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Aggarwal K, Nagpal K. Three-Dimensional Printing as a Progressive Innovative Tool for Customized and Precise Drug Delivery. Crit Rev Ther Drug Carrier Syst 2024; 41:95-130. [PMID: 38037821 DOI: 10.1615/critrevtherdrugcarriersyst.2023046832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
While using three-dimensional printing, materials are deposited layer by layer in accordance with the digital model created by computer-aided design software. Numerous research teams have shown interest in this technology throughout the last few decades to produce various dosage forms in the pharmaceutical industry. The number of publications has increased since the first printed medicine was approved in 2015 by Food and Drug Administration. Considering this, the idea of creating complex, custom-made structures that are loaded with pharmaceuticals for tissue engineering and dose optimization is particularly intriguing. New approaches and techniques for creating unique medication delivery systems are made possible by the development of additive manufacturing keeping in mind the comparative advantages it has over conventional methods of manufacturing medicaments. This review focuses on three-dimensional printed formulations grouped in orally disintegrated tablets, buccal films, implants, suppositories, and microneedles. The various types of techniques that are involved in it are summarized. Additionally, challenges and applications related to three-dimensional printing of pharmaceuticals are also being discussed.
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Affiliation(s)
- Kirti Aggarwal
- Amity Institute of Pharmacy, Amity University, Uttar Pradesh, Noida, AUUP
| | - Kalpana Nagpal
- Amity Institute of Pharmacy, Amity University Uttar Pradesh, Noida, UP-201303, India
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Caracciolo PC, Abraham GA, Battaglia ES, Bongiovanni Abel S. Recent Progress and Trends in the Development of Electrospun and 3D Printed Polymeric-Based Materials to Overcome Antimicrobial Resistance (AMR). Pharmaceutics 2023; 15:1964. [PMID: 37514150 PMCID: PMC10385409 DOI: 10.3390/pharmaceutics15071964] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Antimicrobial resistance (AMR) developed by microorganisms is considered one of the most critical public health issues worldwide. This problem is affecting the lives of millions of people and needs to be addressed promptly. Mainly, antibiotics are the substances that contribute to AMR in various strains of bacteria and other microorganisms, leading to infectious diseases that cannot be effectively treated. To avoid the use of antibiotics and similar drugs, several approaches have gained attention in the fields of materials science and engineering as well as pharmaceutics over the past five years. Our focus lies on the design and manufacture of polymeric-based materials capable of incorporating antimicrobial agents excluding the aforementioned substances. In this sense, two of the emerging techniques for materials fabrication, namely, electrospinning and 3D printing, have gained significant attraction. In this article, we provide a summary of the most important findings that contribute to the development of antimicrobial systems using these technologies to incorporate various types of nanomaterials, organic molecules, or natural compounds with the required property. Furthermore, we discuss and consider the challenges that lie ahead in this research field for the coming years.
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Affiliation(s)
- Pablo C Caracciolo
- Biomedical Polymers Division, Research Institute for Materials Science and Technology (INTEMA), National University of Mar del Plata (UNMdP), National Scientific and Technical Research Council (CONICET), Av. Colón 10850, Mar del Plata 7600, Argentina
| | - Gustavo A Abraham
- Biomedical Polymers Division, Research Institute for Materials Science and Technology (INTEMA), National University of Mar del Plata (UNMdP), National Scientific and Technical Research Council (CONICET), Av. Colón 10850, Mar del Plata 7600, Argentina
| | - Ernesto S Battaglia
- Biomedical Polymers Division, Research Institute for Materials Science and Technology (INTEMA), National University of Mar del Plata (UNMdP), National Scientific and Technical Research Council (CONICET), Av. Colón 10850, Mar del Plata 7600, Argentina
| | - Silvestre Bongiovanni Abel
- Biomedical Polymers Division, Research Institute for Materials Science and Technology (INTEMA), National University of Mar del Plata (UNMdP), National Scientific and Technical Research Council (CONICET), Av. Colón 10850, Mar del Plata 7600, Argentina
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New In Situ-Generated Polymer-Iodine Complexes with Broad-Spectrum Antimicrobial Activity. Microbiol Spectr 2022; 10:e0055022. [PMID: 36125311 PMCID: PMC9603132 DOI: 10.1128/spectrum.00550-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Iodine-containing systems show broad antiseptic properties that can be an invaluable tool in controlling infections in humans and animals. Here, we describe the first proof-of-concept studies on biocidal active polyamide- and polyurethane-iodine complexes that are produced in situ directly during the fabrication and/or polymerization process at laboratory and commercially relevant scales. These polymer-iodine materials are active against a broad range of microorganisms, including bacteria and fungi. It is suggested that the ease of manufacture and subsequent commercialization make said systems especially suited for applications as base materials for medical devices to reduce infection risks and control the spread of pathogens. IMPORTANCE Infectious diseases are of mounting medical and public concern. A major contributor to this trend is the proliferation of medical implants, which are inherently vulnerable to microbial contamination and the subsequent onset of hospital-acquired infections. Moreover, implant-associated infections in humans are often difficult to diagnose and treat and are associated with substantial health care costs. Here, we present the development of biocidal active polyamide- and polyurethane-iodine complexes that are generated in situ during fabrication. We show that the excellent antiseptic properties of water-soluble povidone-iodine can be similarly realized in water-insoluble engineering plastics, specifically polyamide- and polyurethane-iodine. These complexes have inherent biocidal activity against major pathogenic bacteria and fungi.
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Mazarura KR, Kumar P, Choonara YE. Customised 3D printed multi-drug systems: An effective and efficient approach to polypharmacy. Expert Opin Drug Deliv 2022; 19:1149-1163. [PMID: 36059243 DOI: 10.1080/17425247.2022.2121816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Combination therapies continue to improve therapeutic outcomes as currently achieved by polypharmacy. Since the introduction of the polypill, there has been a significant improvement in adherence and patient outcomes. However, the mass production of polypills presents a number of technical, formulation, and clinical challenges. The current one-size-fits-all approach ignores the unique clinical demands of patients, necessitating the adoption of a more versatile tool. That will be the novel, but not so novel, 3D printing. AREAS COVERED : The present review investigates this promising paradigm shift from one medication for all, to customised medicines, providing an overview of the current state of 3D-printed multi-active pharmaceutical forms, techniques applied and printing materials. Details on cost implications, as well as potential limitations and challenges are also elaborated. EXPERT OPINION : 3D printing of multi-active systems, is not only beneficial but also essential. With growing interest in this field, a shift in manufacturing, prescribing, and administration patterns is at this point, unavoidable. Addressing limitations and challenges, as well as data presentation on clinical trial results, will aid in the acceleration of this technology's implementation. However, it is clear that 3D printing is not the end of it, as evidenced by the emerging 4D printing technology.
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Affiliation(s)
- Kundai R Mazarura
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Pradeep Kumar
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Yahya E Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
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Pinho LAG, Gratieri T, Gelfuso GM, Marreto RN, Cunha-Filho M. Three-dimensional printed personalized drug devices with anatomical fit: a review. J Pharm Pharmacol 2021; 74:1391-1405. [PMID: 34665263 DOI: 10.1093/jpp/rgab146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/24/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Three-dimensional printing (3DP) has opened the era of drug personalization, promising to revolutionize the pharmaceutical field with improvements in efficacy, safety and compliance of the treatments. As a result of these investigations, a vast therapeutic field has opened for 3DP-loaded drug devices with an anatomical fit. Along these lines, innovative dosage forms, unimaginable until recently, can be obtained. This review explores 3DP-engineered drug devices described in recent research articles, as well as in patented inventions, and even devices already produced by 3DP with drug-loading potential. KEY FINDINGS 3D drug-loaded stents, implants and prostheses are reviewed, along with devices produced to fit hard-to-attach body parts such as nasal masks, vaginal rings or mouthguards. The most promising 3DP techniques for such devices and the complementary technologies surrounding these inventions are also discussed, particularly the scanners useful for mapping body parts. Health regulatory concerns regarding the new use of such technology are also analysed. SUMMARY The scenario discussed in this review shows that for wearable 3DP drug devices to become a tangible reality to users, it will be necessary to overcome the existing regulatory barriers, create new interfaces with electronic systems and improve the mapping mechanisms of body surfaces.
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Affiliation(s)
- Ludmila A G Pinho
- Laboratory of Food, Drug, and Cosmetics (LTMAC), School of Health Sciences, University of Brasilia, Brasília, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drug, and Cosmetics (LTMAC), School of Health Sciences, University of Brasilia, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drug, and Cosmetics (LTMAC), School of Health Sciences, University of Brasilia, Brasília, DF, Brazil
| | - Ricardo Neves Marreto
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Federal University of Goiás, Goiânia, GO, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drug, and Cosmetics (LTMAC), School of Health Sciences, University of Brasilia, Brasília, DF, Brazil
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Domsta V, Seidlitz A. 3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature. Molecules 2021; 26:4066. [PMID: 34279405 PMCID: PMC8272161 DOI: 10.3390/molecules26134066] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/15/2023] Open
Abstract
The usage of 3D-printing for drug-eluting implants combines the advantages of a targeted local drug therapy over longer periods of time at the precise location of the disease with a manufacturing technique that easily allows modifications of the implant shape to comply with the individual needs of each patient. Research until now has been focused on several aspects of this topic such as 3D-printing with different materials or printing techniques to achieve implants with different shapes, mechanical properties or release profiles. This review is intended to provide an overview of the developments currently described in the literature. The topic is very multifaceted and several of the investigated aspects are not related to just one type of application. Consequently, this overview deals with the topic of 3D-printed drug-eluting implants in the application fields of stents and catheters, gynecological devices, devices for bone treatment and surgical screws, antitumoral devices and surgical meshes, as well as other devices with either simple or complex geometry. Overall, the current findings highlight the great potential of the manufacturing of drug-eluting implants via 3D-printing technology for advanced individualized medicine despite remaining challenges such as the regulatory approval of individualized implants.
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Affiliation(s)
- Vanessa Domsta
- Department of Biopharmacy and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Center of Drug Absorption and Transport, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Anne Seidlitz
- Department of Biopharmacy and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Center of Drug Absorption and Transport, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
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Shannon A, O'Connell A, O'Sullivan A, Byrne M, Clifford S, O'Sullivan KJ, O'Sullivan L. A Radiopaque Nanoparticle-Based Ink Using PolyJet 3D Printing for Medical Applications. 3D PRINTING AND ADDITIVE MANUFACTURING 2020; 7:259-268. [PMID: 36654671 PMCID: PMC9586492 DOI: 10.1089/3dp.2019.0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The aim of this study was to develop a 3D printable radiopaque ink and successfully print a finished artifact. Radiopaque 3D printing would be hugely beneficial to improve the visibility of medical devices and implants, as well as allowing more realistic phantoms and calibration aids to be produced. Most 3D printing technologies are polymer based. Polymers are naturally radiolucent, allowing X-rays to pass through, showing up as faint dark gray regions on X-ray detectors, as for soft tissues. During this study, a 3D printable ultraviolet (UV) curable resin containing zirconium oxide (ZrO2) nanoparticles was developed. 5 wt.% ZrO2 was dispersed in a base resin using a high-shear mixer. Particles remained in suspension for 6-8 h at room temperature, allowing time for 3D printing. A model of a hand including radiopaque bones and a test block demonstrating a range of internal radiopaque features were successfully 3D printed. Radiopacity was demonstrated in the 3D-printed models, and there was good dispersion of ZrO2 within the resin matrix. The impregnated resin remained UV curable and viscosity was not compromised. In this study, 3D-printed radiopaque features demonstrated clear radiopacity under X-ray and microcomputed tomography imaging.
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Affiliation(s)
- Alice Shannon
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
| | - Aine O'Connell
- Radiology Department, University Hospital Limerick, Limerick, Ireland
| | - Aidan O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Michael Byrne
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Seamus Clifford
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Kevin J. O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Leonard O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
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Durga Prasad Reddy R, Sharma V. Additive manufacturing in drug delivery applications: A review. Int J Pharm 2020; 589:119820. [DOI: 10.1016/j.ijpharm.2020.119820] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
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Domínguez-Robles J, Mancinelli C, Mancuso E, García-Romero I, Gilmore BF, Casettari L, Larrañeta E, Lamprou DA. 3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery. Pharmaceutics 2020; 12:E63. [PMID: 31941047 PMCID: PMC7023419 DOI: 10.3390/pharmaceutics12010063] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 01/09/2023] Open
Abstract
Current strategies to treat pelvic organ prolapse (POP) or stress urinary incontinence (SUI), include the surgical implantation of vaginal meshes. Recently, there have been multiple reports of issues generated by these meshes conventionally made of poly(propylene). This material is not the ideal candidate, due to its mechanical properties leading to complications such as chronic pain and infection. In the present manuscript, we propose the use of an alternative material, thermoplastic polyurethane (TPU), loaded with an antibiotic in combination with fused deposition modelling (FDM) to prepare safer vaginal meshes. For this purpose, TPU filaments containing levofloxacin (LFX) in various concentrations (e.g., 0.25%, 0.5%, and 1%) were produced by extrusion. These filaments were used to 3D print vaginal meshes. The printed meshes were fully characterized through different tests/analyses such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputed tomography (μCT), release studies and microbiology testing. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration loaded. The mechanical properties showed that poly(propylene) (PP) is a tougher material with a lower elasticity than TPU, which seemed to be a more suitable material due to its elasticity. In addition, the printed meshes showed a significant bacteriostatic activity on both Staphylococcus aureus and Escherichia coli cultures, minimising the risk of infection after implanting them. Therefore, the incorporation of LFX to the TPU matrix can be used to prepare anti-infective vaginal meshes with enhanced mechanical properties compared with current PP vaginal meshes.
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Affiliation(s)
- Juan Domínguez-Robles
- School of Pharmacy, Queen’s University Belfast, Lisburn Road 97, Belfast BT9 7BL, UK; (J.D.-R.); (C.M.); (B.F.G.)
| | - Caterina Mancinelli
- School of Pharmacy, Queen’s University Belfast, Lisburn Road 97, Belfast BT9 7BL, UK; (J.D.-R.); (C.M.); (B.F.G.)
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza del Rinascimento 6, 61029 Urbino, Italy;
| | - Elena Mancuso
- Nanotechnology and Integrated Bio-Engineering Centre (NIBEC), Ulster University, Jordanstown Campus, Jordanstown BT37 0QB, UK;
| | - Inmaculada García-Romero
- Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast BT9 7BL, UK;
| | - Brendan F. Gilmore
- School of Pharmacy, Queen’s University Belfast, Lisburn Road 97, Belfast BT9 7BL, UK; (J.D.-R.); (C.M.); (B.F.G.)
| | - Luca Casettari
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza del Rinascimento 6, 61029 Urbino, Italy;
| | - Eneko Larrañeta
- School of Pharmacy, Queen’s University Belfast, Lisburn Road 97, Belfast BT9 7BL, UK; (J.D.-R.); (C.M.); (B.F.G.)
| | - Dimitrios A. Lamprou
- School of Pharmacy, Queen’s University Belfast, Lisburn Road 97, Belfast BT9 7BL, UK; (J.D.-R.); (C.M.); (B.F.G.)
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Ballard DH, Tappa K, Boyer CJ, Jammalamadaka U, Hemmanur K, Weisman JA, Alexander JS, Mills DK, Woodard PK. Antibiotics in 3D-printed implants, instruments and materials: benefits, challenges and future directions. JOURNAL OF 3D PRINTING IN MEDICINE 2019; 3:83-93. [PMID: 31258936 PMCID: PMC6587109 DOI: 10.2217/3dp-2019-0007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/23/2019] [Indexed: 04/17/2023]
Abstract
3D printing is an additive manufacturing technology, which permits innovative approaches for incorporating antibiotics into 3D printed constructs. Antibiotic-incorporating applications in medicine have included medical implants, prostheses, along with procedural and surgical instruments. 3D-printed antibiotic-impregnated devices offer the advantages of increased surface area for drug distribution, sequential layers of antibiotics produced through layer-by-layer fabrication, and the ability to rapidly fabricate constructs based on patient-specific anatomies. To date, fused deposition modeling has been the main 3D printing method used to incorporate antibiotics, although inkjet and stereolithography techniques have also been described. This review offers a state-of-the-art summary of studies that incorporate antibiotics into 3D-printed constructs and summarizes the rationale, challenges, and future directions for the potential use of this technology in patient care.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
- Author for correspondence: Tel.: +1 314 226 5464; Fax: +1 314 747 4671;
| | - Karthik Tappa
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Christen J Boyer
- Department of Molecular & Cellular Physiology, Louisiana State University Health Shreveport, LA 71103, USA
| | - Udayabhanu Jammalamadaka
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Kavya Hemmanur
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Jeffery A Weisman
- University of Illinois at Chicago Occupational Medicine, Chicago, IL 60612, USA
| | - Jonathan S Alexander
- Department of Molecular & Cellular Physiology, Louisiana State University Health Shreveport, LA 71103, USA
| | - David K Mills
- Department of Biomedical Engineering, Louisiana Tech University, Ruston, LA 71272, USA
| | - Pamela K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
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11
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3D Printing Custom Bioactive and Absorbable Surgical Screws, Pins, and Bone Plates for Localized Drug Delivery. J Funct Biomater 2019; 10:jfb10020017. [PMID: 30939719 PMCID: PMC6616894 DOI: 10.3390/jfb10020017] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/26/2019] [Accepted: 03/28/2019] [Indexed: 01/06/2023] Open
Abstract
Additive manufacturing has great potential for personalized medicine in osseous fixation surgery, including maxillofacial and orthopedic applications. The purpose of this study was to demonstrate 3D printing methods for the fabrication of patient-specific fixation implants that allow for localized drug delivery. 3D printing was used to fabricate gentamicin (GS) and methotrexate (MTX)-loaded fixation devices, including screws, pins, and bone plates. Scaffolds with different infill ratios of polylactic acid (PLA), both without drugs and impregnated with GS and MTX, were printed into cylindrical and rectangular-shaped constructs for compressive and flexural strength mechanical testing, respectively. Bland PLA constructs showed significantly higher flexural strength when printed in a Y axis at 100% infill compared to other axes and infill ratios; however, there was no significant difference in flexural strength between other axes and infill ratios. GS and MTX-impregnated constructs had significantly lower flexural and compressive strength as compared to the bland PLA constructs. GS-impregnated implants demonstrated bacterial inhibition in plate cultures. Similarly, MTX-impregnated implants demonstrated a cytotoxic effect in osteosarcoma assays. This proof of concept work shows the potential of developing 3D printed screws and plating materials with the requisite mechanical properties and orientations. Drug-impregnated implants were technically successful and had an anti-bacterial and chemotherapeutic effect, but drug addition significantly decreased the flexural and compressive strengths of the custom implants.
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Boyer CJ, Boktor M, Samant H, White LA, Wang Y, Ballard DH, Huebert RC, Woerner JE, Ghali GE, Alexander JS. 3D Printing for Bio-Synthetic Biliary Stents. Bioengineering (Basel) 2019; 6:E16. [PMID: 30744131 PMCID: PMC6466390 DOI: 10.3390/bioengineering6010016] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 12/20/2022] Open
Abstract
Three-dimensional (3D) printing is an additive manufacturing method that holds great potential in a variety of future patient-specific medical technologies. This project validated a novel crosslinked polyvinyl alcohol (XL-PVA) 3D printed stent infused with collagen, human placental mesenchymal stem cells (PMSCs), and cholangiocytes. The biofabrication method in the present study examined 3D printing and collagen injection molding for rapid prototyping of customized living biliary stents with clinical applications in the setting of malignant and benign bile duct obstructions. XL-PVA stents showed hydrophilic swelling and addition of radiocontrast to the stent matrix improved radiographic opacity. Collagen loaded with PMSCs contracted tightly around hydrophilic stents and dense choloangiocyte coatings were verified through histology and fluorescence microscopy. It is anticipated that design elements used in these stents may enable appropriate stent placement, provide protection of the stent-stem cell matrix against bile constituents, and potentially limit biofilm development. Overall, this approach may allow physicians to create personalized bio-integrating stents for use in biliary procedures and lays a foundation for new patient-specific stent fabrication techniques.
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Affiliation(s)
- Christen J Boyer
- Molecular and Cellular Physiology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
- Oral and Maxillofacial Surgery, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Moheb Boktor
- Gastroenterology and Hepatology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Hrishikesh Samant
- Gastroenterology and Hepatology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Luke A White
- Molecular and Cellular Physiology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Yuping Wang
- Obstetrics and Gynecology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, School of Medicine, Washington University, St. Louis, MO 63110, USA.
| | - Robert C Huebert
- Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
| | - Jennifer E Woerner
- Oral and Maxillofacial Surgery, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Ghali E Ghali
- Oral and Maxillofacial Surgery, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
| | - Jonathan S Alexander
- Molecular and Cellular Physiology, Health Sciences Center, Louisiana State University, Shreveport, LA 71103, USA.
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Ballard DH, Jammalamadaka U, Tappa K, Weisman JA, Boyer CJ, Alexander JS, Woodard PK. 3D printing of surgical hernia meshes impregnated with contrast agents: in vitro proof of concept with imaging characteristics on computed tomography. 3D Print Med 2018; 4:13. [PMID: 30649673 PMCID: PMC6283811 DOI: 10.1186/s41205-018-0037-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/20/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Selected medical implants and other 3D printed constructs could potentially benefit from the ability to incorporate contrast agents into their structure. The purpose of the present study is to create 3D printed surgical meshes impregnated with iodinated, gadolinium, and barium contrast agents and characterize their computed tomography (CT) imaging characteristics. Commercial fused deposition layering 3D printing was used to construct surgical meshes impregnated with imaging contrast agents in an in vitro model. Polycaprolactone (PCL) meshes were printed containing iodinated, gadolinium, or barium contrast; control PCL meshes without contrast were also fabricated. The three different contrast agents were mixed with PCL powder and directly loaded into the 3D printer. CT images of the three contrast-containing meshes and the control meshes were acquired and analyzed using small elliptical regions of interest to record the Hounsfield units (HU) of each mesh. Subsequently, to test their solubility and sustainability, the contrast-containing meshes were placed in a 37 °C agar solution for 7 days and imaged by CT at days 1, 3 and 7. RESULTS All 3D printed meshes were visible on CT. Iodinated contrast meshes had the highest attenuation (2528 mean HU), significantly higher than both and gadolinium (1178 mean HU) and barium (592 mean HU) containing meshes. Only barium meshes sustained their visibility in the agar solution; the iodine and gadolinium meshes were poorly perceptible and had significantly lower mean HU compared to their pre-agar solution imaging, with iodine and gadolinium present in the adjacent agar at day 7 CT. CONCLUSION 3D prints embedded with contrast materials through this method displayed excellent visibility on CT; however, only barium mesh maintained visibility after 7 days incubation on agar at human body temperature. This method of 3D printing with barium may have potential applications in a variety of highly personalized and CT visible medical devices.
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Affiliation(s)
- David H. Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110 USA
| | - Udayabhanu Jammalamadaka
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110 USA
| | - Karthik Tappa
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110 USA
| | - Jeffery A. Weisman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110 USA
| | - Christen J. Boyer
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, LA USA
| | - Jonathan Steven Alexander
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, LA USA
| | - Pamela K. Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110 USA
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Boyer CJ, Ballard DH, Yun JW, Xiao AY, Weisman JA, Barzegar M, Alexander JS. Three-Dimensional Printing of Cell Exclusion Spacers (CES) for Use in Motility Assays. Pharm Res 2018; 35:155. [PMID: 29869098 PMCID: PMC6434525 DOI: 10.1007/s11095-018-2431-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 05/15/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE Cell migration/invasion assays are widely used in commercial drug discovery screening. 3D printing enables the creation of diverse geometric restrictive barrier designs for use in cell motility studies, permitting on-demand assays. Here, the utility of 3D printed cell exclusion spacers (CES) was validated as a cell motility assay. METHODS A novel CES fit was fabricated using 3D printing and customized to the size and contour of 12 cell culture plates including 6 well plates of basal human brain vascular endothelial (D3) cell migration cells compared with 6 well plates with D3 cells challenged with 1uM cytochalasin D (Cyto-D), an F-actin anti-motility drug. Control and Cyto-D treated cells were monitored over 3 days under optical microscopy. RESULTS Day 3 cell migration distance for untreated D3 cells was 1515.943μm ± 10.346μm compared to 356.909μm ± 38.562μm for the Cyt-D treated D3 cells (p < 0.0001). By day 3, untreated D3 cells reached confluency and completely filled the original voided spacer regions, while the Cyt-D treated D3 cells remained significantly less motile. CONCLUSIONS Cell migration distances were significantly reduced by Cyto-D, supporting the use of 3D printing for cell exclusion assays. 3D printed CES have great potential for studying cell motility, migration/invasion, and complex multi-cell interactions.
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Affiliation(s)
- Christen J Boyer
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jungmi W Yun
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Adam Y Xiao
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Jeffery A Weisman
- Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Mansoureh Barzegar
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Jonathan Steven Alexander
- Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
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