3D Printing of Thermo-Responsive Methylcellulose Hydrogels for Cell-Sheet Engineering

High-viscosity driven modulation of biomechanical properties of human mesenchymal stem cells promotes osteogenic lineage

Biomechanical cues could effectively govern cell gene expression to direct the differentiation of specific stem cell lineage. Recently, the medium viscosity has emerged as a significant mechanical stimulator that regulates the cellular mechanical properties and various physiological functions. However, whether the medium viscosity can regulate the mechanical properties of human mesenchymal stem cells (hMSCs) to effectively trigger osteogenic differentiation remains uncertain. The mechanism by which cells sense and respond to changes in medium viscosity, and regulate cell mechanical properties to promote osteogenic lineage, remains elusive. In this study, we demonstrated that hMSCs, cultured in a high-viscosity medium, exhibited larger cell spreading area and higher intracellular tension, correlated with elevated formation of actin stress fibers and focal adhesion maturation. Furthermore, these changes observed in hMSCs were associated with activation of TRPV4 (transient receptor potential vanilloid sub-type 4) channels on the cell membrane. This feedback loop among TRPV4 activation, cell spreading and intracellular tension results in calcium influx, which subsequently promotes the nuclear localization of NFATc1 (nuclear factor of activated T cells 1). Concomitantly, the elevated intracellular tension induced nuclear deformation and promoted the nuclear localization of YAP (YES-associated protein). The concurrent activation of NFATc1 and YAP significantly enhanced alkaline phosphatase (ALP) for pre-osteogenic activity. Taken together, these findings provide a more comprehensive view of how viscosity-induced alterations in biomechanical properties of MSCs impact the expression of osteogenesis-related genes, and ultimately promote osteogenic lineage.

Injectable in situ gelling methylcellulose-based hydrogels for bone tissue regeneration

Injectable bone substitutes (IBSs) represent a compelling choice for bone tissue regeneration, as they can be exploited to optimally fill complex bone defects in a minimally invasive manner. In this context, in situ gelling methylcellulose (MC) hydrogels may be engineered to be free-flowing injectable solutions at room temperature and gels upon exposure to body temperature. Moreover, incorporating a suitable inorganic phase can further enhance the mechanical properties of MC hydrogels and promote mineralization, thus assisting early cell adhesion to the hydrogel and effectively guiding bone tissue regeneration. In this work, thermo-responsive IBSs were designed selecting MC as the organic matrix and calcium phosphate (CaP) or CaP modified with graphene oxide (CaPGO) as the inorganic component. The resulting biocomposites displayed a transition temperature around body temperature, preserved injectability even after loading with the inorganic components, and exhibited adequate retention on an ex vivo calf femoral bone defect model. The addition of CaP and CaPGO promoted the in vitro mineralization process already 14 days after immersion in simulated body fluid. Interestingly, combined X-ray diffraction and solid state nuclear magnetic resonance characterizations revealed that the formed biomimetic phase was constituted by crystalline hydroxyapatite and amorphous calcium phosphate. In vitro biological characterization revealed the beneficial impact of CaP and CaPGO, indicating their potential in promoting cell adhesion, proliferation and osteogenic differentiation. Remarkably, the addition of GO, which is very attractive for its bioactive properties, did not negatively affect the injectability of the hydrogel nor the mineralization process, but had a positive impact on cell growth and osteogenic differentiation on both pre-differentiated and undifferentiated cells. Overall, the proposed formulations represent potential candidates for use as IBSs for application in bone regeneration both under physiological and pathological conditions.

Recent Advancements in Hydrogel Biomedical Research in Italy

Hydrogels have emerged as versatile biomaterials with remarkable applications in biomedicine and tissue engineering. Here, we present an overview of recent and ongoing research in Italy, focusing on extracellular matrix-derived, natural, and synthetic hydrogels specifically applied to biomedicine and tissue engineering. The analyzed studies highlight the versatile nature and wide range of applicability of hydrogel-based studies. Attention is also given to the integration of hydrogels within bioreactor systems, specialized devices used in biological studies to culture cells under controlled conditions, enhancing their potential for regenerative medicine, drug discovery, and drug delivery. Despite the abundance of literature on this subject, a comprehensive overview of Italian contributions to the field of hydrogels-based biomedical research is still missing and is thus our focus for this review. Consolidating a diverse range of studies, the Italian scientific community presents a complete landscape for hydrogel use, shaping the future directions of biomaterials research. This review aspires to serve as a guide and map for Italian researchers interested in the development and use of hydrogels in biomedicine.

Tailoring cell sheets for biomedical applications

Cell sheet technology has emerged as a novel scaffold-free approach for cell-based therapies in regenerative medicine. Techniques for harvesting cell sheets are essential to preserve the integrity of living cell sheets. This review provides an overview of fundamental technologies to fabricate cell sheets and recent advances in cell sheet-based tissue engineering. In addition to the commonly used temperature-responsive systems, we introduce alternative approaches, such as ROS-induced, magnetic-controlled, and light-induced cell sheet technologies. Moreover, we discuss the modification of the cell sheet to improve its function, including stacking, genetic modification, and vascularization. With the significant advances in cell sheet technology, cell sheets have been widely applied in various tissues and organs, including but not limited to the lung, cornea, cartilage, periodontium, heart, and liver. This review further describes both the preclinical and clinical applications of cell sheets. We believe that the progress in cell sheet technology would further propel its biomedical applications.

Vancomycin-loaded methylcellulose aerogel scaffolds for advanced bone tissue engineering

Scaffolds grafting combined with local delivery of antibiotics at the injury site may promote bone regeneration along with prevention of infections. In this work, a processing strategy combining the 3D-printing of polysaccharide-based inks with supercritical (sc)CO2 technology was employed to manufacture drug-loaded, nanostructured, and personalized-to-patient aerogels for the first time. Methylcellulose (MC) was employed as graft matrix endowed with nanohydroxyapatite (nHA) to confer bioactivity as required in bone tissue engineering (BTE). MC-nHA aerogels were obtained through the 3D-printing of hydrogel-based scaffolds followed by scCO2 drying. Aerogels were loaded with vancomycin (VAN), an antibiotic employed in the management of bone infections. Textural properties and printing fidelity of scaffolds were studied as well as VAN release, long-term bioactivity, and pre-osteoblasts mineralization. In vitro cell studies and in vivo Artemia salina tests were carried out to evaluate the potential toxicity of the antibiotic-loaded aerogels. Aerogels efficacy in inhibiting bacterial growth was assessed by antimicrobial tests with Staphylococcus aureus. Textural stability of the aerogels after 7 months of storage was also evaluated. Obtained results showed that the scaffolds promoted the intended two-in-one effect (bone repair and infection management simultaneously) in a personalized way, regulating formulation design, drug dose, and porosity.

Crosslinking strategies in modulating methylcellulose hydrogel properties

Methylcellulose (MC) hydrogels are ideal materials for the design of thermo-responsive platforms capable of exploiting the environment temperature as a driving force to activate their smart transition. However, MC hydrogels usually show reduced stability in an aqueous environment and low mechanical properties, limiting their applications' breadth. A possible approach intended to overcome these limitations is chemical crosslinking, which represents a simple yet effective strategy to modify the MC hydrogels' properties (e.g., physicochemical, mechanical, and biological). In this regard, understanding the selected crosslinking method's role in modulating the MC hydrogels' properties is a key factor in their design. This review offers a perspective on the main MC chemical crosslinking approaches reported in the literature. Three main categories can be distinguished: (i) small molecule crosslinkers, (ii) crosslinking by high-energy radiation, and (iii) crosslinking via MC chemical modification. The advantages and limitations of each approach are elucidated, and special consideration is paid to the thermo-responsive properties after crosslinking towards the development of MC hydrogels with enhanced physical stability and mechanical performance, preserving the thermo-responsive behavior.

3D printed pH-responsive tablets containing N-acetylglucosamine-loaded methylcellulose hydrogel for colon drug delivery applications

The pH-responsive drug release approach in combination with three-dimensional (3D) printing for colon-specific oral drug administration can address the limitations of current treatments such as orally administered solid tablets. Such existing treatments fail to effectively deliver the right drug dosage to the colon. In order to achieve targeted drug release profiles, this work aimed at designing and producing 3D printed tablet shells using Eudragit® FS100 and polylactic acid (PLA) where the core was filled with 100 µl of N-acetylglucosamine (GlcNAc)-loaded methyl cellulose (MC) hydrogel. To meet the requirements of such tablets, the effects of polymer blending ratios and MC concentrations on physical, thermal, and material properties of various components of the tablets and most importantly in vitro drug release kinetics were investigated. The tablets with 80/20 wt% of Eudragit® FS100/PLA and the drug-loaded hydrogel with 30 mg/ml GlcNAc and 3% w/v MC showed the most promising results having the best printability, processability, and drug release kinetics besides being non-cytotoxic. Manufacturing of these tablets will be the first milestone in shifting from the conventional "one size fits all" approach to personalized medicine where different dosages and various combinations of drugs can be effectively delivered to the inflammation site.

Repurposing of waste PET by microbial biotransformation to functionalized materials for additive manufacturing

Plastic waste is an outstanding environmental thread. Poly(ethylene terephthalate) (PET) is one of the most abundantly produced single-use plastics worldwide, but its recycling rates are low. In parallel, additive manufacturing is a rapidly evolving technology with wide-ranging applications. Thus, there is a need for a broad spectrum of polymers to meet the demands of this growing industry and address post-use waste materials. This perspective article highlights the potential of designing microbial cell factories to upcycle PET into functionalized chemical building blocks for additive manufacturing. We present the leveraging of PET hydrolyzing enzymes and rewiring the bacterial C2 and aromatic catabolic pathways to obtain high-value chemicals and polymers. Since PET mechanical recycling back to original materials is cost-prohibitive, the biochemical technology is a viable alternative to upcycle PET into novel 3D printing materials, such as replacements for acrylonitrile butadiene styrene. The presented hybrid chemo-bio approaches potentially enable the manufacturing of environmentally friendly degradable or higher-value high-performance polymers and composites and their reuse for a circular economy.

ONE-SENTENCE SUMMARY

Biotransformation of waste PET to high-value platform chemicals for additive manufacturing.

A review on the recent progress, opportunities, and challenges of 4D printing and bioprinting in regenerative medicine

Four-dimensional (4 D) printing is a novel emerging technology, which can be defined as the ability of 3 D printed materials to change their form and functions. The term 'time' is added to 3 D printing as the fourth dimension, in which materials can respond to a stimulus after finishing the manufacturing process. 4 D printing provides more versatility in terms of size, shape, and structure after printing the construct. Complex material programmability, multi-material printing, and precise structure design are the essential requirements of 4 D printing systems. The utilization of stimuli-responsive polymers has increasingly taken the place of cell traction force-dependent methods and manual folding, offering a more advanced technique to affect a construct's adjusted shape transformation. The present review highlights the concept of 4 D printing and the responsive bioinks used in 4 D printing, such as water-responsive, pH-responsive, thermo-responsive, and light-responsive materials used in tissue regeneration. Cell traction force methods are described as well. Finally, this paper aims to introduce the limitations and future trends of 4 D printing in biomedical applications based on selected key references from the last decade.

Smart Methylcellulose Hydrogels for pH-Triggered Delivery of Silver Nanoparticles

Infection is a severe complication in chronic wounds, often leading to morbidity or mortality. Current treatments rely on dressings, which frequently contain silver as a broad-spectrum antibacterial agent, although improper dosing can result in severe side effects. This work proposes a novel methylcellulose (MC)-based hydrogel designed for the topical release of silver nanoparticles (AgNPs) via an intelligent mechanism activated by the pH variations in infected wounds. A preliminary optimization of the physicochemical and rheological properties of MC hydrogels allowed defining the optimal processing conditions in terms of crosslinker (citric acid) concentration, crosslinking time, and temperature. MC/AgNPs nanocomposite hydrogels were obtained via an in situ synthesis process, exploiting MC both as a capping and reducing agent. AgNPs with a 12.2 ± 2.8 nm diameter were obtained. MC hydrogels showed a dependence of the swelling and degradation behavior on both pH and temperature and a noteworthy pH-triggered release of AgNPs (release ~10 times higher at pH 12 than pH 4). 1H-NMR analysis revealed the role of alkaline hydrolysis of the ester bonds (i.e., crosslinks) in governing the pH-responsive behavior. Overall, MC/AgNPs hydrogels represent an innovative platform for the pH-triggered release of AgNPs in an alkaline milieu.

3D Printing Methyl Cellulose Hydrogel Wound Dressings with Parameter Exploration Via Computational Fluid Dynamics Simulation

PURPOSE

To investigate and optimize the use of methyl cellulose in the fabrication of three-dimensional (3D) printed drug-loaded hydrogel wound dressings for the treatment of burns.

METHOD

The effects of incorporating various salts on the properties of methyl cellulose, especially the gelation temperature was investigated for methyl cellulose to undergo gelation at skin temperature (i.e., 31.7°C). The optimized methyl cellulose and salt compositions were then loaded with various drugs beneficial for the treatment of burns. Printability and cumulative release profiles for selected drugs were then obtained, which were then fitted to common release kinetic models. Computational Fluid Dynamics (CFD) simulation was also explored to investigate the relationship between printing parameters and the hydrogel filament produced during extrusion.

RESULTS

The printed hydrogels had moderate dimensional integrity, were found to be stable for up to 2 weeks and demonstrated good swelling properties. In vitro drug release studies of various drugs showed that the hydrogel was able to release various drugs within 6 h and release profiles were fitted to common in vitro drug release models, such as the Korsmeyer Peppas model and the Weibull model. While there were deviations from the actual printing process, CFD simulation was able to predict the shape of the printed structure and showed fair accuracy in determining the mass flow rate and line width of extruded hydrogels.

CONCLUSIONS

Methyl cellulose hydrogels with optimized salt composition demonstrated suitable properties for a wound dressing application, revealing its potential to be used for in situ wound dressing applications.

Click Chemistry Hydrogels for Extrusion Bioprinting: Progress, Challenges, and Opportunities

The emergence of 3D bioprinting has allowed a variety of hydrogel-based "bioinks" to be printed in the presence of cells to create precisely defined cell-loaded 3D scaffolds in a single step for advancing tissue engineering and/or regenerative medicine. While existing bioinks based primarily on ionic cross-linking, photo-cross-linking, or thermogelation have significantly advanced the field, they offer technical limitations in terms of the mechanics, degradation rates, and the cell viabilities achievable with the printed scaffolds, particularly in terms of aiming to match the wide range of mechanics and cellular microenvironments. Click chemistry offers an appealing solution to this challenge given that proper selection of the chemistry can enable precise tuning of both the gelation rate and the degradation rate, both key to successful tissue regeneration; simultaneously, the often bio-orthogonal nature of click chemistry is beneficial to maintain high cell viabilities within the scaffolds. However, to date, relatively few examples of 3D-printed click chemistry hydrogels have been reported, mostly due to the technical challenges of controlling mixing during the printing process to generate high-fidelity prints without clogging the printer. This review aims to showcase existing cross-linking modalities, characterize the advantages and disadvantages of different click chemistries reported, highlight current examples of click chemistry hydrogel bioinks, and discuss the design of mixing strategies to enable effective 3D extrusion bioprinting of click hydrogels.

Microwave-Assisted Synthesis of Modified Glycidyl Methacrylate-Ethyl Methacrylate Oligomers, Their Physico-Chemical and Biological Characteristics

In this study, well-known oligomers containing ethyl methacrylate (EMA) and glycidyl methacrylate (GMA) components for the synthesis of the oligomeric network [P(EMA)-co-(GMA)] were used. In order to change the hydrophobic character of the [P(EMA)-co-(GMA)] to a more hydrophilic one, the oligomeric chain was functionalized with ethanolamine, xylitol (Xyl), and L-ornithine. The oligomeric materials were characterized by nuclear magnetic resonance and Fourier transform infrared spectroscopy, scanning electron microscopy, and differential thermogravimetric analysis. In the final stage, thanks to the large amount of -OH groups, it was possible to obtain a three-dimensional hydrogel (HG) network. The HGs were used as a matrix for the immobilization of methylene blue, which was chosen as a model compound of active substances, the release of which from the matrix was examined using spectrophotometric detection. The cytotoxic test was performed using fluid extracts of the HGs and human skin fibroblasts. The cell culture experiment showed that only [P(EMA)-co-(GMA)] and [P(EMA)-co-(GMA)]-Xyl have the potential to be used in biomedical applications. The studies revealed that the obtained HGs were porous and non-cytotoxic, which gives them the opportunity to possess great potential for use as an oligomeric network for drug reservoirs in in vitro application.

Current Advances in the Regeneration of Degenerated Articular Cartilage: A Literature Review on Tissue Engineering and Its Recent Clinical Translation

Functional ability is the basis of healthy aging. Articular cartilage degeneration is amongst the most prevalent degenerative conditions that cause adverse impacts on the quality of life; moreover, it represents a key predisposing factor to osteoarthritis (OA). Both the poor capacity of articular cartilage for self-repair and the unsatisfactory outcomes of available clinical interventions make innovative tissue engineering a promising therapeutic strategy for articular cartilage repair. Significant progress was made in this field; however, a marked heterogeneity in the applied biomaterials, biofabrication, and assessments is nowadays evident by the huge number of research studies published to date. Accordingly, this literature review assimilates the most recent advances in cell-based and cell-free tissue engineering of articular cartilage and also focuses on the assessments performed via various in vitro studies, ex vivo models, preclinical in vivo animal models, and clinical studies in order to provide a broad overview of the latest findings and clinical translation in the context of degenerated articular cartilage and OA.

Chemically Crosslinked Methylcellulose Substrates for Cell Sheet Engineering

Methylcellulose (MC) hydrogels have been successfully proposed in the field of cell sheet engineering (CSE), allowing cell detachment from their surface by lowering the temperature below their transition temperature (Tt). Among the main limitations of pristine MC hydrogels, low physical stability and mechanical performances limit the breadth of their potential applications. In this study, a crosslinking strategy based on citric acid (CA) was used to prepare thermoresponsive MC hydrogels, with different degrees of crosslinking, to exploit their possible use as substrates in CSE. The investigated amounts of CA did not cause any cytotoxic effect while improving the mechanical performance of the hydrogels (+11-fold increase in E, compared to control MC). The possibility to obtain cell sheets (CSs) was then demonstrated using murine fibroblast cell line (L929 cells). Cells adhered on crosslinked MC hydrogels' surface in standard culture conditions and then were harvested at selected time points as single CSs. CS detachment was achieved simply by lowering the external temperature below the Tt of MC. The detached CSs displayed adhesive and proliferative activity when transferred to new plastic culture surfaces, indicating a high potential for regenerative purposes.

Protein-Based 3D Biofabrication of Biomaterials

Protein/peptide-based hydrogel biomaterial inks with the ability to incorporate various cells and mimic the extracellular matrix's function are promising candidates for 3D printing and biomaterials engineering. This is because proteins contain multiple functional groups as reactive sites for enzymatic, chemical modification or physical gelation or cross-linking, which is essential for the filament formation and printing processes in general. The primary mechanism in the protein gelation process is the unfolding of its native structure and its aggregation into a gel network. This network is then stabilized through both noncovalent and covalent cross-link. Diverse proteins and polypeptides can be obtained from humans, animals, or plants or can be synthetically engineered. In this review, we describe the major proteins that have been used for 3D printing, highlight their physicochemical properties in relation to 3D printing and their various tissue engineering application are discussed.

A dual nozzle 3D printing system for super soft composite hydrogels

Due to their inability to sustain their own weight, 3D printing materials as soft as human tissues is challenging. Hereby we describe the development of an extrusion additive manufacturing (AM) machine able to 3D print super soft hydrogels with micro-scale precision. By designing and integrating new subsystems into a conventional extrusion-based 3D printer, we obtained hardware that encompasses a range of new capabilities. In particular, we integrated a heated dual nozzle extrusion system and a cooling platform in the new system. In addition, we altered the electronics and software of the 3D printer to ensure fully automatized procedures are delivered by the 3D printing device, and super-soft tissue mimicking parts are produced. With regards to the electronics, we added new devices to control the temperature of the extrusion system. As for the software, the firmware of the conventional 3D printer was changed and modified to allow for the flow rate control of the ink, thus eliminating overflows in sections of the printing path where the direction/speed changes sharply.

Scaffold-free cell-based tissue engineering therapies: advances, shortfalls and forecast

Cell-based scaffold-free therapies seek to develop in vitro organotypic three-dimensional (3D) tissue-like surrogates, capitalising upon the inherent capacity of cells to create tissues with efficiency and sophistication that is still unparalleled by human-made devices. Although automation systems have been realised and (some) success stories have been witnessed over the years in clinical and commercial arenas, in vitro organogenesis is far from becoming a standard way of care. This limited technology transfer is largely attributed to scalability-associated costs, considering that the development of a borderline 3D implantable device requires very high number of functional cells and prolonged ex vivo culture periods. Herein, we critically discuss advancements and shortfalls of scaffold-free cell-based tissue engineering strategies, along with pioneering concepts that have the potential to transform regenerative and reparative medicine.

Recent Advances on Bioprinted Gelatin Methacrylate-Based Hydrogels for Tissue Repair

Bioprinting of body tissues has gained great attention in recent years due to its unique advantages, including the creation of complex geometries and printing the patient-specific tissues with various drug and cell types. The most momentous part of the bioprinting process is bioink, defined as a mixture of living cells and biomaterials (especially hydrogels). Among different biomaterials, natural polymers are the best choices for hydrogel-based bioinks due to their intrinsic biocompatibility and minimal inflammatory response in body condition. Gelatin methacryloyl (GelMA) hydrogel is one of the high-potential hydrogel-based bioinks due to its easy synthesis with low cost, great biocompatibility, transparent structure that is useful for cell monitoring, photocrosslinkability, and cell viability. Furthermore, the potential of adjusting properties of GelMA due to the synthesis protocol makes it a suitable choice for soft or hard tissues. In this review, different methods for the bioprinting of GelMA-based bioinks, as well as various effective process parameters, are reviewed. Also, several solutions for challenges in the printing of GelMA-based bioinks are discussed, and applications of GelMA-based bioprinted tissues argued as well. Impact statement Bioprinting has been demonstrated as a promising and alternative approach for organ transplantation to develop various types of living tissue. Bioinks, with great biological characteristics similar to the host tissues and rheological/flow features, are the first requirements for the successful bioprinting approach. Gelatin methacryloyl (GelMA) hydrogel is one of the high-potential hydrogel-based bioinks. This review provides a comprehensive look at different methods for the bioprinting of GelMA-based bioinks and applications of GelMA-based bioprinted tissues for tissue repair.

Printability and Shape Fidelity of Bioinks in 3D Bioprinting

Three-dimensional bioprinting uses additive manufacturing techniques for the automated fabrication of hierarchically organized living constructs. The building blocks are often hydrogel-based bioinks, which need to be printed into structures with high shape fidelity to the intended computer-aided design. For optimal cell performance, relatively soft and printable inks are preferred, although these undergo significant deformation during the printing process, which may impair shape fidelity. While the concept of good or poor printability seems rather intuitive, its quantitative definition lacks consensus and depends on multiple rheological and chemical parameters of the ink. This review discusses qualitative and quantitative methodologies to evaluate printability of bioinks for extrusion- and lithography-based bioprinting. The physicochemical parameters influencing shape fidelity are discussed, together with their importance in establishing new models, predictive tools and printing methods that are deemed instrumental for the design of next-generation bioinks, and for reproducible comparison of their structural performance.

Crosslinking Strategies for 3D Bioprinting of Polymeric Hydrogels

Three-dimensional (3D) bioprinting has recently advanced as an important tool to produce viable constructs that can be used for regenerative purposes or as tissue models. To develop biomimetic and sustainable 3D constructs, several important processing aspects need to be considered, among which crosslinking is most important for achieving desirable biomechanical stability of printed structures, which is reflected in subsequent behavior and use of these constructs. In this work, crosslinking methods used in 3D bioprinting studies are reviewed, parameters that affect bioink chemistry are discussed, and the potential toward improving crosslinking outcomes and construct performance is highlighted. Furthermore, current challenges and future prospects are discussed. Due to the direct connection between crosslinking methods and properties of 3D bioprinted structures, this Review can provide a basis for developing necessary modifications to the design and manufacturing process of advanced tissue-like constructs in future.

Hydrogels for Bioprinting: A Systematic Review of Hydrogels Synthesis, Bioprinting Parameters, and Bioprinted Structures Behavior

Nowadays, bioprinting is rapidly evolving and hydrogels are a key component for its success. In this sense, synthesis of hydrogels, as well as bioprinting process, and cross-linking of bioinks represent different challenges for the scientific community. A set of unified criteria and a common framework are missing, so multidisciplinary research teams might not efficiently share the advances and limitations of bioprinting. Although multiple combinations of materials and proportions have been used for several applications, it is still unclear the relationship between good printability of hydrogels and better medical/clinical behavior of bioprinted structures. For this reason, a PRISMA methodology was conducted in this review. Thus, 1,774 papers were retrieved from PUBMED, WOS, and SCOPUS databases. After selection, 118 papers were analyzed to extract information about materials, hydrogel synthesis, bioprinting process, and tests performed on bioprinted structures. The aim of this systematic review is to analyze materials used and their influence on the bioprinting parameters that ultimately generate tridimensional structures. Furthermore, a comparison of mechanical and cellular behavior of those bioprinted structures is presented. Finally, some conclusions and recommendations are exposed to improve reproducibility and facilitate a fair comparison of results.

Stimuli-Responsive Materials for Tissue Engineering and Drug Delivery

Smart or stimuli-responsive materials are an emerging class of materials used for tissue engineering and drug delivery. A variety of stimuli (including temperature, pH, redox-state, light, and magnet fields) are being investigated for their potential to change a material's properties, interactions, structure, and/or dimensions. The specificity of stimuli response, and ability to respond to endogenous cues inherently present in living systems provide possibilities to develop novel tissue engineering and drug delivery strategies (for example materials composed of stimuli responsive polymers that self-assemble or undergo phase transitions or morphology transformations). Herein, smart materials as controlled drug release vehicles for tissue engineering are described, highlighting their potential for the delivery of precise quantities of drugs at specific locations and times promoting the controlled repair or remodeling of tissues.

Evaluation of the subtle trade-off between physical stability and thermo-responsiveness in crosslinked methylcellulose hydrogels

Methylcellulose (MC) hydrogels, undergoing sol-gel reversible transition upon temperature changes, lend themselves to smart system applications. However, their reduced stability in aqueous environment and unsatisfactory mechanical properties limit the breadth of their possible applications. Here, a crosslinking strategy based on citric acid (CA) was developed: exploiting three crosslinking parameters (CA concentration, crosslinking time, and crosslinking temperature) by a design of experiment approach, optimized crosslinked MC hydrogels (MC-L, MC-M, MC-H) were obtained and characterized. Swelling tests in water revealed the effectiveness of CA crosslinking in modulating the water uptake of MC hydrogels. Both theoretical and experimental analyses showed an increase in the crosslinking density by the rationale selection of process parameters. The extent of sol-gel transition was assessed by swelling tests, Raman spectroscopy and rheological analyses. MC-M samples demonstrated to preserve their thermo-responsive behavior around their lower critical solution temperature (LCST), while showing increased stability and enhanced mechanical properties when compared to pristine MC hydrogels.

Laser-induced Forward Transfer Hydrogel Printing: A Defined Route for Highly Controlled Process

Laser-induced forward transfer is a versatile, non-contact, and nozzle-free printing technique which has demonstrated high potential for different printing applications with high resolution. In this article, three most widely used hydrogels in bioprinting (2% hyaluronic acid sodium salt, 1% methylcellulose, and 1% sodium alginate) were used to study laser printing processes. For this purpose, the authors applied a laser system based on a pulsed infrared laser (1064 nm wavelength, 8 ns pulse duration, 1 – 5 J/cm² laser fluence, and 30 μm laser spot size). A high-speed shooting showed that the increase in fluence caused a sequential change in the transfer regimes: No transfer regime, optimal jetting regime with a single droplet transfer, high speed regime, turbulent regime, and plume regime. It was demonstrated that in the optimal jetting regime, which led to printing with single droplets, the size and volume of droplets transferred to the acceptor slide increased almost linearly with the increase of laser fluence. It was also shown that the maintenance of a stable temperature (±2°C) allowed for neglecting the temperature-induced viscosity change of hydrogels. It was determined that under room conditions (20°C, humidity 50%), the hydrogel layer, due to drying processes, decreased with a speed of about 8 μm/min, which could lead to a temporal variation of the transfer process parameters. The authors developed a practical algorithm that allowed quick configuration of the laser printing process on an applied experimental setup. The configuration is provided by the change of the easily tunable parameters: Laser pulse energy, laser spot size, the distance between the donor ribbon and acceptor plate, as well as the thickness of the hydrogel layer on the donor ribbon slide.

Dual-crosslinked methylcellulose hydrogels for 3D bioprinting applications

Thermo-sensitive methylcellulose (MC) hydrogel has been widely used as a scaffold material for biomedical applications. However, due to its poor mechanical properties, the MC-based hydrogel has rarely been employed in 3D bioprinting for tissue engineering scaffolds. In this study, the dual crosslinkable tyramine-modified MC (MC-Tyr) conjugate was prepared via a two-step synthesis, and its hydrogel showed excellent mechanical properties and printability for 3D bioprinting applications. The MC-Tyr conjugate formed a dual-crosslinked hydrogel by modulating the temperature and/or visible light. A combination of reversible physical crosslinking (thermal crosslinking) and irreversible chemical crosslinking (photocrosslinking) was used in this dual crosslinked hydrogel. Also, the photocrosslinking of MC-Tyr solution was facilitated by visible light exposure in the presence of biocompatible photoinitiators (riboflavin, RF and riboflavin 5'-monophophate, RFp). The RF and RFp were used to compare the cytotoxicity and salting-out effect of MC-Tyr hydrogel, as well as the initiation ability, based on the difference in chemical structure. Also, the influence of the printing parameters on the printed MC hydrogel was investigated. Finally, the cell-laden MC-Tyr bioink was successfully extruded into stable 3D hydrogel constructs with high resolution via a dual crosslinking strategy. Furthermore, the MC-Tyr scaffolds showed excellent cell viability and proliferation.

Hydrogels as Potential Nano-, Micro- and Macro-Scale Systems for Controlled Drug Delivery

This review is an extensive evaluation and essential analysis of the design and formation of hydrogels (HGs) for drug delivery. We review the fundamental principles of HGs (their chemical structures, physicochemical properties, synthesis routes, different types, etc.) that influence their biological properties and medical and pharmaceutical applications. Strategies for fabricating HGs with different diameters (macro, micro, and nano) are also presented. The size of biocompatible HG materials determines their potential uses in medicine as drug carriers. Additionally, novel drug delivery methods for enhancing treatment are discussed. A critical review is performed based on the latest literature reports.

Methylcellulose – a versatile printing material that enables biofabrication of tissue equivalents with high shape fidelity

This minireview highlights the use of the polysaccharide methylcellulose for biofabrication applications. Its properties are useful for printing of dissolvable support structures as well as the development of novel bioinks.

FOUR-DIMENSIONAL BIOPRINTING FOR REGENERATIVE MEDICINE: MECHANISMS TO INDUCE SHAPE VARIATION AND POTENTIAL APPLICATIONS

Regenerative medicine is an exciting field of research, in which significant steps are being taken that are leading to the translation of the technique into clinical practice. In the near future, it is expected that clinicians will have the opportunity to bioprint tissues and organs that closely mimic native human tissues. To do so, imaging of patients must be translated to digital models and then fabricated in a layer-by-layer fashion. The main aim of this review is to elaborate on the possible mechanisms that support four-dimensional bioprinting, as well as provide examples of current and future applications of the technology. This technology, considering time as the fourth dimension, emerged with the aim to develop bioactive functional constructs with programmed stimuli responses. The main idea is to have three-dimensional-printed constructs that are responsive to preplanned stimuli. With this review, the authors aim to provoke creative thinking, highlighting several issues that need to be addressed when reproducing such a complex network as the human body. The authors envision that there are some key features that need to be studied in the near future: printed constructs should be able to respond to different types of stimuli in a timely manner, bioreactors must be developed combining different types of automated stimuli and aiming to replicate the in vivo ecology, and adequate testing procedures must be developed to obtain a proper assessment of the constructs. The effective development of a printed construct that supports tissue maturation according to the anticipated stimuli will significantly advance this promising approach to regenerative medicine.

A Methylcellulose Hydrogel as Support for 3D Plotting of Complex Shaped Calcium Phosphate Scaffolds

3D plotting is an additive manufacturing technology enabling biofabrication, thus the integration of cells or biologically sensitive proteins or growth factors into the manufacturing process. However, most (bio-)inks developed for 3D plotting were not shown to be processed into clinically relevant geometries comprising critical overhangs and cavities, which would collapse without a sufficient support material. Herein, we have developed a support hydrogel ink based on methylcellulose (mc), which is able to act as support as long as the co-plotted main structure is not stable. Therefore, 6 w/v %, 8 w/v % and 10 w/v % mc were allowed to swell in water, resulting in viscous inks, which were characterized for their rheological and extrusion properties. The successful usage of 10 w/v % mc as support ink was proven by multichannel plotting of the support together with a plottable calcium phosphate cement (CPC) acting as main structure. CPC scaffolds displaying critical overhangs or a large central cavity could be plotted accurately with the newly developed mc support ink. The dissolution properties of mc allowed complete removal of the gel without residuals, once CPC setting was finished. Finally, we fabricated a scaphoid bone model by computed tomography data acquisition and co-extrusion of CPC and the mc support hydrogel.

3D bioprinting of functional tissue models for personalized drug screening and in vitro disease modeling

3D bioprinting is emerging as a promising technology for fabricating complex tissue constructs with tailored biological components and mechanical properties. Recent advances have enabled scientists to precisely position materials and cells to build functional tissue models for in vitro drug screening and disease modeling. This review presents state-of-the-art 3D bioprinting techniques and discusses the choice of cell source and biomaterials for building functional tissue models that can be used for personalized drug screening and disease modeling. In particular, we focus on 3D-bioprinted liver models, cardiac tissues, vascularized constructs, and cancer models for their promising applications in medical research, drug discovery, toxicology, and other pre-clinical studies.