Latest Advances in 3D Bioprinting of Cardiac Tissues

Abstract

Cardiovascular diseases (CVDs) are known as the major cause of death worldwide. In spite of tremendous advancements in medical therapy, the gold standard for CVD treatment is still transplantation. Tissue engineering, on the other hand, has emerged as a pioneering field of study with promising results in tissue regeneration using cells, biological cues, and scaffolds. 3D bioprinting is a rapidly growing technique in tissue engineering because of its ability to create complex scaffold structures, encapsulate cells, and perform these tasks with precision. More recently, 3D bioprinting has made its debut in cardiac tissue engineering, and scientists are investigating this technique for development of new strategies for cardiac tissue regeneration. In this review, the fundamentals of cardiac tissue biology, available 3D bioprinting techniques and bioinks, and cells implemented for cardiac regeneration are briefly summarized and presented. Afterward, the pioneering and state‐of‐the‐art works that have utilized 3D bioprinting for cardiac tissue engineering are thoroughly reviewed. Finally, regulatory pathways and their contemporary limitations and challenges for clinical translation are discussed.

3D Printing Approaches to Engineer Cardiac Tissue

“…Alginate's ability to support cell encapsulation and cell growth throughout the bioprinting process is an additional benefit when employing it as a cell-laden material for 3D bioprinting [38]. Additionally, other natural polymers like collagen, silk, chitosan, and hyaluronic acid are also extensively applied [21,[39][40][41].…”

“…Additionally, various biomaterials have been utilized as bioinks for 3D bioprinting cardiac constructs, including alginate, gelatin, collagen, and decellularized extracellular matrix (ECM). These biomaterials are used in conjunction with various bioprinting methods such as extrusion, inkjet, laser-assisted, and light-based techniques [21,22]. Depending on the type of engineered cardiac tissues (e.g., myocardium, vascularization) being created, specific combinations of biomaterials and bioprinters are selected [23][24][25][26].…”

Bioprinting of Cardiac Tissue in Space: Where Are We?

“…[28] The aforementioned techniques were recently reviewed in the context of cardiac tissue bioprinting. [29] Nevertheless, we have summarized the important aspects of each technique and indicated the advantages and disadvantages that microgravity would have if used in space (Table 1).…”

“…Specifically, the viscoelastic properties of the bioink, the inclusion of cellbinding motifs, and post-printing modifications of the bioink, that promote cell alignment, nutrient transport, and electromechanical synchronization all significantly contribute to tissue formation, maturation, and functionalization. [29] The viscoelastic properties of bioinks are critical for achieving shape fidelity and printability of the printed construct. Higher the stiffness of the bioink, higher is the force that is required for dispensing it, which results in increased shear stress (in case of nozzle-based bioprinting systems).…”

Electric‐Field‐Driven Printed 3D Highly Ordered Microstructure with Cell Feature Size Promotes the Maturation of Engineered Cardiac Tissues

“…These solutions offer an improved quality of life for patients with cardiovascular diseases. [2][3][4][5] Humaninduced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are great options for building engineered cardiac tissues (ECTs). This allows us to replace dysfunctional cardiomyocytes and build cardiovascular disease models for drug screening and also cardiotoxicity testing.…”