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Pulumati A, Algarin YA, Kim S, Latta S, Li JN, Nouri K. 3D bioprinting: a review and potential applications for Mohs micrographic surgery. Arch Dermatol Res 2024; 316:147. [PMID: 38698273 DOI: 10.1007/s00403-024-02893-6] [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: 03/14/2024] [Revised: 03/14/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
Mohs Micrographic Surgery (MMS) is effective for treating common cutaneous malignancies, but complex repairs may often present challenges for reconstruction. This paper explores the potential of three-dimensional (3D) bioprinting in MMS, offering superior outcomes compared to traditional methods. 3D printing technologies show promise in advancing skin regeneration and refining surgical techniques in dermatologic surgery. A PubMed search was conducted using the following keywords: "Three-dimensional bioprinting" OR "3-D printing" AND "Mohs" OR "Mohs surgery" OR "Surgery." Peer-reviewed English articles discussing medical applications of 3D bioprinting were included, while non-peer-reviewed and non-English articles were excluded. Patients using 3D MMS models had lower anxiety scores (3.00 to 1.7, p < 0.0001) and higher knowledge assessment scores (5.59 or 93.25% correct responses), indicating better understanding of their procedure. Surgical residents using 3D models demonstrated improved proficiency in flap reconstructions (p = 0.002) and knowledge assessment (p = 0.001). Additionally, 3D printing offers personalized patient care through tailored surgical guides and anatomical models, reducing intraoperative time while enhancing surgical. Concurrently, efforts in tissue engineering and regenerative medicine are being explored as potential alternatives to address organ donor shortages, eliminating autografting needs. However, challenges like limited training and technological constraints persist. Integrating optical coherence tomography with 3D bioprinting may expedite grafting, but challenges remain in pre-printing grafts for complex cases. Regulatory and ethical considerations are paramount for patient safety, and further research is needed to understand long-term effects and cost-effectiveness. While promising, significant advancements are necessary for full utilization in MMS.
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Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA.
| | - Yanci A Algarin
- Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
| | - Sarah Kim
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Steven Latta
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Jeffrey N Li
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
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Mendonça CJA, Guimarães RMDR, Pontim CE, Gasoto SC, Setti JAP, Soni JF, Schneider B. An Overview of 3D Anatomical Model Printing in Orthopedic Trauma Surgery. J Multidiscip Healthc 2023; 16:875-887. [PMID: 37038452 PMCID: PMC10082616 DOI: 10.2147/jmdh.s386406] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/09/2022] [Indexed: 04/12/2023] Open
Abstract
Introduction 3D object printing technology is a resource increasingly used in medicine in recent years, mainly incorporated in surgical areas like orthopedics. The models made by 3D printing technology provide surgeons with an accurate analysis of complex anatomical structures, allowing the planning, training, and surgery simulation. In orthopedic surgery, this technique is especially applied in oncological surgeries, bone, and joint reconstructions, and orthopedic trauma surgeries. In these cases, it is possible to prototype anatomical models for surgical planning, simulating, and training, besides printing of instruments and implants. Purpose The purpose of this paper is to describe the acquisition and processing from computed tomography images for 3D printing, to describe modeling and the 3D printing process of the biomodels in real size. This paper highlights 3D printing with the applicability of the 3D biomodels in orthopedic surgeries and shows some examples of surgical planning in orthopedic trauma surgery. Patients and Methods Four examples were selected to demonstrate the workflow and rationale throughout the process of planning and printing 3D models to be used in a variety of situations in orthopedic trauma surgeries. In all cases, the use of 3D modeling has impacted and improved the final treatment strategy. Conclusion The use of the virtual anatomical model and the 3D printed anatomical model with the additive manufacturing technology proved to be effective and useful in planning and performing the surgical treatment of complex articular fractures, allowing surgical planning both virtual and with the 3D printed anatomical model, besides being useful during the surgical time as a navigation instrument.
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Affiliation(s)
- Celso Junio Aguiar Mendonça
- Musculoskeletal System Unit, Hospital of Federal University of Paraná, Curitiba, Paraná, Brazil
- Postgraduate Program in Electrical Engineering and Industrial Informatics, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
- Correspondence: Celso Junio Aguiar Mendonça, Postgraduate Program in Electrical Engineering and Industrial Informatics – CPGEI, Federal Technological University of Paraná – UTFPR, Av. Sete de Setembro, 3165 – Rebouças, Curitiba, Paraná, 80230-901, Brazil, Tel +55 41 999973900, Email
| | - Ricardo Munhoz da Rocha Guimarães
- Cajuru University Hospital, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
- Postgraduate Program in Biomedical Engineering, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Carlos Eduardo Pontim
- Postgraduate Program in Biomedical Engineering, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Sidney Carlos Gasoto
- Postgraduate Program in Electrical Engineering and Industrial Informatics, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
| | - João Antonio Palma Setti
- Postgraduate Program in Biomedical Engineering, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Jamil Faissal Soni
- Musculoskeletal System Unit, Hospital of Federal University of Paraná, Curitiba, Paraná, Brazil
- Cajuru University Hospital, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Bertoldo Schneider
- Postgraduate Program in Electrical Engineering and Industrial Informatics, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
- Postgraduate Program in Biomedical Engineering, Hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil
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Czyżewski W, Jachimczyk J, Hoffman Z, Szymoniuk M, Litak J, Maciejewski M, Kura K, Rola R, Torres K. Low-Cost Cranioplasty—A Systematic Review of 3D Printing in Medicine. MATERIALS 2022; 15:ma15144731. [PMID: 35888198 PMCID: PMC9315853 DOI: 10.3390/ma15144731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/20/2022] [Accepted: 07/02/2022] [Indexed: 11/22/2022]
Abstract
The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.
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Affiliation(s)
- Wojciech Czyżewski
- Department of Didactics and Medical Simulation, Medical University of Lublin, 20-093 Lublin, Poland; (W.C.); (K.T.)
- Department of Neurosurgery and Pediatric Neurosurgery in Lublin, 20-090 Lublin, Poland; (J.L.); (K.K.); (R.R.)
| | - Jakub Jachimczyk
- Student Scientific Society, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Zofia Hoffman
- Student Scientific Society, Medical University of Lublin, 20-059 Lublin, Poland;
- Correspondence:
| | - Michał Szymoniuk
- Student Scientific Association of Neurosurgery, Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Jakub Litak
- Department of Neurosurgery and Pediatric Neurosurgery in Lublin, 20-090 Lublin, Poland; (J.L.); (K.K.); (R.R.)
- Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Marcin Maciejewski
- Department of Electronics and Information Technology, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Krzysztof Kura
- Department of Neurosurgery and Pediatric Neurosurgery in Lublin, 20-090 Lublin, Poland; (J.L.); (K.K.); (R.R.)
| | - Radosław Rola
- Department of Neurosurgery and Pediatric Neurosurgery in Lublin, 20-090 Lublin, Poland; (J.L.); (K.K.); (R.R.)
| | - Kamil Torres
- Department of Didactics and Medical Simulation, Medical University of Lublin, 20-093 Lublin, Poland; (W.C.); (K.T.)
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Mechanosensitive Osteogenesis on Native Cellulose Scaffolds for Bone Tissue Engineering. J Biomech 2022; 135:111030. [DOI: 10.1016/j.jbiomech.2022.111030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/17/2022] [Accepted: 02/28/2022] [Indexed: 12/23/2022]
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Sheng X, Wang A, Wang Z, Liu H, Wang J, Li C. Advanced Surface Modification for 3D-Printed Titanium Alloy Implant Interface Functionalization. Front Bioeng Biotechnol 2022; 10:850110. [PMID: 35299643 PMCID: PMC8921557 DOI: 10.3389/fbioe.2022.850110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022] Open
Abstract
With the development of three-dimensional (3D) printed technology, 3D printed alloy implants, especially titanium alloy, play a critical role in biomedical fields such as orthopedics and dentistry. However, untreated titanium alloy implants always possess a bioinert surface that prevents the interface osseointegration, which is necessary to perform surface modification to enhance its biological functions. In this article, we discuss the principles and processes of chemical, physical, and biological surface modification technologies on 3D printed titanium alloy implants in detail. Furthermore, the challenges on antibacterial, osteogenesis, and mechanical properties of 3D-printed titanium alloy implants by surface modification are summarized. Future research studies, including the combination of multiple modification technologies or the coordination of the structure and composition of the composite coating are also present. This review provides leading-edge functionalization strategies of the 3D printed titanium alloy implants.
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Affiliation(s)
- Xiao Sheng
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Ao Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Chen Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
- *Correspondence: Chen Li,
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An overview of 3D printing and the orthopaedic application of patient-specific models in malunion surgery. Injury 2022; 53:977-983. [PMID: 34838259 DOI: 10.1016/j.injury.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/12/2021] [Accepted: 11/09/2021] [Indexed: 02/02/2023]
Abstract
As the emerging technology of three-dimensional (3D) printing impacts several facets of medicine, innovative techniques and applications are increasingly being incorporated into clinical workflows. Specifically, 3D printing technology has allowed for the individualization of patient care through the creation of printed surgical guides, patient-specific anatomical models, and simulation practice models. In this paper, we review the broad applications of 3D printing in orthopaedic surgery. The purpose of this paper is to help orthopaedic trauma surgeons understand 3D printing's emerging influence on the delivery of care as well as how to directly apply this technology to their practice. We aim to illustrate these principles through a specific example of a patient who presented for malunion surgery. A 3D printed model of a very complex traumatic scapula malunion was used to not only pre-surgically plan the reconstruction, but to also facilitate provider and patient education. This paper highlights the benefits of 3D printing and how trauma surgeons are uniquely positioned to apply this technology to improve patient care.
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Ferràs-Tarragó J, Grau-Llopis E, Navarrete-Faubel E, Sánchez-González M, Vicent-Carsí V. An Innovative Weightbearing Device for Weightbearing 3-Dimensional Imaging for Foot and Ankle Surgery Preoperative Planning. J Foot Ankle Surg 2021; 60:1124-1130. [PMID: 34024677 DOI: 10.1053/j.jfas.2020.06.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 02/03/2023]
Abstract
Three-dimensional preoperative planning has demonstrated multiple surgical advantages. Currently, we cannot carry out preoperative 3-dimensional planning of foot and ankle orthopedics in most hospitals due to the impossibility of performing weightbearing CT imaging. Our objective is to describe and evaluate an innovative accessible, simple, and effective device that simulates standing while in a supine position, to obtain 3-dimensional images supporting bodyweight load with a conventional CT machine. From a group of 30 volunteers, 10 patients were randomly selected and pressure and its distribution were analyzed while in a standing position in both feet. Differences between both feet were considered normal intrapersonal variability. Subsequently, the right footprint of the same 10 subjects was evaluated in the proposed loading device. Then, their pressures and distribution were compared with respect to standing and with respect to intrapersonal variability. The mean total standing pressure was 93 Kpa (standard deviation [SD] 14.32), which was reduced to 81.95 Kpa (SD 19.54) in the loading device. The load device reduced the pressure by a mean of16% (SD 22% (range -25% to -0.03%). At the hindfoot level, the loading device increased pressure by a mean of 20.59 Kpa, which expressed percentage implies an increase of 14% compared to standing. Due to its easy construction and effectiveness, this is the first device that opens the door of foot and ankle orthopedics in any hospital to 3D preoperative planning and the benefits derived from it.
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Osborn J, Anderson MS, Beddingfield M, Zhang LG, Sarkar K. Acoustic Droplet Vaporization of Perfluorocarbon Droplets in 3D-Printable Gelatin Methacrylate Scaffolds. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:3263-3274. [PMID: 34456086 DOI: 10.1016/j.ultrasmedbio.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
Scientists face a significant challenge in creating effective biomimetic constructs in tissue engineering with sustained and controlled delivery of growth factors. Recently, the addition of phase-shift droplets inside the scaffolds is being explored for temporal and spatial control of biologic delivery through vaporization using external ultrasound stimulation. Here, we explore acoustic droplet vaporization (ADV) in gelatin methacrylate (GelMA), a popular hydrogel used for tissue engineering applications because of its biocompatibility, tunable mechanical properties and rapid reproducibility. We embedded phase-shift perfluorocarbon droplets within the GelMA resin before crosslinking and characterized ADV and inertial cavitation (IC) thresholds of the embedded droplets. We were successful in vaporizing two different perfluorocarbon---perfluoropentane (PFP) and perfluorohexane (PFH)--cores at 2.25- and 5-MHz frequencies and inside hydrogels with varying mechanical properties. The ADV and IC thresholds for PFP droplets in GelMA scaffolds increased with frequency and in stiffer scaffolds. The PFH droplets exhibited ADV and IC activity only at 5 MHz for the range of excitations below 3MPa investigated here and at threshold values higher than those of PFP droplets. The results provide a proof of concept for the possible use of ADV in hydrogel scaffolds for tissue engineering.
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Affiliation(s)
- Jenna Osborn
- Department of Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052, USA
| | - Megan S Anderson
- Department of Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052, USA
| | - Morgan Beddingfield
- Department of Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052, USA
| | - Lijie Grace Zhang
- Department of Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052, USA
| | - Kausik Sarkar
- Department of Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052, USA.
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Abstract
The menisci are fibrocartilaginous semilunar structures in the knee that provide load support. Injury to the meniscus alters its load sharing and biomechanical profile. Knee arthroscopy with meniscus débridement is the most common orthopaedic surgical procedure done in the United States. The current goals of meniscal surgery are to preserve native meniscal tissue and maintain structural integrity. Meniscal preservation is critical to maintain the normal mechanics and homeostasis of the knee; however, it is not always feasible because of the structure's poor blood supply and often requires removal of irreparable tissue with meniscectomy. Efforts have increasingly focused on the promotion of meniscal healing and the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. The purpose of this article was to review current and future meniscal salvage treatments such as meniscus transplant, synthetic arthroplasty, and possible bioprinted meniscus to allow patients to maintain quality of life, limit pain, and delay osteoarthritis.
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Herreros-Pomares A, Zhou X, Calabuig-Fariñas S, Lee SJ, Torres S, Esworthy T, Hann SY, Jantus-Lewintre E, Camps C, Zhang LG. 3D printing novel in vitro cancer cell culture model systems for lung cancer stem cell study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 122:111914. [PMID: 33641907 DOI: 10.1016/j.msec.2021.111914] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/20/2021] [Accepted: 01/23/2021] [Indexed: 12/21/2022]
Abstract
Two-dimensional (2D) in vitro cell cultures and laboratory animals have been used traditionally as the gold-standard preclinical cancer model systems. However, for cancer stem cell (CSC) studies, they exhibit notable limitations on simulating native environment, which depreciate their translatability for clinical development purposes. In this study, different three-dimensional (3D) printing platforms were used to establish novel 3D cell cultures enriched in CSCs from non-small cell lung cancer (NSCLC) patients and cell lines. Rigid scaffolds with an elevated compressive modulus and uniform pores and channels were produced using different filaments. Hydrogel-based scaffolds were printed with a more irregular distribution of pores and a lower compressive modulus. As a 3D model of reference, suspension spheroid cultures were established. Therein, cancer cell lines exhibited enhanced proliferation profiles on rigid scaffolds compared to the same cells grown on either hydrogel scaffolds or tumor spheres. Meanwhile, primary cancer cells grew considerably better on hydrogel scaffolds or in tumor sphere culture, compared to cells grown on rigid scaffolds. Gene expression analysis confirmed that tumor spheres and cells seeded on hydrogel scaffolds significantly overexpress most of stemness and invasion promoters tested compared to control cells grown in 2D culture. A different phenomenon was observed within cells growing on the rigid scaffolds, where fewer significant variations in gene expression were detected. Our findings provide strong evidence for the advantageous usage of 3D printed models, especially those which use GelMA-PEGDA hydrogels as the primary scaffold material, for studying lung CSCs. The results demonstrated that the 3D printed scaffolds were better to mimic tumor complexity and regulate cancer cell behavior than in vivo 2D culture models.
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Affiliation(s)
- Alejandro Herreros-Pomares
- Mixed Unit TRIAL, Fundación Investigacíón Hospital General Universitario de Valencia & Centro de Investigación Príncipe Felipe, Valencia, Spain; CIBERONC, Valencia, Spain
| | - Xuan Zhou
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, United States
| | - Silvia Calabuig-Fariñas
- Mixed Unit TRIAL, Fundación Investigacíón Hospital General Universitario de Valencia & Centro de Investigación Príncipe Felipe, Valencia, Spain; CIBERONC, Valencia, Spain; Department of Pathology, Universitat de València, Valencia, Spain
| | - Se-Jun Lee
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, United States
| | - Susana Torres
- Mixed Unit TRIAL, Fundación Investigacíón Hospital General Universitario de Valencia & Centro de Investigación Príncipe Felipe, Valencia, Spain; CIBERONC, Valencia, Spain
| | - Timothy Esworthy
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, United States
| | - Sung Yun Hann
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, United States
| | - Eloísa Jantus-Lewintre
- Mixed Unit TRIAL, Fundación Investigacíón Hospital General Universitario de Valencia & Centro de Investigación Príncipe Felipe, Valencia, Spain; CIBERONC, Valencia, Spain; Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
| | - Carlos Camps
- Mixed Unit TRIAL, Fundación Investigacíón Hospital General Universitario de Valencia & Centro de Investigación Príncipe Felipe, Valencia, Spain; CIBERONC, Valencia, Spain; Department of Medical Oncology, Hospital General Universitario de Valencia, Valencia, Spain; Department of Medicine, Universitat de València, Valencia, Spain.
| | - Lijie Grace Zhang
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, United States; Department of Biomedical Engineering, The George Washington University, Washington, DC, United States; Department of Electrical and Computer Engineering, The George Washington University, Washington, DC, United States; Department of Medicine, The George Washington University, Washington, DC, United States.
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Zhou X, Nowicki M, Sun H, Hann SY, Cui H, Esworthy T, Lee JD, Plesniak M, Zhang LG. 3D Bioprinting-Tunable Small-Diameter Blood Vessels with Biomimetic Biphasic Cell Layers. ACS APPLIED MATERIALS & INTERFACES 2020; 12:45904-45915. [PMID: 33006880 DOI: 10.1021/acsami.0c14871] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Blood vessel damage resulting from trauma or diseases presents a serious risk of morbidity and mortality. Although synthetic vascular grafts have been successfully commercialized for clinical use, they are currently only readily available for large-diameter vessels (>6 mm). Small-diameter vessel (<6 mm) replacements, however, still present significant clinical challenges worldwide. The primary objective of this study is to create novel, tunable, small-diameter blood vessels with biomimetic two distinct cell layers [vascular endothelial cell (VEC) and vascular smooth muscle cell (VSMC)] using an advanced coaxial 3D-bioplotter platform. Specifically, the VSMCs were laden in the vessel wall and VECs grew in the lumen to mimic the natural composition of the blood vessel. First, a novel bioink consisting of VSMCs laden in gelatin methacryloyl (GelMA)/polyethylene(glycol)diacrylate/alginate and lyase was designed. This specific design is favorable for nutrient exchange in an ambient environment and simultaneously improves laden cell proliferation in the matrix pore without the space restriction inherent with substance encapsulation. In the vessel wall, the laden VSMCs steadily grew as the alginate was gradually degraded by lyase leaving more space for cell proliferation in matrices. Through computational fluid dynamics simulation, the vessel demonstrated significantly perfusable and mechanical properties under various flow velocities, flow viscosities, and temperature conditions. Moreover, both VSMCs in the scaffold matrix and VECs in the lumen steadily proliferated over time creating a significant two-cell-layered structure. Cell proliferation was confirmed visually through staining the markers of alpha-smooth muscle actin and cluster of differentiation 31, commonly tied to angiogenesis phenomena, in the vessel matrices and lumen, respectively. Furthermore, the results were confirmed quantitatively through gene analysis which suggested good angiogenesis expression in the blood vessels. This study demonstrated that the printed blood vessels with two distinct cell layers of VECs and VSMCs could be potential candidates for clinical small-diameter blood vessel replacement applications.
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Affiliation(s)
- Xuan Zhou
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Margaret Nowicki
- Department of Civil and Mechanical Engineering, The United States Military Academy, West Point, New York 10996, United States
| | - Hao Sun
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Sung Yun Hann
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Haitao Cui
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Timothy Esworthy
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - James D Lee
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Michael Plesniak
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
| | - Lijie Grace Zhang
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington District of Columbia 20052, United States
- Department of Biomedical Engineering, The George Washington University, Washington District of Columbia 20052, United States
- Department of Electrical and Computer Engineering, The George Washington University, Washington District of Columbia 20052, United States
- Department of Medicine, The George Washington University, Washington District of Columbia 20052, United States
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Zhou X, Tenaglio S, Esworthy T, Hann SY, Cui H, Webster TJ, Fenniri H, Zhang LG. Three-Dimensional Printing Biologically Inspired DNA-Based Gradient Scaffolds for Cartilage Tissue Regeneration. ACS APPLIED MATERIALS & INTERFACES 2020; 12:33219-33228. [PMID: 32603082 DOI: 10.1021/acsami.0c07918] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cartilage damage caused by aging, repeated overloading, trauma, and diseases can result in chronic pain, inflammation, stiffness, and even disability. Unlike other types of tissues (bone, skin, muscle, etc.), cartilage tissue has an extremely weak regenerative capacity. Currently, the gold standard surgical treatment for repairing cartilage damage includes autografts and allografts. However, these procedures are limited by insufficient donor sources and the potential for immunological rejection. After years of development, engineered tissue now provides a valuable artificial replacement for tissue regeneration purposes. Three-dimensional (3D) bioprinting technologies can print customizable hierarchical structures with cells. The objective of the current work was to prepare a 3D-printed three-layer gradient scaffold with lysine-functionalized rosette nanotubes (RNTK) for improving the chondrogenic differentiation of adipose-derived mesenchymal stem cells (ADSCs). Specifically, biologically inspired RNTKs were utilized in our work because they have unique surface chemistry and biomimetic nanostructure to improve cell adhesion and growth. Different ratios of gelatin methacrylate (GelMA) and poly(ethylene glycol) diacrylate (PEGDA) were printed into a three-layer GelMA-PEGDA gradient scaffold using a stereolithography-based printer, followed by coating with RNTKs. The pores and channels (∼500 μm) were observed in the scaffold. It was found that the population of ADSCs on the GelMA-PEGDA-RNTK scaffold increased by 34% compared to the GelMA-PEGDA scaffold (control). Moreover, after 3 weeks of chondrogenic differentiation, collagen II, glycosaminoglycan, and total collagen synthesis on the GelMA-PEGDA-RNTK scaffold significantly respectively increased by 59%, 71%, and 60%, as compared to the control scaffold. Gene expression of collagen II α1, SOX 9, and aggrecan in the ADSCs growing on the GelMA-PEGDA-RNTK scaffold increased by 79%, 52%, and 47% after 3 weeks, compared to the controls, respectively. These results indicated that RNTKs are a promising type of nanotubes for promoting chondrogenic differentiation, and the present 3D-printed three-layer gradient GelMA-PEGDA-RNTK scaffold shows considerable promise for future cartilage repair and regeneration.
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Affiliation(s)
| | | | | | | | | | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts 02115, United States
| | - Hicham Fenniri
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts 02115, United States
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