited structure act as functional micro-capillaries. These 3D printed capillary structures were shown to be capable of functioning as a simple electroosmotic pump (EOP), where the maximum flow rate of a single capillary EOP was up to 1.0 μl min^-1 at electric fields of up to 750 V cm^-1. Importantly, higher flow rates were readily achieved by printing parallel multiplexed capillary arrays.

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.

Patient-Specific Organoid and Organ-on-a-Chip: 3D Cell-Culture Meets 3D Printing and Numerical Simulation

The last few decades have witnessed diversified in vitro models to recapitulate the architecture and function of living organs or tissues and contribute immensely to advances in life science. Two novel 3D cell culture models: 1) Organoid, promoted mainly by the developments of stem cell biology and 2) Organ-on-a-chip, enhanced primarily due to microfluidic technology, have emerged as two promising approaches to advance the understanding of basic biological principles and clinical treatments. This review describes the comparable distinct differences between these two models and provides more insights into their complementarity and integration to recognize their merits and limitations for applicable fields. The convergence of the two approaches to produce multi-organoid-on-a-chip or human organoid-on-a-chip is emerging as a new approach for building 3D models with higher physiological relevance. Furthermore, rapid advancements in 3D printing and numerical simulations, which facilitate the design, manufacture, and results-translation of 3D cell culture models, can also serve as novel tools to promote the development and propagation of organoid and organ-on-a-chip systems. Current technological challenges and limitations, as well as expert recommendations and future solutions to address the promising combinations by incorporating organoids, organ-on-a-chip, 3D printing, and numerical simulation, are also summarized.

Three-Dimensional Engineered Peripheral Nerve: Toward a New Era of Patient-Specific Nerve Repair Solutions

Reconstruction of peripheral nerve injuries (PNIs) with substance loss remains challenging because of limited treatment solutions and unsatisfactory patient outcomes. Currently, nerve autografting is the first-line management choice for bridging critical-sized nerve defects. The procedure, however, is often complicated by donor site morbidity and paucity of nerve tissue, raising a quest for better alternatives. The application of other treatment surrogates, such as nerve guides, remains questionable, and it is inefficient in irreducible nerve gaps. More importantly, these strategies lack customization for personalized patient therapy, which is a significant drawback of these nerve repair options. This negatively impacts the fascicle-to-fascicle regeneration process, critical to restoring the physiological axonal pathway of the disrupted nerve. Recently, the use of additive manufacturing (AM) technologies has offered major advancements to the bioengineering solutions for PNI therapy. These techniques aim at reinstating the native nerve fascicle pathway using biomimetic approaches, thereby augmenting end-organ innervation. AM-based approaches, such as three-dimensional (3D) bioprinting, are capable of biofabricating 3D-engineered nerve graft scaffolds in a patient-specific manner with high precision. Moreover, realistic in vitro models of peripheral nerve tissues that represent the physiologically and functionally relevant environment of human organs could also be developed. However, the technology is still nascent and faces major translational hurdles. In this review, we spotlighted the clinical burden of PNIs and most up-to-date treatment to address nerve gaps. Next, a summarized illustration of the nerve ultrastructure that guides research solutions is discussed. This is followed by a contrast of the existing bioengineering strategies used to repair peripheral nerve discontinuities. In addition, we elaborated on the most recent advances in 3D printing and biofabrication applications in peripheral nerve modeling and engineering. Finally, the major challenges that limit the evolution of the field along with their possible solutions are also critically analyzed.

3D-Printed Microfluidics and Potential Biomedical Applications

3D printing is a smart additive manufacturing technique that allows the engineering of biomedical devices that are usually difficult to design using conventional methodologies such as machining or molding. Nowadays, 3D-printed microfluidics has gained enormous attention due to their various advantages including fast production, cost-effectiveness, and accurate designing of a range of products even geometrically complex devices. In this review, we focused on the recent significant findings in the field of 3D-printed microfluidic devices for biomedical applications. 3D printers are used as fabrication tools for a broad variety of systems for a range of applications like diagnostic microfluidic chips to detect different analytes, for example, glucose, lactate, and glutamate and the biomarkers related to different clinically relevant diseases, for example, malaria, prostate cancer, and breast cancer. 3D printers can print various materials (inorganic and polymers) with varying density, strength, and chemical properties that provide users with a broad variety of strategic options. In this article, we have discussed potential 3D printing techniques for the fabrication of microfluidic devices that are suitable for biomedical applications. Emerging diagnostic technologies using 3D printing as a method for integrating living cells or biomaterials into 3D printing are also reviewed.

3D printing of functional microrobots

3D printing (also called "additive manufacturing" or "rapid prototyping") is able to translate computer-aided and designed virtual 3D models into 3D tangible constructs/objects through a layer-by-layer deposition approach. Since its introduction, 3D printing has aroused enormous interest among researchers and engineers to understand the fabrication process and composition-structure-property correlation of printed 3D objects and unleash its great potential for application in a variety of industrial sectors. Because of its unique technological advantages, 3D printing can definitely benefit the field of microrobotics and advance the design and development of functional microrobots in a customized manner. This review aims to present a generic overview of 3D printing for functional microrobots. The most applicable 3D printing techniques, with a focus on laser-based printing, are introduced for the 3D microfabrication of microrobots. 3D-printable materials for fabricating microrobots are reviewed in detail, including photopolymers, photo-crosslinkable hydrogels, and cell-laden hydrogels. The representative applications of 3D-printed microrobots with rational designs heretofore give evidence of how these printed microrobots are being exploited in the medical, environmental, and other relevant fields. A future outlook on the 3D printing of microrobots is also provided.

Thickness-Dependent Permeation Properties of Quenched and Standard Laser-Sintered Polyamide 12 Sheets

The laser sintering of polymers is an additive manufacturing technology that is becoming increasingly established in the industrial environment. This study investigated the thickness-dependent permeation properties of laser-sintered (LS) polymers as required to design and produce components with a special barrier performance to gaseous substances. Helium and oxygen permeation experiments were carried out on quenched and standard LS polyamide 12 (PA12) sheets generated with two, four, six, and eight layers at a constant powder layer thickness of 100 µm. The structural properties of the sheets were examined by differential scanning calorimetry, light microscopy, and X-ray micro-computed tomography. A reduction in thickness resulted in higher diffusion coefficients for both types of LS sheets. An explanation could be the large volume fraction of poorly sintered powder particles adhering to the surfaces and incomplete melting and low consolidation of the polymer at small thicknesses. The thickness-dependency of the solubility coefficients was the opposite, especially for the standard LS sheets, which might be related to the larger pore volume in thicker sheets. As both effects compensated for each other, nearly constant permeation coefficients for all thicknesses were observed. The results provide further insights into different material characteristics of thin LS PA12 structures and offer new information on factors relevant to their solution and diffusion behavior.

Steroid Eluting Esophageal-Targeted Drug Delivery Devices for Treatment of Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic atopic disease that has become increasingly prevalent over the past 20 years. A first-line pharmacologic option is topical/swallowed corticosteroids, but these are adapted from asthma preparations such as fluticasone from an inhaler and yield suboptimal response rates. There are no FDA-approved medications for the treatment of EoE, and esophageal-specific drug formulations are lacking. We report the development of two novel esophageal-specific drug delivery platforms. The first is a fluticasone-eluting string that could be swallowed similar to the string test "entero-test" and used for overnight treatment, allowing for a rapid release along the entire length of esophagus. In vitro drug release studies showed a target release of 1 mg/day of fluticasone. In vivo pharmacokinetic studies were carried out after deploying the string in a porcine model, and our results showed a high local level of fluticasone in esophageal tissue persisting over 1 and 3 days, and a minimal systemic absorption in plasma. The second device is a fluticasone-eluting 3D printed ring for local and sustained release of fluticasone in the esophagus. We designed and fabricated biocompatible fluticasone-loaded rings using a top-down, Digital Light Processing (DLP) Gizmo 3D printer. We explored various strategies of drug loading into 3D printed rings, involving incorporation of drug during the print process (pre-loading) or after printing (post-loading). In vitro drug release studies of fluticasone-loaded rings (pre and post-loaded) showed that fluticasone elutes at a constant rate over a period of one month. Ex vivo pharmacokinetic studies in the porcine model also showed high tissue levels of fluticasone and both rings and strings were successfully deployed into the porcine esophagus in vivo. Given these preliminary proof-of-concept data, these devices now merit study in animal models of disease and ultimately subsequent translation to testing in humans.

3D Printing Technologies in Metallic Implants: A Thematic Review on the Techniques and Procedures

Additive manufacturing (AM) is among the most attractive methods to produce implants, the processes are very swift and it can be precisely controlled to meet patient's requirement since they can be produced in exact shape, dimension, and even texture of different living tissues. Until now, lots of methods have emerged and used in this field with diverse characteristics. This review aims to comprehensively discuss 3D printing (3DP) technologies to manufacture metallic implants, especially on techniques and procedures. Various technologies based on their main properties are categorized, the effecting parameters are introduced, and the history of AM technology is briefly analyzed. Subsequently, the utilization of these AM-manufactured components in medicine along with their effectual variables is discussed, and special attention is paid on to the production of porous scaffolds, taking pore size, density, etc., into consideration. Finally, 3DP of the popular metallic systems in medical applications such as titanium, Ti6Al4V, cobalt-chromium alloys, and shape memory alloys are studied. In general, AM manufactured implants need to comply with important requirements such as biocompatibility, suitable mechanical properties (strength and elastic modulus), surface conditions, custom-built designs, fast production, etc. This review aims to introduce the AM technologies in implant applications and find new ways to design more sophisticated methods and compatible implants that mimic the desired tissue functions.

DLP 3D Printing Meets Lignocellulosic Biopolymers: Carboxymethyl Cellulose Inks for 3D Biocompatible Hydrogels

The development of new bio-based inks is a stringent request for the expansion of additive manufacturing towards the development of 3D-printed biocompatible hydrogels. Herein, methacrylated carboxymethyl cellulose (M-CMC) is investigated as a bio-based photocurable ink for digital light processing (DLP) 3D printing. CMC is chemically modified using methacrylic anhydride. Successful methacrylation is confirmed by ¹H NMR and FTIR spectroscopy. Aqueous formulations based on M-CMC/lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) photoinitiator and M-CMC/Dulbecco’s Modified Eagle Medium (DMEM)/LAP show high photoreactivity upon UV irradiation as confirmed by photorheology and FTIR. The same formulations can be easily 3D-printed through a DLP apparatus to produce 3D shaped hydrogels with excellent swelling ability and mechanical properties. Envisaging the application of the hydrogels in the biomedical field, cytotoxicity is also evaluated. The light-induced printing of cellulose-based hydrogels represents a significant step forward in the production of new DLP inks suitable for biomedical applications.

High throughput direct 3D bioprinting in multiwell plates

Advances in three dimensional (3D) bioprinting have enabled the fabrication of sophisticated 3D tissue scaffolds for biological and medical applications, where high speed, high throughput production in well plates is a critical need. Here, we present an integrated 3D bioprinting platform based on microscale continuous optical printing, capable of high throughput in situ rapid fabrication of complex 3D biomedical samples in multiwell plate formats for subsequent culture and analysis. Our high throughput 3D bioprinter (HT-3DP) was used to showcase constructs of varying spatial geometries of biomimetic significance, tunable mechanical properties, as well as reproducibility. Live hepatocellular carcinoma 3D tissue scaffolds were fabricated in situ in multiwell plates, after which a functional drug response assay against the chemotherapy drug doxorubicin was performed. Dual cell-type populations involving both live hepatocellular carcinoma as well as human umbilical vein endothelial cells were also printed to demonstrate dual-tissue fabrication capability. This work demonstrates a significant advancement in that the production rate of 3D bioprinted tissue scaffolds with controllable spatial architectures and mechanical properties can now be done on a high throughput scale, enabling rapid generation of in vitro 3D tissue models within conventional multiwell cell culture plates for high throughput preclinical drug screening and disease modeling.

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.

Three-Dimensional Printed Devices in Droplet Microfluidics

Droplet microfluidics has become the most promising subcategory of microfluidics since it contributes numerous applications to diverse fields. However, fabrication of microfluidic devices for droplet formation, manipulation and applications is usually complicated and expensive. Three-dimensional printing (3DP) provides an exciting alternative to conventional techniques by simplifying the process and reducing the cost of fabrication. Complex and novel structures can be achieved via 3DP in a simple and rapid manner, enabling droplet microfluidics accessible to more extensive users. In this article, we review and discuss current development, opportunities and challenges of applications of 3DP to droplet microfluidics.

Mechanics of shape distortion of DLP 3D printed structures during UV post-curing

Digital light processing (DLP) three-dimensional (3D) printing technology has advantages of fast printing speed and high printing precision. It can print objects with small and complex geometrical features and has been widely used in jewelry manufacturing and dentistry. In DLP printing, it is common to use post-treatment with UV light irradiation to improve the final mechanical properties. However, it was found that the UV post-curing process can lead to shape distortion and thus reduction of dimension accuracy. In this paper, we combined photopolymerization reaction kinetics and Euler-Bernoulli beam theory to study UV post-curing induced shape distortion of thin structures prepared by DLP 3D printing. Experiments were conducted to characterize the evolution of mechanical behavior of printed samples during the post-printing process, which was correlated to printing parameters (printing time of single-layer, height of single-layer and printing UV intensity), post-curing UV light intensity and the thickness of the strip. Moreover, post-curing induced distortion was used for the fabrication of 3D structures.

Application of Micro-Scale 3D Printing in Pharmaceutics

3D printing, as one of the most rapidly-evolving fabrication technologies, has released a cascade of innovation in the last two decades. In the pharmaceutical field, the integration of 3D printing technology has offered unique advantages, especially at the micro-scale. When printed at a micro-scale, materials and devices can provide nuanced solutions to controlled release, minimally invasive delivery, high-precision targeting, biomimetic models for drug discovery and development, and future opportunities for personalized medicine. This review aims to cover the recent advances in this area. First, the 3D printing techniques are introduced with respect to the technical parameters and features that are uniquely related to each stage of pharmaceutical development. Then specific micro-sized pharmaceutical applications of 3D printing are summarized and grouped according to the provided benefits. Both advantages and challenges are discussed for each application. We believe that these technologies provide compelling future solutions for modern medicine, while challenges remain for scale-up and regulatory approval.

Biofabrication of phenotypic pulmonary fibrosis assays

Biofabrication techniques have enabled the formation of complex models of many biological tissues. We present a framework to contextualize biofabrication techniques within a disease modeling application. Fibrosis is a progressive disease interfering with tissue structure and function, which stems from an aberrant wound healing response. Epithelial injury and clot formation lead to fibroblast invasion and activation, followed by contraction and remodeling of the extracellular matrix. These stages have healthy wound healing variants in addition to the pathogenic analogs that are seen in fibrosis. This review evaluates biofabrication of a variety of phenotypic cell-based fibrosis assays. By recapitulating different contributors to fibrosis, these assays are able to evaluate biochemical pathways and therapeutic candidates for specific stages of fibrosis pathogenesis. Biofabrication of these culture models may enable phenotypic screening for improved understanding of fibrosis biology as well as improved screening of anti-fibrotic therapeutics.

Omnidirectional Printing of Soft Elastomer for Liquid-State Stretchable Electronics

Stretchable electronics has emerged as a new class of electronic technology to expand the applications of conventional electronics built on rigid wafers. Among various systems, liquid-state devices utilize electronically active liquids to achieve excellent stretchability and durability. The widespread adaption to such attractive form of device is hindered by the lack of robust fabrication approach to precisely and efficiently assemble liquid-state materials into functional systems. In this study, an additive manufacturing platform for digital fabrication of three-dimensional elastomeric structures is reported. The shear-thinning ink is formulated to enable omnidirectional printing process. Various elastic features with complex architectures are generated without using sacrificial materials, which consist of overhanging parts, suspended structures, and embedded channels. Harnessing the unique printability allows facile creation of elastomeric sensors with strain- and pressure-sensing capabilities by simply filling the embedded microchannels with liquid metal. A smart glove to capture hand gestures is also demonstrated as a fully integrated electronic system with liquid-state components. The liquid-state stretchable electronics developed here may find potential applications in biomedical instruments, wearable devices, and soft robotics.

Projection Printing of Ultrathin Structures with Nanoscale Thickness Control

Spatial control of photon energy has been a central part of many light-based manufacturing processes. We report a direct projection printing method for ultrathin structures with nanoscale thickness control by using a patterned evanescent field. The evanescent field is induced by total internal reflection at the interface between the substrate and a prepolymer solution, and it is patterned by a phase-only spatial light modulator. The ultrathin structure is printed on a high-refractive-index glass substrate through photopolymerization. An iterative algorithm is used to calculate the phase pattern for generating arbitrary holography images and making the image plane to coincide with the interface. The thickness of the pattern is limited by the penetration depth of the evanescent field. Experiment results demonstrated that polymer structures as thin as 200 nm can be patterned without significant process optimization. Such fine control in thickness could transform many techniques such as light-based 3D printing and laser direct-write manufacturing.

Thiol–yne chemistry for 3D printing: exploiting an off-stoichiometric route for selective functionalization of 3D objects

An alkyne monomer, bis(propargyl) fumarate, is synthesized and mixed to a thiol monomer to produce DLP-3D printable formulations. Using off-stoichiometric formulations it is possible to print functionalizable objects.

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.

Projection-Based 3D Printing of Cell Patterning Scaffolds with Multiscale Channels

To fully actualize artificial, cell-laden biological models in tissue engineering, such as 3D organoids and organs-on-a-chip systems, cells need to be patterned such that they can precisely mimic natural microenvironments in vitro. Despite increasing interest in this area, patterning cells at multiscale (∼10 μm to 10 mm) remains a significant challenge in bioengineering. Here, we report a projection-based 3D printing system that achieves rapid and high-resolution fabrication of hydrogel scaffolds featuring intricate channels for multiscale cell patterning. Using this system, we were able to use biocompatible poly(ethylene glycol)diacrylate in fabricating a variety of scaffold architectures, ranging from regular geometries such as serpentine, spiral, and fractal-like to more irregular/intricate geometries, such as biomimetic arborescent and capillary networks. A red food dye solution was able to freely fill all channels in the scaffolds, from the trunk (>1100 μm in width) to the small branch (∼17 μm in width) without an external pump. The dimensions of the printed scaffolds remained stable over 3 days while being immersed in Dulbecco's phosphate-buffered saline at 37 °C, and a penetration analysis revealed that these scaffolds are suitable for metabolic and nutrient transport. Cell patterning experiments showed that red fluorescent protein-transfected A549 human nonsmall lung cancer cells adhered well in the scaffolds' channels, and showed further attachment and penetration during cell culture proliferation.