Three-Dimensional Printing Strategies for Irregularly Shaped Cartilage Tissue Engineering: Current State and Challenges

Wang, Hui; Wang, Zhonghan; Li, He; Liu, Jiaqi; Li, Ronghang; Zhu, Xuejie; Ren, Mingchun; Wang, Mingli; Liu, Yuzhe; Li, Youbin; Jia, Yunlong; Wang, Chenyu; Wang, Jincheng

doi:10.3389/fbioe.2021.777039

Cited by 10 publications

(4 citation statements)

References 165 publications

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“…Consequently, PCL has been widely employed in tracheotomy research, producing substitutes that exhibit remarkable resistance to compressive stresses and assist cartilage regeneration 47 . Despite these advancements, PCL scaffolds face challenges in pre‐clinical studies, triggering an inflammatory reaction that leads to the granulation formation and subsequent lumen stenosis 48 . Explorations into novel materials for 3D printing, such as polyurethane (PU), have demonstrated adequate mechanical support and facilitated cartilage formation 49 .…”

Section: Te Strategymentioning

confidence: 99%

“… 47 Despite these advancements, PCL scaffolds face challenges in pre‐clinical studies, triggering an inflammatory reaction that leads to the granulation formation and subsequent lumen stenosis. 48 Explorations into novel materials for 3D printing, such as polyurethane (PU), have demonstrated adequate mechanical support and facilitated cartilage formation. 49 Continual endeavors in 3D printing of tracheal scaffolds, employing diverse materials and distinctive tubular designs reveal promising initial outcomes, although limited by single‐cell type technologies, deficiency of mechanical characterization, and inadequate revascularization.…”

Section: Te Strategymentioning

confidence: 99%

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Tissue‐engineered tracheal implants: Advancements, challenges, and clinical considerations

Wei,

Zhang,

Luo

et al. 2024

Bioengineering & Transla Med

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Restoration of extensive tracheal damage remains a significant challenge in respiratory medicine, particularly in instances stemming from conditions like infection, congenital anomalies, or stenosis. The trachea, an essential element of the lower respiratory tract, constitutes a fibrocartilaginous tube spanning approximately 10–12 cm in length. It is characterized by 18 ± 2 tracheal cartilages distributed anterolaterally with the dynamic trachealis muscle located posteriorly. While tracheotomy is a common approach for patients with short‐length defects, situations requiring replacement arise when the extent of lesion exceeds 1/2 of the length in adults (or 1/3 in children). Tissue engineering (TE) holds promise in developing biocompatible airway grafts for addressing challenges in tracheal regeneration. Despite the potential, the extensive clinical application of tissue‐engineered tracheal substitutes encounters obstacles, including insufficient revascularization, inadequate re‐epithelialization, suboptimal mechanical properties, and insufficient durability. These limitations have led to limited success in implementing tissue‐engineered tracheal implants in clinical settings. This review provides a comprehensive exploration of historical attempts and lessons learned in the field of tracheal TE, contextualizing the clinical prerequisites and vital criteria for effective tracheal grafts. The manufacturing approaches employed in TE, along with the clinical application of both tissue‐engineered and non‐tissue‐engineered approaches for tracheal reconstruction, are discussed in detail. By offering a holistic view on TE substitutes and their implications for the clinical management of long‐segment tracheal lesions, this review aims to contribute to the understanding and advancement of strategies in this critical area of respiratory medicine.

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Section: Te Strategymentioning

confidence: 99%

Section: Te Strategymentioning

confidence: 99%

Tissue‐engineered tracheal implants: Advancements, challenges, and clinical considerations

Wei,

Zhang,

Luo

et al. 2024

Bioengineering & Transla Med

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“…The use of high molecular weight polymers in 3D printing of irregularly shaped cartilage has also been reported in several studies, including poly (lactic-co-glycolic acid) (PLGA) (Wei et al, 2020), PLA (Rosenzweig et al, 2015), PCL (Xu et al, 2019;Li et al, 2021a), and polyurethane (Kim et al, 2019), to print cartilage scaffolds that are stable due to their optimal mechanical properties. Although natural bio-ink has good biocompatibility, its stability and mechanical properties are less satisfactory, and it is inclined to represent more rapid degradation, while synthetic bio-ink has excellent mechanical properties, but the lack of biological activity remains to be a major drawback (Wang et al, 2021). Zopf et al (2015) developed a 3D-printed PCL scaffold seeded with swine chondrocytes, which was then injected with a hydrogelbased construct involving growth and differentiation factors, which increased chondroinductivity in animal models after transplantation.…”

Section: D Printing Techniquesmentioning

confidence: 99%

The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia

Huang,

Zhao,

Wang

et al. 2023

Front. Bioeng. Biotechnol.

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Microtia is a congenital deformity of the ear with an incidence of about 0.8–4.2 per 10,000 births. Total auricular reconstruction is the preferred treatment of microtia at present, and one of the core technologies is the preparation of cartilage scaffolds. Autologous costal cartilage is recognized as the best material source for constructing scaffold platforms. However, costal cartilage harvest can lead to donor-site injuries such as pneumothorax, postoperative pain, chest wall scar and deformity. Therefore, with the need of alternative to autologous cartilage, in vitro and in vivo studies of biomaterial scaffolds and cartilage tissue engineering have gradually become novel research hot points in auricular reconstruction research. Tissue-engineered cartilage possesses obvious advantages including non-rejection, minimally invasive or non-invasive, the potential of large-scale production to ensure sufficient donors and controllable morphology. Exploration and advancements of tissue-engineered cartilaginous framework are also emerging in aspects including three-dimensional biomaterial scaffolds, acquisition of seed cells and chondrocytes, 3D printing techniques, inducing factors for chondrogenesis and so on, which has greatly promoted the research process of biomaterial substitute. This review discussed the development, current application and research progress of cartilage tissue engineering in auricular reconstruction, particularly the usage and creation of biomaterial scaffolds. The development and selection of various types of seed cells and inducing factors to stimulate chondrogenic differentiation in auricular cartilage were also highlighted. There are still confronted challenges before the clinical application becomes widely available for patients, and its long-term effect remains to be evaluated. We hope to provide guidance for future research directions of biomaterials as an alternative to autologous cartilage in ear reconstruction, and finally benefit the transformation and clinical application of cartilage tissue engineering and biomaterials in microtia treatment.

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“…Such heterogeneity has been applied in osteochondral tissue engineering to mimic gradient microstructure to induce osteochondral regeneration [11]. The external ear has been distinguished by its intricate morphology and varied biomechanical properties across the auricular cartilage [12][13][14][15]. The composition and arrangement of the ECM have been found to vary in different regions of auricular cartilage and evolve with age [16][17][18][19].…”

Section: Ivyspringmentioning

confidence: 99%

Upregulated desmin/integrin β1/MAPK axis promotes elastic cartilage regeneration with increased ECM mechanical strength

Zhang,

Lu,

et al. 2023

Int. J. Biol. Sci.

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Elastic cartilage tissue engineering is promising for providing available scaffolds for plastic reconstructive surgery. The insufficient mechanical strength of regenerative tissue and scarce resources of reparative cells are two obstacles for the preparation of tissue-engineered elastic cartilage scaffolds. Auricular chondrocytes are important reparative cells for elastic cartilage tissue engineering, but resources are scarce. Identifying auricular chondrocytes with enhanced capability of elastic cartilage formation is conducive to reducing the damage to donor sites by decreasing the demand on native tissue isolation. Based on the biochemical and biomechanical differences in native auricular cartilage, we found that auricular chondrocytes with upregulated desmin expressed more integrin β1, forming a stronger interaction with the substrate. Meanwhile, activated MAPK pathway was found in auricular chondrocytes highly expressing desmin. When desmin was knocked down, the chondrogenesis and mechanical sensitivity of chondrocytes were both impaired, and the MAPK pathway was downregulated. Finally, auricular chondrocytes highly expressing desmin regenerated more elastic cartilage with increased ECM mechanical strength. Therefore, desmin/integrin β1/MAPK signaling can not only serve as a selection standard but also a manipulation target of auricular chondrocytes to promote elastic cartilage regeneration.

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Three-Dimensional Printing Strategies for Irregularly Shaped Cartilage Tissue Engineering: Current State and Challenges

Cited by 10 publications

References 165 publications

Tissue‐engineered tracheal implants: Advancements, challenges, and clinical considerations

Tissue‐engineered tracheal implants: Advancements, challenges, and clinical considerations

The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia

Upregulated desmin/integrin β1/MAPK axis promotes elastic cartilage regeneration with increased ECM mechanical strength

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