Roadmap on biomaterials for women’s health

Abstract

The application of engineering tools and techniques to studying women’s health, including biomaterials-based approaches, is a research field experiencing robust growth. Biomaterials are natural or synthetic materials used to repair or replace damaged tissues or organs or replicate an organ’s physiological function. However, in addition to in vivo applications, there has been substantial recent interest in biomaterials for in vitro systems. Such artificial tissues and organs are employed in drug discovery, functional cell biological investigations, and basic research that would be ethically impossible to conduct in living women. This Roadmap is a collection of eleven sections written by leading and up-and-coming experts in this field who review and discuss four aspects of biomaterials for women’s health. These include conditions that disproportionately but not exclusively affect women (e.g., breast cancer), conditions unique to female reproductive organs, in both non-pregnant and pregnant states, and sex differences in non-reproductive tissues (e.g., the cardiovascular system). There is a strong need to develop this exciting field, with the potential to materially influence women’s lives worldwide.

Controlling placental spheroid growth and phenotype using engineered synthetic hydrogel matrices

“…18 Trophoblast cells and placental spheroids are commonly grown in 2D on polystyrene culture systems that do not recapitulate native extracellular matrix (ECM) cues and the native 3D placental environment. 22 To enhance these systems, groups often use ECM like collagen I, 5,9 decellularized placenta, 23 Matrigel™, 24 or fibronectin 25,26 layered on 2D surfaces; however, 2D ECM systems do not provide 3D signaling and mechanical forces, which impact cell morphology and function. 3D cell culture systems, such as Matrigel, [27][28][29] Geltrex™, 30 and gelatin methacrylate, [31][32][33][34] have been employed to create villous-like structures and spheroids using primary isolated trophoblasts; however, these naturally derived hydrogel systems have high variability in their ECM components and limited control over the environmental cues presented, which may lead to poor experimental reproducibility.…”

Inflammatory serum factors from aortic valve stenosis patients modulate sex differences in valvular myofibroblast activation and osteoblast-like differentiation

“…Using hydrogels as precision biomaterials 54,55 enabled our assessment of annexin A2 and cystatin C as drivers of sexspecific myofibroblast activation and osteoblast-like differentiation. Several studies have used hydrogels as mimics of the native aortic valve matrix.…”

The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender

“…It seems appropriate to make a brief mention of materials, because male and female cells may respond differently to the natural and synthetic biomaterials that are used to repair or substitute injured tissues or organs or mimic an organ's functions [61,62]. However, only a minority of biomaterial studies (3.7%) are performed on cells.…”