Three-Dimensional Bioprinting of Cell-Laden Constructs Using Polysaccharide-Based Self-Healing Hydrogels

Cell-adhesive double network self-healing hydrogel capable of cell and drug encapsulation: New platform to construct biomimetic environment with bottom-up approach

This study presents the development and characterization of a novel double-network self-healing hydrogel based on N-carboxyethyl chitosan (CEC) and oxidized dextran (OD) with the incorporation of crosslinked collagen (CEC-OD/COL-GP) to enhance its biological and physicochemical properties. The hydrogel formed via dynamic imine bond formation exhibited efficient self-healing within 30 min, and a compressive modulus recovery of 92 % within 2 h. In addition to its self-healing ability, CEC-OD/COL-GP possesses unique physicochemical characteristics including transparency, injectability, and adhesiveness to various substrates and tissues. Cell encapsulation studies confirmed the biocompatibility and suitability of the hydrogel as a cell-culture scaffold, with the presence of a collagen network that enhances cell adhesion, spreading, long-term cell viability, and proliferation. Leveraging their unique properties, we engineered assemblies of self-healing hydrogel modules for controlled spatiotemporal drug delivery and constructed co-culture models that simulate angiogenesis in tumor microenvironments. Overall, the CEC-OD/COL-GP hydrogel is a versatile and promising material for biomedical applications, offering a bottom-up approach for constructing complex structures with self-healing capabilities, controlled drug release, and support for diverse cell types in 3D environments. This hydrogel platform has considerable potential for advancements in tissue engineering and therapeutic interventions.

Nanocomposite Hydrogel Bioinks for 3D Bioprinting of Tumor Models

In vitro tumor models were successfully constructed by 3D bioprinting; however, bioinks with proper viscosity, good biocompatibility, and tunable biophysical and biochemical properties are highly desirable for tumor models that closely recapitulated the main features of native tumors. Here, we developed a nanocomposite hydrogel bioink that was used to construct ovarian and colon cancer models by 3D bioprinting. The nanocomposite bioink was composed of aldehyde-modified cellulose nanocrystals (aCNCs), aldehyde-modified hyaluronic acid (aHA), and gelatin. The hydrogels possessed tunable gelation time, mechanical properties, and printability by controlling the ratio between aCNCs and gelatin. In addition, ovarian and colorectal cancer cells embedded in hydrogels showed high survival rates and rapid growth. By the combination of 3D bioprinting, ovarian and colorectal tumor models were constructed in vitro and used for drug screening. The results showed that gemcitabine had therapeutic effects on ovarian tumor cells. However, the ovarian tumor model showed drug resistance for oxaliplatin treatment.

Polysaccharide-protein based scaffolds for cartilage repair and regeneration

Cartilage repair and regeneration have become a global issue that millions of patients from all over the world need surgical intervention to repair the articular cartilage annually due to the limited self-healing capability of the cartilage tissues. Cartilage tissue engineering has gained significant attention in cartilage repair and regeneration by integration of the chondrocytes (or stem cells) and the artificial scaffolds. Recently, polysaccharide-protein based scaffolds have demonstrated unique and promising mechanical and biological properties as the artificial extracellular matrix of natural cartilage. In this review, we summarize the modification methods for polysaccharides and proteins. The preparation strategies for the polysaccharide-protein based hydrogel scaffolds are presented. We discuss the mechanical, physical and biological properties of the polysaccharide-protein based scaffolds. Potential clinical translation and challenges on the artificial scaffolds are also discussed.

One Stone Three Birds: Silver Sulfadiazine Modulates the Stability and Dynamics of Hydrogels for Infected Wound Healing

Dynamic covalent bond hydrogels have demonstrated significant application potential in biomedical fields for their dynamic reversibility. However, the contradiction between the stability and dynamics of the hydrogel restricts its application. Here, utilizing silver sulfadiazine (AgSD) as a catalyst, hyaluronic acid-based hydrogels are constructed through imine bond crosslinking and incorporated disulfide bonds within the same crosslinking chain. It is found that AgSD can accelerate the formation of imine crosslinking bonds to improve the stability of hydrogels, thereby shortening the gelation time by ≈36.9 times, enhancing compression strength and adhesion strength by ≈2.4 times and 1.7 times, respectively, while inhibiting swelling and degradation rates to ≈2.1 times and 3.7 times. Besides, AgSD can coordinate with disulfide bonds to enhance the dynamics of hydrogel, enhancing the hydrogel self-healing efficiency by ≈2.3 times while reducing the relaxation time by ≈25.1 times. Significantly, AgSD imparts remarkable antibacterial properties to the hydrogel, thereby effectively facilitating the healing of bacterial infected wounds. Consequently, introducing AgSD enables hydrogels to possess concurrent stability, dynamics, and antibacterial properties. This strategy of regulating hydrogels by introducing AgSD provides a valuable reference for the application of dynamic covalent bonds.

Enhancing regenerative medicine with self-healing hydrogels: A solution for tissue repair and advanced cyborganic healthcare devices

Considering the global burden related to tissue and organ injuries or failures, self-healing hydrogels may be an attractive therapeutic alternative for the future. Self-healing hydrogels are highly hydrated 3D structures with the ability to self-heal after breaking, this property is attributable to a variety of dynamic non-covalent and covalent bonds that are able to re-linking within the matrix. Self-healing ability specially benefits minimal invasive medical treatments with cell-delivery support. Moreover, those tissue-engineered self-healing hydrogels network have demonstrated effectiveness for myriad purposes; for instance, they could act as delivery-platforms for different cargos (drugs, growth factors, cells, among others) in tissues such as bone, cartilage, nerve or skin. Besides, self-healing hydrogels have currently found their way into new and novel applications; for example, with the development of the self-healing adhesive hydrogels, by merely aiding surgical closing processes and by providing biomaterial-tissue adhesion. Furthermore, conductive hydrogels permit the stimuli and monitoring of natural electrical signals, which facilitated a better fitting of hydrogels in native tissue or the diagnosis of various health diseases. Lastly, self-healing hydrogels could be part of cyborganics - a merge between biology and machinery - which can pave the way to a finer healthcare devices for diagnostics and precision therapies.

An overview of nasal cartilage bioprinting: from bench to bedside

Nasal cartilage diseases and injuries are known as significant challenges in reconstructive medicine, affecting a substantial number of individuals worldwide. In recent years, the advent of three-dimensional (3D) bioprinting has emerged as a promising approach for nasal cartilage reconstruction, offering potential breakthroughs in the field of regenerative medicine. This paper provides an overview of the methods and challenges associated with 3D bioprinting technologies in the procedure of reconstructing nasal cartilage tissue. The process of 3D bioprinting entails generating a digital 3D model using biomedical imaging techniques and computer-aided design to integrate both internal and external scaffold features. Then, bioinks which consist of biomaterials, cell types, and bioactive chemicals, are applied to facilitate the precise layer-by-layer bioprinting of tissue-engineered scaffolds. After undergoing in vitro and in vivo experiments, this process results in the development of the physiologically functional integrity of the tissue. The advantages of 3D bioprinting encompass the ability to customize scaffold design, enabling the precise incorporation of pore shape, size, and porosity, as well as the utilization of patient-specific cells to enhance compatibility. However, various challenges should be considered, including the optimization of biomaterials, ensuring adequate cell viability and differentiation, achieving seamless integration with the host tissue, and navigating regulatory attention. Although numerous studies have demonstrated the potential of 3D bioprinting in the rebuilding of such soft tissues, this paper covers various aspects of the bioprinted tissues to provide insights for the future development of repair techniques appropriate for clinical use.

Self-Healing Hydrogel Bioelectronics

Hydrogels have emerged as powerful building blocks to develop various soft bioelectronics because of their tissue-like mechanical properties, superior bio-compatibility, the ability to conduct both electrons and ions, and multiple stimuli-responsiveness. However, hydrogels are vulnerable to mechanical damage, which limits their usage in developing durable hydrogel-based bioelectronics. Self-healing hydrogels aim to endow bioelectronics with the property of repairing specific functions after mechanical failure, thus improving their durability, reliability, and longevity. This review discusses recent advances in self-healing hydrogels, from the self-healing mechanisms, material chemistry, and strategies for multiple properties improvement of hydrogel materials, to the design, fabrication, and applications of various hydrogel-based bioelectronics, including wearable physical and biochemical sensors, supercapacitors, flexible display devices, triboelectric nanogenerators (TENGs), implantable bioelectronics, etc. Furthermore, the persisting challenges hampering the development of self-healing hydrogel bioelectronics and their prospects are proposed. This review is expected to expedite the research and applications of self-healing hydrogels for various self-healing bioelectronics.

Nonvascularized bone grafts: how successful are they in reconstruction of segmental mandibular defects?

OBJECTIVE

Segmental mandibular defects can occur due to various etiologies, including trauma and tumor resection. Reconstruction should provide adequate support for subsequent dental rehabilitation and allow for proper occlusion. Nonvascularized bone grafts have been used for reconstructing mandibular defects in cases where vascularized grafts were not feasible. The objective of this study was to assess the success rate of these grafts in reconstruction of segmental defects of various sizes in the mandible.

STUDY DESIGN

Fifty patients were included in this retrospective chart review. Length of the grafts varied from 3 to 20 cm and patients were followed up from 4 to 80 months. Fifteen grafts were harvested from anterior iliac crest, 23 from posterior iliac crest, 9 grafts were a combination of either with costochondral graft, and 3 were solely allografts. Bone morphogenetic protein was utilized in 41 cases as an adjunct.

RESULTS

Success was defined as continuity of bone clinically and radiographically at a 4-month follow-up. Nonvascularized bone grafting was successful in 90% of cases. Complications were observed in 34% of cases, of which the most common were infection followed by wound dehiscence.

CONCLUSIONS

Our study demonstrated substantial success rate with nonvascularized bone grafts in reconstruction of segmental mandibular defects.

Rapid self-healing carboxymethyl chitosan/hyaluronic acid hydrogels with injectable ability for drug delivery

In this study, the quaternized carboxymethyl chitosan (QCMCS), oxidized hyaluronic acid (OHA), 3,3'-dithiobis-(propionohydrazide) (DTP) were used as raw materials for the synthesis of hydrogels with excellent properties as carriers for drug release. The hydrogels were prepared by a simple "one-pot" method without external stimuli on the basis of interactions between formed dynamic covalent bonds (imine bonds, acylhydrazone bonds, disulfide bonds) and hydrogen bonds. The hydrogels had rapid self-healing properties, with a self-healing rate of 96 % after 30 min, as well as good pH responsiveness and excellent cytocompatibility (up to 98 % cell survival). The compressive stress of the hydrogels reached 423 kPa. Moreover, a representative drug (acetylsalicylic acid) demonstrated sustained release in the hydrogels (>72 h). The drug release behaviour was shown to be consistent with the Fick diffusion mechanism by kinetic modelling. Collectively, the findings demonstrate that the QCMCS + OHA + DTP injectable self-healing hydrogels are a potential material for the construction of pH-controlled drug delivery platforms.

3D Printing of Self-Healing Materials

This review article presents a comprehensive overview of the latest advances in the field of 3D printable structures with self-healing properties. Three-dimensional printing (3DP) is a versatile technology that enables the rapid manufacturing of complex geometric structures with precision and functionality not previously attainable. However, the application of 3DP technology is still limited by the availability of materials with customizable properties specifically designed for additive manufacturing. The addition of self-healing properties within 3D printed objects is of high interest as it can improve the performance and lifespan of structural components, and even enable the mimicking of living tissues for biomedical applications, such as organs printing. The review will discuss and analyze the most relevant results reported in recent years in the development of self-healing polymeric materials that can be processed via 3D printing. After introducing the chemical and physical self-healing mechanism that can be exploited, the literature review here reported will focus in particular on printability and repairing performances. At last, actual perspective and possible development field will be critically discussed.

Recent advances in 3D bioprinted cartilage-mimicking constructs for applications in tissue engineering

Human cartilage tissue can be categorized into three types: hyaline cartilage, elastic cartilage and fibrocartilage. Each type of cartilage tissue possesses unique properties and functions, which presents a significant challenge for the regeneration and repair of damaged tissue. Bionics is a discipline in which humans study and imitate nature. A bionic strategy based on comprehensive knowledge of the anatomy and histology of human cartilage is expected to contribute to fundamental study of core elements of tissue repair. Moreover, as a novel tissue-engineered technology, 3D bioprinting has the distinctive advantage of the rapid and precise construction of targeted models. Thus, by selecting suitable materials, cells and cytokines, and by leveraging advanced printing technology and bionic concepts, it becomes possible to simultaneously realize multiple beneficial properties and achieve improved tissue repair. This article provides an overview of key elements involved in the combination of 3D bioprinting and bionic strategies, with a particular focus on recent advances in mimicking different types of cartilage tissue.

Fabrication and characterization of porous, degradable, biocompatible poly(vinyl alcohol)/tannic acid/gelatin/hyaluronic acid hydrogels with good mechanical properties for cartilage tissue engineering

At present, articular cartilage repair and regeneration remain still one of the most concerned problems due to its poor self-healing capacity. Among the tissue engineering materials, hydrogel is considered an ideal candidate due to its similarity to extracellular matrices. Despite the good biocompatibility of gelatin and hyaluronic acid hydrogels, they are still limited to serve as tissue engineering materials by fast degradation rate and poor mechanical performances. In order to solve these problems, novel polyvinyl alcohol/tannic acid/gelatin/hyaluronic acid (PTGH) hydrogels are prepared by a facile physical crosslinked method. The PTGH hydrogels exhibit a high moisture content (85%) and porosity (87%). Meanwhile, the porous microstructures and mechanical properties (compressive strength: 0.85-2.59 MPa; compressive modulus: 57.88-124.27 kPa) can be controlled by adjusting the mass ratio of PT/GH. In vitro degradation analysis shows that the PTGH hydrogels can be degraded gradually in PBS solution with the presence of lysozyme. For this gel system, based on the hydrogen bonds among molecules, it improved the mechanical properties of gelatin and hyaluronic acid hydrogels. With the degradation of PTGH hydrogels, the release of gelatin and hyaluronic acid can have a continuous effort for the cartilage tissue regeneration and repair. In addition, in vitro cell culture results show that the PTGH hydrogels have no negative effects on chondrocytes growth and proliferation. In all, the PTGH hydrogels exhibit potential applications for articular cartilage tissue repair and regeneration.

Nanomaterials-incorporated hydrogels for 3D bioprinting technology

In the field of tissue engineering and regenerative medicine, various hydrogels derived from the extracellular matrix have been utilized for creating engineered tissues and implantable scaffolds. While these hydrogels hold immense promise in the healthcare landscape, conventional bioinks based on ECM hydrogels face several challenges, particularly in terms of lacking the necessary mechanical properties required for 3D bioprinting process. To address these limitations, researchers are actively exploring novel nanomaterial-reinforced ECM hydrogels for both mechanical and functional aspects. In this review, we focused on discussing recent advancements in the fabrication of engineered tissues and monitoring systems using nanobioinks and nanomaterials via 3D bioprinting technology. We highlighted the synergistic benefits of combining numerous nanomaterials into ECM hydrogels and imposing geometrical effects by 3D bioprinting technology. Furthermore, we also elaborated on critical issues remaining at the moment, such as the inhomogeneous dispersion of nanomaterials and consequent technical and practical issues, in the fabrication of complex 3D structures with nanobioinks and nanomaterials. Finally, we elaborated on plausible outlooks for facilitating the use of nanomaterials in biofabrication and advancing the function of engineered tissues.

4D Printing Shape-Morphing Hybrid Biomaterials for Advanced Bioengineering Applications

Four-dimensional (4D) printing is an innovative additive manufacturing technology used to fabricate structures that can evolve over time when exposed to a predefined environmental stimulus. 4D printed objects are no longer static objects but programmable active structures that accomplish their functions thanks to a change over time in their physical/chemical properties that usually displays macroscopically as a shapeshifting in response to an external stimulus. 4D printing is characterized by several entangled features (e.g., involved material(s), structure geometry, and applied stimulus entities) that need to be carefully coupled to obtain a favorable fabrication and a functioning structure. Overall, the integration of micro-/nanofabrication methods of biomaterials with nanomaterials represents a promising approach for the development of advanced materials. The ability to construct complex and multifunctional triggerable structures capable of being activated allows for the control of biomedical device activity, reducing the need for invasive interventions. Such advancements provide new tools to biomedical engineers and clinicians to design dynamically actuated implantable devices. In this context, the aim of this review is to demonstrate the potential of 4D printing as an enabling manufacturing technology to code the environmentally triggered physical evolution of structures and devices of biomedical interest.

Development of Biocompatible 3D-Printed Artificial Blood Vessels through Multidimensional Approaches

Within the human body, the intricate network of blood vessels plays a pivotal role in transporting nutrients and oxygen and maintaining homeostasis. Bioprinting is an innovative technology with the potential to revolutionize this field by constructing complex multicellular structures. This technique offers the advantage of depositing individual cells, growth factors, and biochemical signals, thereby facilitating the growth of functional blood vessels. Despite the challenges in fabricating vascularized constructs, bioprinting has emerged as an advance in organ engineering. The continuous evolution of bioprinting technology and biomaterial knowledge provides an avenue to overcome the hurdles associated with vascularized tissue fabrication. This article provides an overview of the biofabrication process used to create vascular and vascularized constructs. It delves into the various techniques used in vascular engineering, including extrusion-, droplet-, and laser-based bioprinting methods. Integrating these techniques offers the prospect of crafting artificial blood vessels with remarkable precision and functionality. Therefore, the potential impact of bioprinting in vascular engineering is significant. With technological advances, it holds promise in revolutionizing organ transplantation, tissue engineering, and regenerative medicine. By mimicking the natural complexity of blood vessels, bioprinting brings us one step closer to engineering organs with functional vasculature, ushering in a new era of medical advancement.

Application of chitosan with different molecular weights in cartilage tissue engineering

Cartilage tissue engineering involves the invention of novel implantable cartilage replacement materials to help heal cartilage injuries that do not heal themselves, aiming to overcome the shortcomings of current clinical cartilage treatments. Chitosan has been widely used in cartilage tissue engineering because of its similar structure to glycine aminoglycan, which is widely distributed in connective tissues. The molecular weight, as an important structural parameter of chitosan, affects not only the method of chitosan composite scaffold preparation but also the effect on cartilage tissue healing. Thus, this review identifies methods for the preparation of chitosan composite scaffolds with low, medium and high molecular weights, as well as a range of chitosan molecular weights appropriate for cartilage tissue repair, by summarizing the application of different molecular weights of chitosan in cartilage repair in recent years.

Chitosan and its derivatives in 3D/4D (bio) printing for tissue engineering and drug delivery applications

Tissue engineering research has undergone to a revolutionary improvement, thanks to technological advancements, such as the introduction of bioprinting technologies. The ability to develop suitable customized biomaterial inks/bioinks, with excellent printability and ability to promote cell proliferation and function, has a deep impact on such improvements. In this context, printing inks based on chitosan and its derivatives have been instrumental. Thus, the current review aims at providing a comprehensive overview on chitosan-based materials as suitable inks for 3D/4D (bio)printing and their applicability in creating advanced drug delivery platforms and tissue engineered constructs. Furthermore, relevant strategies to improve the mechanical and biological performances of this biomaterial are also highlighted.

Fabricating the cartilage: recent achievements

This review aims to describe the most recent achievements and provide an insight into cartilage engineering and strategies to restore the cartilage defects. Here, we discuss cell types, biomaterials, and biochemical factors applied to form cartilage tissue equivalents and update the status of fabrication techniques, which are used at all stages of engineering the cartilage. The actualized concept to improve the cartilage tissue restoration is based on applying personalized products fabricated using a full cycle platform: a bioprinter, a bioink consisted of ECM-embedded autologous cell aggregates, and a bioreactor. Moreover, in situ platforms can help to skip some steps and enable adjusting the newly formed tissue in the place during the operation. Only some achievements described have passed first stages of clinical translation; nevertheless, the number of their preclinical and clinical trials is expected to grow in the nearest future.

Polysaccharide-based biomaterials in a journey from 3D to 4D printing

3D printing is a state-of-the-art technology for the fabrication of biomaterials with myriad applications in translational medicine. After stimuli-responsive properties were introduced to 3D printing (known as 4D printing), intelligent biomaterials with shape configuration time-dependent character have been developed. Polysaccharides are biodegradable polymers sensitive to several physical, chemical, and biological stimuli, suited for 3D and 4D printing. On the other hand, engineering of mechanical strength and printability of polysaccharide-based scaffolds along with their aneural, avascular, and poor metabolic characteristics need to be optimized varying printing parameters. Multiple disciplines such as biomedicine, chemistry, materials, and computer sciences should be integrated to achieve multipurpose printable biomaterials. In this work, 3D and 4D printing technologies are briefly compared, summarizing the literature on biomaterials engineering though printing techniques, and highlighting different challenges associated with 3D/4D printing, as well as the role of polysaccharides in the technological shift from 3D to 4D printing for translational medicine.

Advances in mechanically robust and biomimetic polysaccharide-based constructs for cartilage tissue engineering

The purpose of cartilage tissue engineering is to provide artificial constructs with biological functions and mechanical features that resemble native tissue to improve tissue regeneration. Biochemical characteristics of the cartilage extracellular matrix (ECM) microenvironment provide a platform for researchers to develop biomimetic materials for optimal tissue repair. Due to the structural similarity of polysaccharides into physicochemical characteristics of cartilage ECM, these natural polymers capture special attention for developing biomimetic materials. The mechanical properties of constructs play a crucial influence in load-bearing cartilage tissues. Moreover, the addition of appropriate bioactive molecules to these constructs can promote chondrogenesis. Here, we discuss polysaccharide-based constructs that can be used to create substitutes for cartilage regeneration. We intend to focus on newly developed bioinspired materials, fine-tuning the mechanical properties of constructs, the design of carriers loaded by chondroinductive agents, and development of appropriate bioinks as a bioprinting approach for cartilage regeneration.

Marine-Inspired Approaches as a Smart Tool to Face Osteochondral Regeneration

The degeneration of osteochondral tissue represents one of the major causes of disability in modern society and it is expected to fuel the demand for new solutions to repair and regenerate the damaged articular joints. In particular, osteoarthritis (OA) is the most common complication in articular diseases and a leading cause of chronic disability affecting a steady increasing number of people. The regeneration of osteochondral (OC) defects is one of the most challenging tasks in orthopedics since this anatomical region is composed of different tissues, characterized by antithetic features and functionalities, in tight connection to work together as a joint. The altered structural and mechanical joint environment impairs the natural tissue metabolism, thus making OC regeneration even more challenging. In this scenario, marine-derived ingredients elicit ever-increased interest for biomedical applications as a result of their outstanding mechanical and multiple biologic properties. The review highlights the possibility to exploit such unique features using a combination of bio-inspired synthesis process and 3D manufacturing technologies, relevant to generate compositionally and structurally graded hybrid constructs reproducing the smart architecture and biomechanical functions of natural OC regions.

Structurally Dynamic Gelatin-Based Hydrogels with Self-Healing, Shape Memory, and Cytocompatible Properties for 4D Printing

Three-dimensional (3D) printable hydrogels with a shape memory effect have emerged as a new class of 4D printing materials recently and found wide applications in various fields. However, synergistically endowing such materials with good mechanical strength and biocompatibility for biomedical uses remains challenging. In this study, a series of multiresponsive hydrogels have been prepared through a dynamic covalent imine/Diels-Alder network from biocompatible starting materials of modified gelatin and poly(ethylene glycol)-based polymers. By further secondary crosslinking with a hyperbranched triethoxysilane reagent (HPASi) that contains multiple supramolecular hydrogen bonding, the hydrogels presented a strengthened self-healing and temperature-responsive shape memory effect. With the additional features of superior stretchability (elongation at break up to 523%), good cytocompatibility, and 3D printable properties, these multifunctional hydrogels showed great potential for broad biomedical applications.

Tissues and organ printing: An evolution of technology and materials

Since its beginnings, three-dimensional printing (3DP) technology has been successful because of ongoing advances in operating principles, the range of materials and cost-saving measures. However, the 3DP technological progressions in the biomedical sector have majorly taken place in the last decade after the evolution of novel 3DP systems, generally categorised as bioprinters and biomaterials to provide a replacement, transplantation or regeneration of the damaged organs and tissue constructs of the human body. There is now substantial scientific literature accessible to support the benefits of digital healthcare procedures with the help of bioprinters. It is of the highest significance to know the fundamental principles of the available printers and the compatibility of biomaterials as their feedstock, notwithstanding the huge potential of bioprinting systems to manufacture organs and other human body components. This paper provides a precise and helpful reading of the different categories of bioprinters, suitable biomaterials, numerical simulations and modelling and examples of much acknowledged clinical practices. The paper will also cite the prominent issues that still have not received desired solutions. Overall, the article will be of great use for all the professionals, scholars and engineers concerned with the 3DP, bioprinting and biomaterials.

Systematic review on the application of 3D-bioprinting technology in orthoregeneration: current achievements and open challenges

BACKGROUND

Joint degeneration and large or complex bone defects are a significant source of morbidity and diminished quality of life worldwide. There is an unmet need for a functional implant with near-native biomechanical properties. The potential for their generation using 3D bioprinting (3DBP)-based tissue engineering methods was assessed. We systematically reviewed the current state of 3DBP in orthoregeneration.

METHODS

This review was performed using PubMed and Web of Science. Primary research articles reporting 3DBP of cartilage, bone, vasculature, and their osteochondral and vascular bone composites were considered. Full text English articles were analyzed.

RESULTS

Over 1300 studies were retrieved, after removing duplicates, 1046 studies remained. After inclusion and exclusion criteria were applied, 114 articles were analyzed fully. Bioink material types and combinations were tallied. Cell types and testing methods were also analyzed. Nearly all papers determined the effect of 3DBP on cell survival. Bioink material physical characterization using gelation and rheology, and construct biomechanics were performed. In vitro testing methods assessed biochemistry, markers of extracellular matrix production and/or cell differentiation into respective lineages. In vivo proof-of-concept studies included full-thickness bone and joint defects as well as subcutaneous implantation in rodents followed by histological and µCT analyses to demonstrate implant growth and integration into surrounding native tissues.

CONCLUSIONS

Despite its relative infancy, 3DBP is making an impact in joint and bone engineering. Several groups have demonstrated preclinical efficacy of mechanically robust constructs which integrate into articular joint defects in small animals. However, notable obstacles remain. Notably, researchers encountered pitfalls in scaling up constructs and establishing implant function and viability in long term animal models. Further, to translate from the laboratory to the clinic, standardized quality control metrics such as construct stiffness and graft integration metrics should be established with investigator consensus. While there is much work to be done, 3DBP implants have great potential to treat degenerative joint diseases and provide benefit to patients globally.

Improvement of bio-based polyurethane and its optimal application in controlled release fertilizer

In the past decades, polyurethane has emerged as a new material that has been widely developed and applied in coated controlled release fertilizers (CRFs). Particularly in recent years, the excessive consumption of petroleum resources and increasing demand for sustainable development have resulted in considerable interest in bio-based polyurethane coated controlled-release fertilizers. This review article focuses on the application and progress of environmentally friendly bio-based materials in the polyurethane-coated CRF industry. We also explore prospects for the green and sustainable development of coated CRFs. Using animal and plant oils, starch, lignin, and cellulose as raw materials, polyols can be produced by physical, chemical, and biological means to replace petroleum-based materials and polyurethane film coating for CRFs can be prepared. Various modifications can also improve the hydrophobicity and degradability of polyurethane film. A growing body of research on bio-based polyurethane has revealed its great potential in the production and application of coated CRFs. The purpose of this review is to highlight the practicality of bio-based materials in the application of polyurethane-coated CRFs and to clarify their current limitations.

Development and Characterization of Complementary Polymer Network Bioinks for 3D Bioprinting of Soft Tissue Constructs

The development of three-dimensional (3D) bioprinting has been hindered by a narrow "biofabrication window" with a limited variety of feasible bioinks which are compatible with both high printability and well cytocompatibility. Herein, a generalizable strategy using complementary polymer network (CPN) bioinks has been developed in the current study, to address the conflict between the printability and cytocompatibility of bioinks in extrusion 3D bioprinting, especially for the manufacture of soft tissue constructs. In our strategy, CPN bioinks are formed though mixing two interpenetrated polymer networks, one of which is a photocrosslinkable polymer network, and the other is a dynamic polymer network crosslinked by reversible covalent linkage, thereby endowed with well reversible thixotropy. Compatible with well printability, shape fidelity, and cytocompatibility, the utilization of CPN bioinks provides a viable solution for extrusion 3D bioprinting of photocrosslinkable biomaterials at a low concentration, thus suitable for soft tissue construct fabrication. Briefly, this study is testified to be a successful attempt to extend the bioink diversity within the "biofabrication window", and offers a novel insight into designing more feasible bioinks based on their special rheological properties, for further tissue engineering and biomedicine application. This article is protected by copyright. All rights reserved.

Alginate-Lysozyme Nanofibers Hydrogels with Improved Rheological Behavior, Printability and Biological Properties for 3D Bioprinting Applications

In this study, alginate nanocomposite hydrogel bioinks reinforced with lysozyme nanofibers (LNFs) were developed. Alginate-LNF (A-LNF) suspensions with different LNF contents (1, 5 and 10 wt.%) were prepared and pre-crosslinked with 0.5% (w/v) CaCl₂ to formulate A-LNF inks. These inks exhibit proper shear-thinning behavior and good recovery properties (~90%), with the pre-crosslinking step playing a crucial role. A-LNF fully crosslinked hydrogels (with 2% (w/v) CaCl₂) that mimic 3D printing scaffolds were prepared, and it was observed that the addition of LNFs improved several properties of the hydrogels, such as the morphology, swelling and degradation profiles, and mechanical properties. All formulations are also noncytotoxic towards HaCaT cells. The printing parameters and 3D scaffold model were then optimized, with A-LNF inks showing improved printability. Selected A-LNF inks (A-LNF0 and A-LNF5) were loaded with HaCaT cells (cell density 2 × 10⁶ cells mL⁻¹), and the cell viability within the bioprinted scaffolds was evaluated for 1, 3 and 7 days, with scaffolds printed with the A-LNF5 bioink showing the highest values for 7 days (87.99 ± 1.28%). Hence, A-LNF bioinks exhibited improved rheological performance, printability and biological properties representing a good strategy to overcome the main limitations of alginate-based bioinks.

Oxidized Hyaluronic Acid-Gelatin-Based Hydrogels for Tissue Engineering and Soft Tissue Mimicking

Hydrogels are ideal materials for mimicking and engineering soft tissue. Hyaluronic acid is a linear polysaccharide native to the human extracellular matrix. In this study, we first develop and characterize two hydrogel compositions built from oxidized HA and gelatin with and without alginate-di-aldehyde (ADA) crosslinked by ionic and enzymatic agents with potential applications in soft tissue engineering and tissue mimicking structures. The stability under incubation conditions was improved by adjusting crosslinking times. Through large-strain mechanical measurements, the hydrogels' properties were compared to human brain tissue and the samples containing ADA revealed similar mechanical properties to the native tissue specimens in cyclic compression-tension. In vitro characterization demonstrated a high viability of encapsulated mouse embryonic fibroblasts and a spreading of the cells in case of ADA-free samples.

Manufacturing of self-standing multi-layered 3D-bioprinted alginate-hyaluronate constructs by controlling the cross-linking mechanisms for tissue engineering applications

3D bioprinting of self-supporting stable tissue and organ structure is critically important in extrusion-based bioprinting system, especially for tissue engineering and regenerative medicine applications. However, the development of self-standing bioinks with desired crosslinking density, biocompatibility, tunable mechanical strength and other properties like self-healing, in situ gelation, drug or protein incorporation is still a challenge. In this study, we report a hydrogel bioink prepared from alginate (Alg) and hyaluronic acid (HA) crosslinked through multiple crosslinking mechanisms, i.e., acyl-hydrazone, hydrazide interactions and calcium ions. These Alg-HA gels were highly dynamic and shear-thinning with exceptional biocompatibility and tunable mechanical properties. The increased dynamic nature of the gels is mainly chemically attributed to the presence of acyl-hydrazone bonds formed between the amine groups of the acyl-hydrazide of alginate and the monoaldehyde of the hyaluronic acid. Among the different combinations of Alg-HA gel compositions prepared, the A5H5 (Alginate-acyl-hydrazide: HA-monoaldehyde, ratio 50:50) one showed a gelation time of ~60 s, viscosity of ~400 Pa.s (at zero shear rate), high stability in various pH solutions and increased degradation time (>50 days) than the other samples. The A5H5 gels showed high printability with increased post-printing stability as observed from the 3D printed structures (e.g., hollow tube (~100 layers), porous cube (~50 layers), star, heart-in, meniscus and lattice). The scanning electron microscopy analysis of the 3D constructs and hydrogels showed the interconnected pores (~181 µm) and crosslinked networks. Further, the gels showed sustained release of 5-amino salicylic acid and bovine serum albumin. Also, the mechanical properties were tuned by secondary crosslinking via different calcium concentrations. In vitro assays confirmed the cytocompatibility of these gels, where the 3D bioprinted lattice and tubular (~70 layers) constructs demonstrated high cell viability under fluorescence analysis. In in vivo studies, Alg-HA gel showed high biocompatibility (>90%) and increased angiogenesis (3 folds) and reduced macrophage infiltration (2-fold decrease), demonstrating the promising potential of these hydrogels in 3D bioprinting applications for tissue engineering and regenerative medicine with tunable properties.

Design and Synthesis of Stem Cell-Laden Keratin/Glycol Chitosan Methacrylate Bioinks for 3D Bioprinting

With the advancements in tissue engineering and three-dimensional (3D) bioprinting, physiologically relevant three-dimensional structures with suitable mechanical and bioactive properties that mimic the biological tissue can be designed and fabricated. However, the available bioinks are less than demanded. In this research, the readily available biomass sources, keratin and glycol chitosan, were selected to develop a UV-curable hydrogel that is feasible for the 3D bioprinting process. Keratin methacrylate and glycol chitosan methacrylate were synthesized, and a hybrid bioink was created by combining this protein-polysaccharide cross-linked hydrogel. While human hair keratin could provide biological functions, the other composition, glycol chitosan, could further enhance the mechanical strength of the construct. The mechanical properties, degradation profile, swelling behavior, cell viability, and proliferation were investigated with various ratios of keratin methacrylate to glycol chitosan methacrylate. The composition of 2% (w/v) keratin methacrylate and 2% (w/v) chitosan methacrylate showed a significantly higher cell number and swelling percentage than other compositions and was designated as the bioink for 3D printing afterward. The feasibility of stem cell loading in the selected formula was examined with an extrusion-based bioprinter. The cells and spheroids can be successfully printed with the synthesized bioink into a specific shape and cultured. This work provides a potential option for bioinks and delivers insights into personalization research on stem cell-laden biofabricated hydrogels in the future.

Exploring the Impact of Chitosan Composites as Artificial Organs

Chitosan and its allies have in multiple ways expanded into the medical, food, chemical, and biological industries and is still expanding. With its humble beginnings from marine shell wastes, the deacetylated form of chitin has come a long way in clinical practices. The biomedical applications of chitosan are truly a feather on its cap, with rarer aspects being chitosan’s role in tissue regeneration and artificial organs. Tissue regeneration is a highly advanced and sensitive biomedical application, and the very fact that chitosan is premiering here is an authentication of its ability to deliver. In this review, the various biomedical applications of chitosan are touched on briefly. The synthesis methodologies that are specific for tissue engineering and biomedical applications have been listed. What has been achieved using chitosan and chitosan composites in artificial organ research as well as tissue regeneration has been surveyed and presented. The lack of enthusiasm, as demonstrated by the very few reports online with respect to chitosan composites and artificial organs, is highlighted, and the reasons for this lapse speculated. What more needs be done to expand chitosan and its allies for a better utilization and exploitation to best benefit the construction of artificial organs and building of tissue analogs has been discussed.

Characterization of cubosomes immobilized in hydrogels of hyaluronic acid and their use for diclofenac controlled delivery

Cubosomes are dispersions of bicontinuous surfactant phases that constitute an assertive option to carry and release drugs and biomolecules, offering high efficiency of entrapment and specificity towards biological targets. This paper reports, for the first time to the best of our knowledge, the immobilization and characterization of cubosomes in chemically cross-linked oxi-hyaluronic acid and the evaluation of their use for controlled delivery of diclofenac, which is chosen as a model drug. Immobilized cubosomes prepared with phytantriol and bearing either negative or positive charges (in this case due to the addition of a cationic surfactant) were characterized by small angle X-ray scattering (SAXS) analysis and high-resolution confocal microscopy, confirming that their internal structure remains unaltered and that they appear uniformly distributed within the hydrogel matrix. Their release properties were assessed, and a limited leaching of the cubosomes from the hydrogel matrix with sustained release of the entrapped diclofenac was confirmed. These results enable the use of immobilized cubosomes as an attractive platform for biomedical applications, significantly extending the already promising features of cubosomes.

Recent Advances of Self-Healing Polymer Materials via Supramolecular Forces for Biomedical Applications

Noncovalent interactions can maintain the three-dimensional structures of biomacromolecules (e.g., polysaccharides and proteins) and control specific recognition in biological systems. Supramolecular chemistry was gradually developed as a result, and this led to design and application of self-healing materials. Self-healing materials have attracted attention in many fields, such as coatings, bionic materials, elastomers, and flexible electronic devices. Nevertheless, self-healing materials for biomedical applications have not been comprehensively summarized, even though many reports have been focused on specific areas. In this Review, we first introduce the different categories of supramolecular forces used in preparing self-healing materials and then describe biological applications developed in the last 5 years, including antibiofouling, smart drug/protein delivery, wound healing, electronic skin, cartilage lubrication protection, and tissue engineering scaffolds. Finally, the limitations of current biomedical applications are indicated, key design points are offered for new biological self-healing materials, and potential directions for biological applications are highlighted.

Multiple Crosslinking Hyaluronic Acid Hydrogels with Improved Strength and 3D Printability

Hyaluronic acid (HA) hydrogel is preferred for biomedicine applications, as it possesses biodegradability, biocompatibility, and cell-regulated capacity as well as high hydration nature similar to the native extracellular matrix. However, HA hydrogel fabricated via a 3D printing technique often faces poor printing properties. In this study, maleiated sodium hyaluronate (MHA) with a high substituted degree of the acrylate group (i.e., 2.27) and thiolated sodium hyaluronate (SHHA) were synthesized. By blending these modified HAs, the MHA/SHHA hydrogels were prepared via pre-crosslinking through thiol-acrylate Michael addition and subsequently covalent crosslinking using thiol-acrylate and acrylate-acrylate photopolymerization mechanisms. Rheological properties, swelling behaviors, and mechanical properties can be modulated by altering the molar ratio of the thiol group and acrylate group. The results showed that the MHA/SHHA hydrogel precursors have rapidly gelling capacity and improved compressive strength. Based on these results, high-resolution hydrogel scaffolds with good structural stability were prepared by extrusion-based 3D printing. This HA hydrogel is cytocompatible and capable of supporting adherence of L929 cells, indicating its great potential for tissue engineering scaffolds.

Processing of Self-Healing Polymers for Soft Robotics

Soft robots are, due to their softness, inherently safe and adapt well to unstructured environments. However, they are prone to various damage types. Self-healing polymers address this vulnerability. Self-healing soft robots can recover completely from macroscopic damage, extending their lifetime. For developing healable soft robots, various formative and additive manufacturing methods have been exploited to shape self-healing polymers into complex structures. Additionally, several novel manufacturing techniques, noted as (re)assembly binding techniques that are specific to self-healing polymers, have been created. Herein, the wide variety of processing techniques of self-healing polymers for robotics available in the literature is reviewed, and limitations and opportunities discussed thoroughly. Based on defined requirements for soft robots, these techniques are critically compared and validated. A strong focus is drawn to the reversible covalent and (physico)chemical cross-links present in the self-healing polymers that do not only endow healability to the resulting soft robotic components, but are also beneficial in many manufacturing techniques. They solve current obstacles in soft robots, including the formation of robust multi-material parts, recyclability, and stress relaxation. This review bridges two promising research fields, and guides the reader toward selecting a suitable processing method based on a self-healing polymer and the intended soft robotics application.

Dynamic Protein and Polypeptide Hydrogels Based on Schiff Base Co-assembly for Biomedicine

Stimuli-responsive hydrogels are promising building blocks for biomedical devices, attributable to their excellent hydrophilicity, biocompatibility, and dynamic responsiveness to temperature, light, pH, and water content. Although hydrogels find interesting applications...

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.

Strong, Self-Healing Gelatin Hydrogels Cross-Linked by Double Dynamic Covalent Chemistry

Hydrogels constructed from natural sources have received increased attention recently, including applications in biomedical fields. They are protein or polysaccharide cross-linked scaffolds that display water retention and are able to recognize host cargos. Their excellent biocompatibility does not always combine with high mechanical strength (up to 136 kPa) and thermostability, making them less useful in biomedical applications. This paper reports biocompatible gelatin hydrogels, double cross-linked via imine and Diels-Alder (DA) dynamic covalent frameworks. They showed integrated advantages of adjustable and durable mechanical strength, good thermal stability, biocompatibility for promoting cell growth and reasonable degradable rate. These hydrogels possess remarkable self-healing property, acid/alkali resistance at 65 °C and good integrity in organic solvents at 130 °C, holding great potential for biomedical applications in the areas such as cartilage regeneration, articular reconstruction or soft robotics.

Three-dimensional bioprinting of polysaccharide-based self-healing hydrogels with dual cross-linking

Three-dimensional (3D) bioprinting technique is useful to fabricate constructs with functional and biological structures for various biomedical applications. Oxidized hyaluronate (OHA) and glycol chitosan (GC) can form autonomous self-healing hydrogels when adipic acid dihydrazide (ADH) is used. We demonstrate that hyaluronate-alginate hybrid (HAH) polymers can be used for secondary physical cross-linking of OHA/GC/ADH hydrogel with calcium ions after 3D printing. The molecular weight of hyaluronate can be varied while keeping the molecular weight of alginate in HAH. The mechanical stiffness and stability of gels after 3D printing are strongly dependent on the molecular weight of HAH at the same cross-linking density. In vitro chondrogenic differentiation of ATDC5 cells encapsulated in 3D-printed constructs is dependent on the molecular weight of HAH in gels. This dual cross-linking system consisting of naturally occurring biocompatible polysaccharides may have potential in the 3D bioprinting of custom-made scaffolds for tissue engineering applications.

3D Printing of dynamic tissue scaffold by combining self-healing hydrogel and self-healing ferrogel

Hydrogels have been widely utilized in tissue engineering applications as functional and biological synthetic extracellular matrices (ECMs) can be created with gels. However, typical hydrogels cannot be exploited in 3D printing, especially in extrusion printing, unless post-cross-linking after printing is provided. Additionally, dynamic tissue scaffolds that can mimic ECM environments in the body have been demonstrated to be useful in tissue engineering. Here, we hypothesized that a 3D-printed dynamic tissue scaffold could be fabricated by combining self-healing hydrogel and self-healing ferrogel without post-cross-linking, which could be useful for the regulation of cell phenotype under magnetic stimulation. Hydrogels were formed from oxidized sodium hyaluronate and glycol chitosan, and adipic acid dihydrazide was additionally utilized for self-healing behavior of the gel. Superparamagnetic iron oxide nanoparticles (SPIONs) were also used to prepare a magnetically responsive hydrogel system (i.e., ferrogel). Physicochemical properties, cytotoxicity, and printability of the self-healing hydrogel/ferrogel system fabricated by a 3D printing process, were investigated. Dimensional changes in a tissue scaffold were achieved by the application of a magnetic field. Interestingly, chondrogenic differentiation of ATDC5 cells cultured within the dynamic tissue scaffold was enhanced by applying a magnetic field in vitro. This approach may be useful for fabricating dynamic tissue scaffolds by a 3D printing method for tissue engineering applications.