3D Bioprinting - Definition, Principle, Process, Types, Applications
3D Bioprinting - Definition, Principle, Process, Types, Applications
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Table of Contents
What is 3D Bioprinting?
What are Bioinks?
Basic Principle of 3D Bioprinting
1. Biomimicry
2. Autonomous self-assembly
3. Mini tissues building blocks
Basic Steps of 3D Bioprinting (process)
1. Prebioprinting
2. Bioprinting
3. Postbioprinting
3D Bioprinting Technology (Types)
1. Extrusion based bioprinting
2. Inkjet-based bioprinting
3. Pressure-assisted bioprinting (PAB)
4. Laser-assisted bioprinting (LAB)
5. Stereolithography (STL)
What are Bioprinters?
Bioprinter Components
How do Bioprinter works?
Examples of 3D bioprinters
Applications of 3D Bioprinting
1. Tissue engineering
2. Drug development/screening
3. Toxicology Screening
4. Tissue model for cancer research
Limitations and Future Challenges of 3D Bioprinting
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References
What is 3D Bioprinting?
3D Bioprinting is the method of printing biomedical structures with the use of viable cells,
biological molecules, and biomaterials.
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The term bioink doesn’t only indicate the cells used in manufacturing, but also carrier
molecules that provide support to the growing cells.
Common carrier materials used with cells during bioprinting are biopolymer gels that act as
a 3D molecular scaffold so that cells can attach, grow, and increase.
The biopolymers used in bioink are essential as they retain water which provides
mechanical stability to the engineered tissues.
The selection of bioink for a particular process is an important step as the selected bioinks
should have desired physicochemical properties that include mechanical, chemical,
biological, and rheological characteristics.
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Figure: Distinction between a bioink (left side) and a biomaterial ink (right side). In a bioink,
cells are a mandatory component of the printing formulation in the form of single cells,
coated cells or cell aggregates (of one or several cell types), or also in combination with
materials (for example seeded onto microcarriers, embedded in microgels, formulated in a
physical hydrogel, or formulated with hydrogel precursors). In the case of biomaterial ink, in
principle any biomaterial can be used for printing and cell-seeding occurs post-fabrication.
Image Source: https://doi.org/10.1016/j.actbio.2020.06.040.
The bioinks used in the bioprinting process should have the following properties:
1. The bioinks used should be able to provide adequate mechanical strength and
robustness while maintaining the tissue-matching mechanics in the resulting tissue
constructs.
2. The bioink molecules should have adjustable gelation and stabilization to result in high
shape fidelity during bioprinting.
3. The bioinks should be biocompatible and can undergo biodegradability according to
the natural microenvironment of the tissue.
4. The bioinks should be suitable for chemical modifications to form specific tissues.
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Figure: Schematic illustration of the 3D bioprinting process and optical images of the printing
set up and printing constructs. Image Source: Springer Nature.
1. Biomimicry
Biomimicry is the manufacture of identical reproductions of cellular and extracellular
components of tissues and organs after a detailed examination of nature itself.
In order to achieve biomimicry, specific cellular functional components of tissues are to be
precisely reproduced.
Since the materials used in the process have a significant influence on cell attachment, cell
size, and morphology, the control of proliferation and differentiation of cells is present in
the scaffold.
A detailed understanding of the microenvironment, including the arrangement of cell types,
composition of the extracellular matrix, a gradient of soluble and insoluble factors, and the
nature of biological forces is required.
2. Autonomous self-assembly
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Basic Steps of 3D Bioprinting (process)
The overall process of 3D bioprinting can be achieved via three distinct steps; pre-bioprinting,
bioprinting, and post-bioprinting.
1. Prebioprinting
The first step of prebioprinting is the formation of a model that is used by the printer and
the choosing of materials to be used during the process.
It begins with the extraction of biopsy of a tissue which provides a biological model that is
to be recreated by the 3D bioprinting method.
Technologies like computed tomography (CT) or magnetic resonance imaging (MRI) scans
are used in this step.
The images obtained through these methods are tomographically reconstructed to obtain
2D images.
Cells necessary for the process are then selected and multiplied. The cell mass thus formed
is mixed with oxygen and other nutrients to keep them viable.
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2. Bioprinting
The second step is the actual printing process where the bioink is placed in the printer to
form a 3D structure.
The mixture of cells, nutrients, and matrix, together forming bioink, is then placed onto the
printer cartridge, which then deposits the material based on the digital model prepared.
The formation of biological constructs involves the deposition of bioink onto the scaffold in
a layer-by-layer approach to generate a 3D tissue structure.
This step of the bioprinting process is a complex process as it requires the formation of
different cell types based on the type of tissues and organs to be formed.
3. Postbioprinting
Postbioprinting is the last step of the bioprinting process, which is important to provide
stability to the printed structure.
In order to maintain the structure and function of the biological matter, physical and
chemical stimulations are required.
These stimulations provide signals to the cells to reorganize and maintain the growth of
tissues.
In the absence of this step, the mechanical structure of the material might be disrupted,
which then affects the functioning of the material.
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The extrusion-based 3D bioprinting utilizes one of the two mechanisms to produce the
desired result; the semi-solid extrusion (SSE) and the fused deposition modeling (FDM)
based 3D printing.
In the SSE based 3D bioprinting, pressurized air or rotating screw gear is used to extrude a
continuous stream of semi-solid materials through a nozzle which is deposited in a layer-
by-layer fashion to form a 3D structure.
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The FDM 3D bioprinting, however, utilizes high temperature to melt thermoplastic filaments
which are then extruded through a nozzle to deposit in a layer-by-layer fashion to produce
a 3D structure.
The two principal components of all extrusion-based 3D printers include the extrusion
system and the positioning system; thus, both of these systems should be accurate enough
to produce a visually and geometrically accurate structure.
The extrusion-based 3D bioprinting method has been widely used in various biomedical
sectors ranging from the pharmaceutical industry to research sectors.
The technology is commonly used for single tissue applications, and to manufacture
scaffolds that mimic tissue interfaces.
The technology is capable of producing models that mimic soft tissues and bone structures
which provide an opportunity for possible implants.
2. Inkjet-based bioprinting
Inkjet bioprinting or drop-on-demand bioprinting is the most commonly used technology
for both non-biological and biological applications.
This technology was initially only used for 2D ink-based printing but was later modified by
replacing the ink in the cartridge with biological material, and the paper was replaced by an
electronically controlled elevator stage to provide control.
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Inkjet bioprinting is based on the ejection of drops of liquid onto a substrate by thermal or
acoustic forces.
Thermal inkjet bioprinting can be achieved by electrically heating the print head to
generate pressure that causes the release of droplets from the nozzle.
In the case of acoustic inkjet bioprinting, a piezoelectric crystal is used that creates an
acoustic wave inside the print head to break the liquid into droplets.
When a voltage is applied to a piezoelectric substance, a rapid change in shape is induced.
This, in turn, generates pressure required to force droplets out of the nozzle.
Both of these methods have their own advantages and disadvantages; thus, the selection of
inkjet bioprinting technology should be made based on the desired purpose.
Some of the common applications of inkjet bioprinting are the regeneration of functional
skin and cartilage tissues where the high printing speed of this technique enables direct
deposition of cells and biomaterials onto skin and cartilage lesions.
Besides, inkjet bioprinting also allows the deposition of primary or stem cells with uniform
density onto lesions while maintaining cell viability and function.
Layered cartilage constructs have also been developed using a combination of inkjet
bioprinting and electrospinning technology.
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The speed of the printers remains low, and it provides about 40-80% cell viability.
The use of pressure-assisted bioprinting allows room temperature processing and direct
incorporation of homogenous cells onto the substrate.
Pressure-based bioprinting has been used in the printing of cells and organs with
functional activity.
The technique has been used to produce human mesenchymal cells, endothelial cells, and
osteogenic progenitors.
Besides, the method can also be used to obtain multicellular bioprinted constructs with
retention of heterogeneous cell organization in various mammalian bodies.
The mesenchymal cell constructs obtained via pressure-based bioprinting can then be
differentiated into other cells that can retain activity in vivo.
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The principle of laser-assisted bioprinting is the use of the laser to induce forward transfer
of biomaterials onto a solid surface.
The laser present on the printer irradiates the ribbon, which causes the liquid biomaterial to
evaporate and reach the receiving substrate in droplet form.
The receiving substrate consists of biopolymers or a cell culture medium which assists
cellular adhesion and sustained growth of the biomaterial.
Laser-assisted bioprinting has been used to produce a cellularized skin constructs with
relevant cell densities in a layered tissue construct.
Cells of the human dermal fibroblasts, pulmonary artery endothelial cells, and breast cancer
cells can be produced via laser-assisted bioprinting.
5. Stereolithography (STL)
Stereolithography is a freeform, nozzle free technique used to produce the 3D structure of
biological and non-biological materials.
The stereolithography technique has the highest fabrication accuracy, and a large number
of materials can be used in the process.
The technique utilizes light-sensitive hydrogels that are deposited in a layer-by-layer
fashion to form a 3D structure.
The speed of this method is very fast (about 40,000 mm/s) with cell viability of more than
90%.
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This technique has been used in several ways to produce tissues and organs of different
animals, including humans.
Besides, the technique was tested upon on DNA material, but the use of UV light has
chances of affecting the DNA structure. However, a custom light source can be prepared to
use with DNA molecules.
Bioprinters are automated robotic devices that work on the basis of different mechanisms.
3D printers that can only print cell-free scaffolds but cannot dispense living cells are not
considered bioprinters.
The first commercial 3D bioprinter was prepared in Germany at Freiburg University by Prof.
Ralf Mulhaupt’s group.
The evolution of 3D bioprinters is a continuous process that involved the hybridization of
new technological approaches to creating new advanced forms of bioprinters.
There are different types of bioprinters depending on the technique of bioprinting
employed by the machines; inkjet bioprinters, extrusion-based bioprinters, and laser-based
bioprinters.
These bioprinters work on different mechanisms and are generally used for different
purposes depending on the type of biomaterials used.
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Bioprinter Components
The size of the printers is dictated by the functional specifications depending on the
desirable bioprinted tissue or organ construct.
The number of nozzles or openings also depends on the functional specification of the
device.
Other specific components, like laser sources and temperature controls, are different in
different types of bioprinters.
Different types of bioprinters have different components, but these bioprinters share some
common characteristics with five main structural-functional components; robotic
positioning in the X-Y-Z axis, nozzle or disperser or extrusion machine, operational or
controlling system, and receiver substrate.
a. Head mount
The head of the printer is attached to a metal plate that runs along the horizontal axis. The
motor on the x-axis moves the metal plate side to side to deposit the biomaterial in a
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horizontal direction.
b. Elevator
The elevator is the metal track running vertically at the back of the machine. It is driven by
the z-axis motor that moves the head of the printer in an up and down direction.
c. Platform
The platform is a shelf present at the bottom of the machine that provides a space for the
organ to rest during the fabrication process.
The platform can either be a scaffold or a Petri dish. A third motor is also present in the
printer that moves the platform along the y-axis.
d. Reservoirs
The reservoir is present on the print head that holds the biomaterial that is to be deposited
during the printing process.
e. Nozzle
The biomaterial in the reservoir present in the print head is forced out through a small
nozzle or syringe which is present just above the platform.
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It is achieved by the movement of the print head in all directions to generate the required
depth and thickness.
Once a layer reaches the platform, it solidifies either by cooling or via a chemical reaction.
To the solidified layer, a new layer is deposited to form a stable structure.
The organ thus formed is removed from the printer and placed in an incubator to allow the
structures to settle and stabilize.
Examples of 3D bioprinters
3D bioprinters are developed by different companies like Cellink that can create cartilages,
skin, bones, and muscles.
Depending on the mechanism of bioprinting utilized, bioprinters like inkjet printers, laser
printers, etc. are used for different purposes.
Applications of 3D Bioprinting
1. Tissue engineering
Tissue engineering is one of the most prominent applications of 3D bioprinting. It enables
the fabrication of complex tissues and organs that can replace failed or lost tissues.
Production of functional tissues and organs at clinically relevant dimensions is challenging
as the integration of the vascular network of arteries and veins and incorporation of various
cell types to reinvent complex organ biology are not easy to achieve.
Nevertheless, a wide variety of tissues have been successfully bioprinted while maintaining
mechanical integrity and functioning.
Some of the common examples of tissues that have been bioprinted for various purposes:
a. Skin
Keratinocytes are then bioprinted on top of alternating layers of human foreskin fibroblasts
and acellular collagen layers to fabricate constructs with densely packed cells in epidermal
layers.
The tissue constructs prepared are engrafted with the host after about 10 days in the
stratified epidermis.
This results in early signs of differentiation and formation of the stratum corneum as well as
some blood vessels.
The biomaterial used for the process might differ but the most common cells used are
keratinocytes and fibroblasts.
Besides, skin with infections or diseases can be used as biomaterials for bioprinting to
study the pathophysiology of the disease.
Bone and cartilage fabrication is the most mature use of bioprinting as the composition of
such hard tissues is uncomplicated and is mostly composed of inorganic elements.
Even though other techniques like gas foaming, salt leaching, and freeze-drying have been
employed to produce such hard tissues, 3D bioprinting produces the most accurate
structures.
Thermal inkjet bioprinter is used to fabricate polymethacrylate scaffolds from bone-
marrow-derived human mesenchymal stem cells.
The cells are coprinted with nanoparticles of bioactive glass to control the spatial
placement of cells.
In cartilage tissue engineering, a printable bioink is prepared as a combination of nano
fibrillated cellulose and alginate with human chondrocytes as living soft tissue.
c. Blood vessels
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During bioprinting, hydrogen gels including sodium alginates and chitosan are bioprinted
directly in tubular form with encapsulated cells.
The tubular structures thus formed have improved metabolic transportation and cellular
viability.
d. Liver tissue
Bioprinting of liver tissue is comparatively less prevalent as the cells of the liver have strong
regeneration ability.
However, there is a limitation of healthy donors, and the regeneration period for such liver
is long.
The bioink used for this purpose include cells like primary hepatocytes and stem-cell-
derived hepatocytes.
3D printing technology can provide the exact size and shape of the liver, which is suitable
for fo the patient.
Bioprinting produces canaliculi that are linked together by the collagen matrix to form
larger structures.
2. Drug development/screening
Drug discovery requires time-consuming and costly processes that demand substantial
financial investment and workforce.
Thus, the development of a technique to improve the ability to predict the efficacy and
toxicity of newly developed drugs earlier in the drug discovery process helps in reducing
the time and money required.
Bioprinting can fabricate 3D tissue models that resemble that of native tissue and are
capable of high throughput assays.
Most commonly, liver and tumor tissues are the primary focus to create tissue models for
pharmaceuticals.
Besides, depending on the target cells of developed drugs, the tissue models of such cells
can be prepared and tested.
Initially, tissue constructs of epithelial cells are prepared as these cells form the lining
through which the drug diffuses into the bloodstream.
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Based on the studies on such constructs, the path of drugs and their action on the target
cells can be assumed.
Similarly, bioprinting can be used as an alternate way for the development of prescription
drugs.
The drugs can even be customized for each patient by preparing appropriate doses of drug
print by using a set of biochemical inks.
3D printed composite pills containing multiple drugs with unique release rates can be used
instead of taking multiple pills throughout the day.
3. Toxicology Screening
Toxicology screening or testing is the process of identifying potential adverse effects of
chemicals on individuals or to the environment.
Chemicals might include compounds like pharmaceutical ingredients, cosmetic ingredients,
household, and industrial chemicals.
Studies evaluating the toxicity of some chemicals might require a larger number of human
subjects with diverse metabolism, which might seem unethical.
Some studies can be performed on animals, but animal might not predict human responses
to an accurate or reliable manner.
Instead, the use of 3D bioprinting can provide a highly-automated and advanced
technology that can produce constructs that mimic the structure and function of human
tissues.
The use of such constructs facilitates real-time monitoring and high throughput screening
of various chemicals.
Testing of cosmetic ingredients on human-relevant skin tissue models has been performed
for a long time.
These tests study skin absorption, skin irritation, skin corrosion, and skin sensitization on
models mimicking human tissue structures.
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interactions.
However, 3D bioprinting allows the recapitulation of the cancer microenvironment so as to
study cancer pathogenesis and metastasis accurately.
Multiple cell types can be simultaneously bioprinted to form multicellular structures in a
reproducible manner with a spatially mediated microenvironment and controlled cell
density and cell-cell distance.
Bioprinting of HeLa cells can be done in a gelatin-alginate composite hydrogel so as to
study cell aggregation.
These tissues can be used to study the progression of cancer and the changes in tissue
structure and function with the progression.
Besides, tissue models can also be used to study the efficiency of treatment methods
against various carcinogens.
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About Author
Anupama Sapkota
Anupama Sapkota has a B.Sc. in Microbiology from St. Xavier’s College, Kathmandu, Nepal.
She is particularly interested in studies regarding antibiotic resistance with a focus on drug
discovery.
Biology, Biotechnology
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