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Gómez-Fernández H, Alhakim-Khalak F, Ruiz-Alonso S, Díaz A, Tamayo J, Ramalingam M, Larra E, Pedraz JL. Comprehensive review of the state-of-the-art in corneal 3D bioprinting, including regulatory aspects. Int J Pharm 2024; 662:124510. [PMID: 39053675 DOI: 10.1016/j.ijpharm.2024.124510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/12/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
The global shortage of corneal transplants has spurred an urgency in the quest for efficient treatments. This systematic review not only provides a concise overview of the current landscape of corneal morphology, physiology, diseases, and conventional treatments but crucially delves into the forefront of tissue engineering for corneal regeneration. Emphasizing cellular and acellular components, bioprinting techniques, and pertinent biological assays, it explores optimization strategies for manufacturing and cost-effectiveness. To bridge the gap between research and industrial production, the review outlines the essential regulatory strategy required in Europe, encompassing relevant directives, frameworks, and governing bodies. This comprehensive regulatory framework spans the entire process, from procuring initial components to marketing and subsequent product surveillance. In a pivotal shift towards the future, the review culminates by highlighting the latest advancements in this sector, particularly the integration of tissue therapy with artificial intelligence. This synergy promises substantial optimization of the overall process, paving the way for unprecedented breakthroughs in corneal regeneration. In essence, this review not only elucidates the current state of corneal treatments and tissue engineering but also outlines regulatory pathways and anticipates the transformative impact of artificial intelligence, providing a comprehensive guide for researchers, practitioners, and policymakers in the field.
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Affiliation(s)
- Hodei Gómez-Fernández
- NanoBioCel Research Group, Laboratory of Pharmacy and Pharmaceutical Technology. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain; AJL Ophthalmic, Ferdinand Zeppelin Kalea, 01510 Vitoria-Gasteiz, Spain.
| | - Fouad Alhakim-Khalak
- NanoBioCel Research Group, Laboratory of Pharmacy and Pharmaceutical Technology. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain; Bioaraba, NanoBioCel Research Group, 01009 Vitoria-Gasteiz, Spain; Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain.
| | - Sandra Ruiz-Alonso
- NanoBioCel Research Group, Laboratory of Pharmacy and Pharmaceutical Technology. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain; Bioaraba, NanoBioCel Research Group, 01009 Vitoria-Gasteiz, Spain; Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain.
| | - Aitor Díaz
- AJL Ophthalmic, Ferdinand Zeppelin Kalea, 01510 Vitoria-Gasteiz, Spain.
| | - Julen Tamayo
- AJL Ophthalmic, Ferdinand Zeppelin Kalea, 01510 Vitoria-Gasteiz, Spain.
| | - Murugam Ramalingam
- NanoBioCel Research Group, Laboratory of Pharmacy and Pharmaceutical Technology. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain; Bioaraba, NanoBioCel Research Group, 01009 Vitoria-Gasteiz, Spain; Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain; Joint Research Laboratory (JRL) on Bioprinting and Advanced Pharma Development, A Joined Venture of TECNALIA, Centro de investigación Lascaray Ikergunea, Avenida Miguel de Unamuno, 01006 Vitoria-Gasteiz, Spain.
| | - Eva Larra
- AJL Ophthalmic, Ferdinand Zeppelin Kalea, 01510 Vitoria-Gasteiz, Spain.
| | - José L Pedraz
- NanoBioCel Research Group, Laboratory of Pharmacy and Pharmaceutical Technology. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain; Bioaraba, NanoBioCel Research Group, 01009 Vitoria-Gasteiz, Spain; Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain; Joint Research Laboratory (JRL) on Bioprinting and Advanced Pharma Development, A Joined Venture of TECNALIA, Centro de investigación Lascaray Ikergunea, Avenida Miguel de Unamuno, 01006 Vitoria-Gasteiz, Spain.
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Abstract
New developments in additive manufacturing and regenerative medicine have the potential to radically disrupt the traditional pipelines of therapy development and medical device manufacture. These technologies present a challenge for regulators because traditional regulatory frameworks are designed for mass manufactured therapies, rather than bespoke solutions. 3D bioprinting technologies present another dimension of complexity through the inclusion of living cells in the fabrication process. Herein we overview the challenge of regulating 3D bioprinting in comparison to existing cell therapy products as well as custom-made 3D printed medical devices. We consider a range of specific challenges pertaining to 3D bioprinting in regenerative medicine, including classification, risk, standardization and quality control, as well as technical issues related to the manufacturing process and the incorporated materials and cells.
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Affiliation(s)
- Tajanka Mladenovska
- Department of Surgery, St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, 3065, Australia
- Aikenhead Centre for Medical Discovery (ACMD), St Vincent's Hospital Melbourne, Fitzroy, Victoria, 3065, Australia
| | - Peter F Choong
- Department of Surgery, St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, 3065, Australia
- Aikenhead Centre for Medical Discovery (ACMD), St Vincent's Hospital Melbourne, Fitzroy, Victoria, 3065, Australia
| | - Gordon G Wallace
- Aikenhead Centre for Medical Discovery (ACMD), St Vincent's Hospital Melbourne, Fitzroy, Victoria, 3065, Australia
- Intelligent Polymer Research Institute, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Cathal D O'Connell
- Department of Surgery, St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, 3065, Australia
- Aikenhead Centre for Medical Discovery (ACMD), St Vincent's Hospital Melbourne, Fitzroy, Victoria, 3065, Australia
- Discipline of Electrical & Biomedical Engineering, RMIT University, Melbourne, Victoria, 3000, Australia
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