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      Embedded 3D bioprinting – An emerging strategy to fabricate biomimetic & large vascularized tissue constructs

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          Abstract

          Three–dimensional bioprinting is an advanced tissue fabrication technique that allows printing complex structures with precise positioning of multiple cell types layer–by–layer. Compared to other bioprinting methods, extrusion bioprinting has several advantages to print large–sized tissue constructs and complex organ models due to large build volume. Extrusion bioprinting using sacrificial, support and embedded strategies have been successfully employed to facilitate printing of complex and hollow structures. Embedded bioprinting is a gel–in–gel approach developed to overcome the gravitational and overhanging limits of bioprinting to print large–sized constructs with a micron–scale resolution. In embedded bioprinting, deposition of bioinks into the microgel or granular support bath will be facilitated by the sol–gel transition of the support bath through needle movement inside the granular medium. This review outlines various embedded bioprinting strategies and the polymers used in the embedded systems with advantages, limitations, and efficacy in the fabrication of complex vascularized tissues or organ models with micron–scale resolution. Further, the essential requirements of support bath systems like viscoelasticity, stability, transparency and easy extraction to print human scale organs are discussed. Additionally, the organs or complex geometries like vascular constructs, heart, bone, octopus and jellyfish models printed using support bath assisted printing methods with their anatomical features are elaborated. Finally, the challenges in clinical translation and the future scope of these embedded bioprinting models to replace the native organs are envisaged.

          Graphical abstract

          Progress of embedded bioprinting from 2011 to 2023.

          Highlights

          • Sacrificial, support and embedded extrusion strategies for printing complex structures were discussed.

          • This review outlines the advantages & limitations of various embedded bioprinting strategies.

          • Ideal requirements of support bath systems to print human-scale organs are discussed.

          • Challenges in clinical translation & future potential of embedded bioprinting are elaborated.

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          Most cited references218

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          3D bioprinting of collagen to rebuild components of the human heart

          Collagen is the primary component of the extracellular matrix in the human body. It has proved challenging to fabricate collagen scaffolds capable of replicating the structure and function of tissues and organs. We present a method to 3D-bioprint collagen using freeform reversible embedding of suspended hydrogels (FRESH) to engineer components of the human heart at various scales, from capillaries to the full organ. Control of pH-driven gelation provides 20-micrometer filament resolution, a porous microstructure that enables rapid cellular infiltration and microvascularization, and mechanical strength for fabrication and perfusion of multiscale vasculature and tri-leaflet valves. We found that FRESH 3D-bioprinted hearts accurately reproduce patient-specific anatomical structure as determined by micro–computed tomography. Cardiac ventricles printed with human cardiomyocytes showed synchronized contractions, directional action potential propagation, and wall thickening up to 14% during peak systole.
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            3D bioprinting for engineering complex tissues.

            Bioprinting is a 3D fabrication technology used to precisely dispense cell-laden biomaterials for the construction of complex 3D functional living tissues or artificial organs. While still in its early stages, bioprinting strategies have demonstrated their potential use in regenerative medicine to generate a variety of transplantable tissues, including skin, cartilage, and bone. However, current bioprinting approaches still have technical challenges in terms of high-resolution cell deposition, controlled cell distributions, vascularization, and innervation within complex 3D tissues. While no one-size-fits-all approach to bioprinting has emerged, it remains an on-demand, versatile fabrication technique that may address the growing organ shortage as well as provide a high-throughput method for cell patterning at the micrometer scale for broad biomedical engineering applications. In this review, we introduce the basic principles, materials, integration strategies and applications of bioprinting. We also discuss the recent developments, current challenges and future prospects of 3D bioprinting for engineering complex tissues. Combined with recent advances in human pluripotent stem cell technologies, 3D-bioprinted tissue models could serve as an enabling platform for high-throughput predictive drug screening and more effective regenerative therapies.
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              Three-dimensional bioprinting of thick vascularized tissues.

              The advancement of tissue and, ultimately, organ engineering requires the ability to pattern human tissues composed of cells, extracellular matrix, and vasculature with controlled microenvironments that can be sustained over prolonged time periods. To date, bioprinting methods have yielded thin tissues that only survive for short durations. To improve their physiological relevance, we report a method for bioprinting 3D cell-laden, vascularized tissues that exceed 1 cm in thickness and can be perfused on chip for long time periods (>6 wk). Specifically, we integrate parenchyma, stroma, and endothelium into a single thick tissue by coprinting multiple inks composed of human mesenchymal stem cells (hMSCs) and human neonatal dermal fibroblasts (hNDFs) within a customized extracellular matrix alongside embedded vasculature, which is subsequently lined with human umbilical vein endothelial cells (HUVECs). These thick vascularized tissues are actively perfused with growth factors to differentiate hMSCs toward an osteogenic lineage in situ. This longitudinal study of emergent biological phenomena in complex microenvironments represents a foundational step in human tissue generation.
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                Author and article information

                Contributors
                Journal
                Bioact Mater
                Bioact Mater
                Bioactive Materials
                KeAi Publishing
                2452-199X
                21 October 2023
                February 2024
                21 October 2023
                : 32
                : 356-384
                Affiliations
                [1]Tissue Engineering & Additive Manufacturing (TEAM) Lab, Center for Nanotechnology & Advanced Biomaterials, ABCDE Innovation Center, School of Chemical & Biotechnology, SASTRA Deemed University, Thanjavur, India
                Author notes
                []Corresponding authors. Tissue Engineering & Additive Manufacturing (TEAM) Lab, Center for Nanotechnology & Advanced Biomaterials, ABCDE Innovation Center, School of Chemical & Biotechnology, SASTRA Deemed University, Thanjavur - 613 401, Tamil Nadu, India. dhakshinamoorthy@ 123456scbt.sastra.edu swami@ 123456sastra.edu
                Article
                S2452-199X(23)00317-1
                10.1016/j.bioactmat.2023.10.012
                10618244
                37920828
                f2ff2d22-4a0d-4224-bc8e-27eba7249c52
                © 2023 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 16 June 2023
                : 16 September 2023
                : 10 October 2023
                Categories
                Review Article

                bioprinting,bioinks,embedded bioprinting,complex bioprinting,supportive bioprinting,organ models bioprinting

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