An Integration of a Peristaltic Pump-Based Extruder into a 3D Bioprinter Dedicated to Hydrogels

A critical review on advances and challenges of bioprinted cardiac patches

Myocardial infarction (MI), which causes irreversible myocardium necrosis, affects 0.25 billion people globally and has become one of the most significant epidemics of our time. Over the past few years, bioprinting has moved beyond a concept of simply incorporating cells into biomaterials, to strategically defining the microenvironment (e.g., architecture, biomolecular signalling, mechanical stimuli, etc.) within which the cells are printed. Among the different bioprinting applications, myocardial repair is a field that has seen some of the most significant advances towards the management of the repaired tissue microenvironment. This review critically assesses the most recent biomedical innovations being carried out in cardiac patch bioprinting, with specific considerations given to the biomaterial design parameters, growth factors/cytokines, biomechanical and bioelectrical conditioning, as well as innovative biomaterial-based "4D" bioprinting (3D scaffold structure + temporal morphology changes) of myocardial tissues, immunomodulation and sustained delivery systems used in myocardium bioprinting. Key challenges include the ability to generate large quantities of cardiac cells, achieve high-density capillary networks, establish biomaterial designs that are comparable to native cardiac extracellular matrix, and manage the sophisticated systems needed for combining cardiac tissue microenvironmental cues while simultaneously establishing bioprinting technologies yielding both high-speed and precision. This must be achieved while considering quality assurance towards enabling reproducibility and clinical translation. Moreover, this manuscript thoroughly discussed the current clinical translational hurdles and regulatory issues associated with the post-bioprinting evaluation, storage, delivery and implantation of the bioprinted myocardial patches. Overall, this paper provides insights into how the clinical feasibility and important regulatory concerns may influence the design of the bioink (biomaterials, cell sources), fabrication and post-fabrication processes associated with bioprinting of the cardiac patches. This paper emphasizes that cardiac patch bioprinting requires extensive collaborations from imaging and 3D modelling technical experts, biomaterial scientists, additive manufacturing experts and healthcare professionals. Further, the work can also guide the field of cardiac patch bioprinting moving forward, by shedding light on the potential use of robotics and automation to increase productivity, reduce financial cost, and enable standardization and true commercialization of bioprinted cardiac patches. STATEMENT OF SIGNIFICANCE: The manuscript provides a critical review of important themes currently pursued for heart patch bioprinting, including critical biomaterial design parameters, physiologically-relevant cardiac tissue stimulations, and newly emerging cardiac tissue bioprinting strategies. This review describes the limited number of studies, to date in the literature, that describe systemic approaches to combine multiple design parameters, including capabilities to yield high-density capillary networks, establish biomaterial composite designs similar to native cardiac extracellular matrix, and incorporate cardiac tissue microenvironmental cues, while simultaneously establishing bioprinting technologies that yield high-speed and precision. New tools such as artificial intelligence may provide the analytical power to consider multiple design parameters and identify an optimized work-flow(s) for enabling the clinical translation of bioprinted cardiac patches.

Solvent types used for the preparation of hydrogels determine their mechanical properties and influence cell viability through gelatine and calcium ions release

Alginate-gelatin hydrogels are the most commonly used materials for 3D bioprinting. Their printability depends on their properties, and these derive from the way they are prepared and their very composition. Therefore, the aim of the study was to investigate the type of solvent (deionized water, phosphate buffer, and culture medium) and contents of gelatin in the composition of hydrogel (2% wt/vol alginate, 6% and 9% wt/vol of gelatin) on their biological, physicochemical, and mechanical properties, as well as printability and the ability of cells to proliferate in the printed structures. The results obtained revealed that all the manufactured hydrogel materials are biocompatible. The use of deionized water as a solvent results in the highest degree of cross-linking of hydrogels, thus obtaining a polymer with the highest rigidity. Moreover, an increase in gelatin content leads to an increase in the Young's modulus value, irrespectively of the solvent in which the hydrogels were prepared. Based on the chemical structure, it is more reasonable to use a culture medium for bioink preparation due to free NH and NH₂ groups being present, which are ligands for cell attachment and their proliferation. For the selected material (2A9GM), the printability and high viability of the cells after printing were confirmed. In this case, the concentration of the cross-linking agent influences gelatin amount release and calcium ions release, and these two processes determine the change in the viability of the cells encapsulated in the bioink.

Study of the Pulse of Peristaltic Pumps for Use in 3D Extrusion Bioprinting

Peristaltic pumps are used in healthcare for their ability to aseptically displace various fluids, including medium-density gels and suspended solids. However, they have the undesirable characteristic of pulsing at their output. Three-dimensional printing is becoming a reality in tissue engineering, and it generally uses syringes to extrude hydrogels. One of the problems to be solved is the microdosing of biomaterials or bioinks when it is necessary to print large volumes. The use of peristaltic pumps in bioprinting is desirable as it does not limit the volume to the contents of a syringe while achieving dosage control. A peristaltic pump was designed and implemented to avoid pulsation errors and microliter dosing while allowing a large amount of fluid displacement. Two pumps with equal displacement were built. The first uses the conventional profile and is the baseline for comparisons, while the second presents the profile studied and proposed. The concepts demonstrated by Bernoulli were used, fixing the height of a column of water, while the two pumps provide flow to the system asynchronously, allowing the reading of pressure as a function of the speed variation created by the pulsation of each pump. An approximately 100 times reduction in pulsation was observed during fluid displacement with the variance reduced from 2.64 to 0.025 s². The two pumps were also installed on a modified Ultimaker FDM 3D printer, and a standard for comparison was printed using a water-based hydrogel, corn starch, and corn-derived triglyceride, showing that the proposed pump improves the deposition quality of the material. Three-dimensional prints, tubes 20 mm in diameter by 8 mm in height and 0.7 mm in wall width, were also produced. Videos obtained show that the first pump was not able to print more than 4 mm in height, while the second prints the model with high quality and without deficiency. The results show that the new pump profile is able to provide a sufficiently constant volume for three-dimensional printing with excellent deposition control, building a simple object but difficult to obtain for a common peristaltic pump.

Fiber Thickness and Porosity Control in a Biopolymer Scaffold 3D Printed through a Converted Commercial FDM Device

3D printing has opened exciting new opportunities for the in vitro fabrication of biocompatible hybrid pseudo-tissues. Technologies based on additive manufacturing herald a near future when patients will receive therapies delivering functional tissue substitutes for the repair of their musculoskeletal tissue defects. In particular, bone tissue engineering (BTE) might extensively benefit from such an approach. However, designing an optimal 3D scaffold with adequate stiffness and biodegradability properties also guaranteeing the correct cell adhesion, proliferation, and differentiation, is still a challenge. The aim of this work was the rewiring of a commercial fuse deposition modeling (FDM) 3D printer into a 3D bioplotter, aiming at obtaining scaffold fiber thickness and porosity control during its manufacturing. Although it is well-established that FDM is a fast and low-price technology, the high temperatures required for printing lead to limitations in the biomaterials that can be used. In our hands, modifying the printing head of the FDM device with a custom-made holder has allowed to print hydrogels commonly used for embedding living cells. The results highlight a good resolution, reproducibility and repeatability of alginate/gelatin scaffolds obtained via our custom 3D bioplotter prototype, showing a viable strategy to equip a small-medium laboratory with an instrument for manufacturing good-quality 3D scaffolds for cell culture and tissue engineering applications.

Extrusion-Based 3D Printing of Ceramic Pastes: Mathematical Modeling and In Situ Shaping Retention Approach

Extrusion-based three-dimensional (3D) printing methods are preferred and emerging approaches for freely digital fabrication of ceramics due to ease of use, low investment, high utilization of materials, and good adaptability to multi-materials. However, systematic knowledge still lacks an explanation for what is their 3D printability. Moreover, some uncontrollable factors including extrudate shape retention and nonuniform drying inevitably limit their industrial applications. The purpose of this research was to present a new shaping retention method based on mathematical synthesis modeling for extrusion-based 3D-printing of ceramic pastes. Firstly, the steady-state equilibrium equation of the extrusion process was derived to provide clearer theoretical indications than purely experimental methods. Furthermore, a mathematical description framework was synthesized to better understand the extrusion-based 3D-printing of ceramic pastes from several realms: pastes rheology, extrudability, shape-holdability, and drying kinetics. Secondly, for eliminating shaping drawbacks (e.g., deformation and cracks) originating from non-digital control factors, we put forward a digital shape-retention technology inspired by the generalized drying kinetics of porous materials, which was different from existing retention solutions, e.g., freezing retention, thermally induced gelation, and using removable support structures. In addition, we developed an in situ hot air flow drying device easily attached to the nozzle of existing 3D printers. Confirmatory 3D-printing experiments of thin-walled cone-shape benchmark parts and the fire arrowhead-like object clearly demonstrated that the presented shape-retention method not only upgraded layer-by-layer forming capability but also enabled digital control of extrudate solidification. In addition, many more experimental results statistically showed that both fully solid parts and purely thin-wall parts had higher dimensional accuracy and better surface quality than the offline drying method. The 3D printed ceramic products with complex profiled surfaces conceivably demonstrated that our improved extrusion-based 3D-printing process of ceramic pastes has game-changing potentials beyond the traditional craftsmanship capacity.