You have probably heard of the promise of bioprinting for controllably creating tissues and organs thanks to a layer-by-layer deposition of biomaterial-based inks (bioinks). So far, it is fulfilling those expectations as it is now one of the most rapidly growing sectors thanks to the regenerative capacity of most of the constructs it is able to create, with a market that is expected to reach sales of $1.4 billion in 2024, rising at a CAGR of 35.4% during 2019-2024, according to BCC Research. Contributing to the markets’ excitement about bioprinting technologies and the pronounced growth rate are the multi-million partnership agreements and formidable product portfolios being built by several companies around the globe. Perhaps the biggest example for this enthusiasm occurred when Cellink, one of the first bioprinting companies, went public in 2017 on the Nasdaq Stockholm, shares were oversubscribed by 1070%, which contributed to the founder Erik Gatenholm being included on the Forbes’ “30 under 30” list in 2018.
What you may not be aware of is that there are medical devices currently being developed that would bioprint human tissue INSIDE the patient’s own body. It is called in-situ bioprinting, and it is the next big thing in medtech. The in-situ approach seeks to address current limitations that have prevented bioprinted implants to reach the clinic. Among the most notable are the need for a bioreactor for the maturation of artificially-created tissues and organs, which can be cost and time-consuming as well as incompatible with all type of incorporated cells. Moreover, the shape of the constructs may differ from the actual defect size owing to the resolution limit of computed tomography (CT) and magnetic resonance imaging (MRI) scans. The handling of soft-tissues and the retention of their structure and function once manufactured can be challenging as well.
Despite the fact that no in situ bioprinter has been commercialized for bioprinting in clinical settings, several groups have already bioprinted skin, bone and cartilage in vivo. For that purpose, two approaches have been used: robotic arms and handheld medical devices. Both strategies assist the surgeon in performing a surgery much easier with repeatability and accuracy. Handheld bioprinters are although preferred due to some crucial advantages over robotic instruments, including their smaller dimensions, major freedom to deposit bioinks in spaces of difficult access, greater ease of movement within facilities and, most importantly, their superior affordability. It is believed that the future incorporation of inspector sensors, machine vision and feedback control systems and the combination of such instruments with tissue-specific bioinks would provide real-time quality control of printed scaffolds, minimizing the error during surgery and allowing rapid corrections for quality assurance.
Cells for Cells is one company that designed and tested a new handheld tool for in situ arthroscopic 3D bioprinting. Recently, the Chilean company announced the continuation of their partnership agreement with Medxcell (Switzerland) to co-develop ArthroPaint. “ArthroPaint can completely fill osteochondral defects thanks to its patent-pending technology that can reproduce topography of the patients’ own articular cartilage surface profile and generate a personalized and faithful reconstruction of the lesion” tells Dr. Juan Pablo Acevedo, the lead PI of the project at Cells for Cells and Assistant Professor at Universidad de los Andes. The biotech firm is currently using its Inkure®Cartilage bioink to regenerate hyaline cartilage with the handhelpd bioprinting tool to ensure reproducibility of results, although Acevedo mentions other bioinks could be used as well. The ArthroPaint follows the current trend of minimally-invasive surgery that derives in more successful long term post-operative outcomes, a feature that was recognized when the project obtained non-diluting funds from Chile Ministry of Economy’s renowned agency CORFO. Thus, in a few years, this technology that harnesses the advantages of 3D bioprinting and minimally invasive robotic systems would become one of the first biofabrication tools that reconstructs tissue directly at the site of repair (in-situ) accessing a cartilage repair/regeneration market valued at USD 414.6 million in 2016 by MarketsandMarkets.
Written by Maximiliano Kunze
Cold-adaptation of a methacrylamide gelatin towards the expansion of the biomaterial toolbox for specialized functionalities in tissue engineering,Materials Science and Engineering: C, Volume 102, September 2019, Pages 373-390