Three-Dimensional Bioprinting of Cartilage by the Use of Stem Cells: A Strategy to Improve Regeneration

Abstract

Cartilage lesions fail to heal spontaneously, leading to the development of chronic conditions which worsen the life quality of patients. Three-dimensional scaffold-based bioprinting holds the potential of tissue regeneration through the creation of organized, living constructs via a “layer-by-layer” deposition of small units of biomaterials and cells. This technique displays important advantages to mimic natural cartilage over traditional methods by allowing a fine control of cell distribution, and the modulation of mechanical and chemical properties. This opens up a number of new perspectives including personalized medicine through the development of complex structures (the osteochondral compartment), different types of cartilage (hyaline, fibrous), and constructs according to a specific patient’s needs. However, the choice of the ideal combination of biomaterials and cells for cartilage bioprinting is still a challenge. Stem cells may improve material mimicry ability thanks to their unique properties: the immune-privileged status and the paracrine activity. Here, we review the recent advances in cartilage three-dimensional, scaffold-based bioprinting using stem cells and identify future developments for clinical translation. Database search terms used to write this review were: “articular cartilage”, “menisci”, “3D bioprinting”, “bioinks”, “stem cells”, and “cartilage tissue engineering”.

Scaffolding Strategies for Tissue Engineering and Regenerative Medicine Applications

“…Compared with non-biological 3D printing, technical challenges related to the sensitivity of living cells to the shear stress during the bioprinting process can be found [151], which requires the integration of knowledge in the fields of engineering, biomaterials science, cell biology, and physics. Bioprinting techniques have already been proposed for the fabrication of 3D hydrogel-based structures, envisioning several tissue transplantations or substitutions, including skin [152], bone [153], vascular grafts [154], intervertebral disc (IVD) [102], meniscus, and cartilage [155]. More recently, the development of high-throughput in vitro platforms of healthy and diseased tissues of the human body came to address the TE field to a different level of precision medicine [156], and the 3D bioprinted hydrogels emerged as highly precise biomimetic matrices [157].…”

iPSC Bioprinting: Where are We at?

“…Articular cartilage damage has a limited healing potential, forming fibrous scar tissue with compromised mechanical and biochemical properties. Bioprinting has emerged as a promising technology to address this, by the creation of organized and living constructs layer-by-layer to mimic natural cartilage or the osteochondral interface [62]. Current treatment strategy includes autologous chondrocytes implantation (ACI), which requires two invasive surgical procedures, and healing depends on autologous chondrocytes quality and quantity [63].…”

Adipose-derived mesenchymal stem/stromal cells: from the lab bench to the basic concepts for clinical translation

“…The deposition of the bioink, in turns, has to be controlled, cytocompatible, bioresorbable and satisfy the ECM features. Most suitable scaffolds for cartilage regeneration are composed of hydrogel, since gel consistency allows the mixing of the cells with growth factors and provide the lubrication characteristic, contributing to the cells commitment towards the chondrogenic phenotype (Roseti et al, 2018).…”