The 3D-McMap Guidelines: Three-Dimensional Multicomposite Microsphere Adaptive Printing.

Microspheres, synthesized from diverse natural or synthetic polymers, are readily utilized in biomedical tissue engineering to improve the healing of various tissues. Their ability to encapsulate growth factors, therapeutics, and natural biomolecules, which can aid tissue regeneration, makes microspheres invaluable for future clinical therapies. While microsphere-supplemented scaffolds have been investigated, a pure microsphere scaffold with an optimized architecture has been challenging to create via 3D printing methods due to issues that prevent consistent deposition of microsphere-based materials and their ability to maintain the shape of the 3D-printed structure. Utilizing the extrusion printing process, we established a methodology that not only allows the creation of large microsphere scaffolds but also multicomposite matrices into which cells, growth factors, and therapeutics encapsulated in microspheres can be directly deposited during the printing process. Our 3D-McMap method provides some critical guidelines for issues with scaffold shape fidelity during and after printing. Carefully timed breaks, minuscule drying steps, and adjustments to extrusion parameters generated an evenly layered large microsphere scaffold that retained its internal architecture. Such scaffolds are superior to other microsphere-containing scaffolds, as they can release biomolecules in a highly controlled spatiotemporal manner. This capability permits us to study cell responses to the delivered signals to develop scaffolds that precisely modulate new tissue formation.

Enhancement of properties of a cell-laden GelMA hydrogel-based bioink via calcium phosphate phase transition.

To improve the properties of the hydrogel-based bioinks, a calcium phosphate phase transition was applied, and the products were examined. We successfully enhanced the mechanical properties of the hydrogels by adding small amounts (< 0.5 wt%) of alpha-tricalcium phosphate (α-TCP) to photo-crosslinkable gelatin methacrylate (GelMA). As a result of the hydrolyzing calcium phosphate phase transition involvingα-TCP, which proceeded for 36 h in the cell culture medium, calcium-deficient hydroxyapatite was produced. Approximately 18 times the compressive modulus was achieved for GelMA with 0.5 wt%α-TCP (20.96 kPa) compared with pure GelMA (1.18 kPa). Although cell proliferation decreased during the early stages of cultivation, both osteogenic differentiation and mineralization activities increased dramatically when the calcium phosphate phase transition was performed with 0.25 wt%α-TCP. The addition ofα-TCP improved the printability and fidelity of GelMA, as well as the structural stability and compressive modulus (approximately six times higher) after three weeks of culturing. Therefore, we anticipate that the application of calcium phosphate phase transition to hydrogels may have the potential for hard tissue regeneration.

Support-less ceramic 3D printing of bioceramic structures using a hydrogel bath.

Volumetric bone tissue defects are beyond the intrinsic regenerative capacity of bone tissue. With the recent development of ceramic 3D printing, various bioceramic scaffolds that can induce bone regeneration are being actively developed. However, hierarchical bone is complex, with overhanging structures that require additional sacrificial support during ceramic 3D printing. Not only can this increase the overall process time and material consumption, but breaks and cracks may occur when sacrificial supports are removed from fabricated ceramic structures. In this study, a support-less ceramic printing (SLCP) process using a hydrogel bath was developed to facilitate the manufacture of complex bone substitutes. A hydrogel bath, consisting of pluronic P123 with temperature-sensitive properties, mechanically supported the fabricated structure when the bioceramic ink was extruded into the bath and promoted the cement reaction to cure the bioceramic. SLCP enables the fabrication of complex bone constructs with overhanging structures, such as the mandible and maxillofacial bones, with reduced overall processing time and material consumption. Scaffolds fabricated by SLCP showed more cell adhesion, higher cell growth rate, and osteogenic protein expression due to their rougher surface than conventionally printed scaffolds. Hybrid scaffolds were fabricated by SLCP to co-print cells and bioceramics, and SLCP provided a cell-friendly environment, exhibiting high cell viability. SLCP enables control of the shape of various cells, bioactive substances, and bioceramics and thus can be used as an innovative 3D bioprinting technique to manufacture complex hierarchical bone structures.

Multifunctional bone substitute using carbon dot and 3D printed calcium-deficient hydroxyapatite scaffolds for osteoclast inhibition and fluorescence imaging.

Multifunctional bone substitute materials (BSM) have gained considerable attention with the exponential increase in aging populations. The development of hybrid materials for diagnosis and therapy of bone-related diseases and dysfunctions, especially, has been a significant challenge in the biological and the biomedical field, due to the shortage of agents with specificity and selectivity toward bone. In this study, a hybrid material, referred as Alen-CDs@CDHA, fabricated from alendronate-conjugated carbon dots (Alen-CDs) and calcium-deficient hydroxyapatite (CDHA, the mineral component of bones) scaffolds is offered as a novel multifunctional BSM for in vivo osteoclasts deactivation and fluorescence imaging. The fluorescent Alen-CDs were hydrothermally prepared using phytic acid as carbon source, followed by conjugating alendronate, for controlled alendronate release and fluorescent imaging under acidic conditions. As-prepared fluorescent Alen-CDs were consecutively immobilized on surfaces of CDHA scaffolds, exhibiting high affinity by bisphosphonate group, easily fabricated from α-tricalcium phosphate (α-TCP) paste using three-dimensional (3D) printing system. The resultant Alen-CDs@CDHA caused a significant decrease (> 50%) in viability of osteoclasts at 7 days after in vitro treatment. Furthermore, when Alen-CDs@CDHA was implanted in balb/c nude mice for in vivo evaluation, we found Alen-CDs@CDHA to be suitable for bone imaging through fluorescence signals, without necrosis or inflammatory symptoms in the epidermal tissues. Thus, these observations offer new opportunities for a novel and revolutionary use of Alen-CDs@CDHA as highly specific multifunctional BSM for bone diagnosis and imaging, and as bone-specific drug delivery materials, eventually providing anti-osteoclastogenic treatments solution for degenerative bone disorders. STATEMENT OF SIGNIFICANCE: Alen-CDs@CDHA significantly reduced the viability of osteoclasts and fluorescently imaged in vivo after transplantation, releasing drug via pH modulation. The development of fluorescence materials for bone imaging remains still a major challenge in the biomedical field owing to the shortage of selectivity and specificity. The results could lead to improvements in bone treatment strategies, as it could reduce the invasiveness of procedures and the associated negative outcomes, and increase the precision of strategies. Further, we believe that this study will be of interest to the readership of your journal as clearly focuses on the advancement of a biomaterial, where we have engineered a substance to substitute bone and integrate with a living system.

Selective Detection of an Infection Biomarker by an Osteo-Friend Scaffold: Development of a Multifunctional Artificial Bone Substitute.

Developments in three-dimensional (3D) printing technologies have led to many potential applications in various biomedical fields, especially artificial bone substitutes (ABSs). However, due to the characteristics of artificial materials, biocompatibility and infection remain issues. Here, multifunctional ABSs have been designed to overcome these issues by the inclusion of a biochemical modality that allows simultaneous detection of an infection biomarker by osteo-friend 3D scaffolds. The developed multifunctional scaffolds consist of calcium-deficient hydroxyapatite (CDHA), which has a similar geometric structure and chemical composition to human bone, and gold nanoparticles (Au NPs), which assists osteogenesis and modulates the fluorescence of labels in their microenvironment. The Au NPs were subsequently conjugated with fluorescent dye-labeled probe DNA, which allowed selective interaction with a specific target biomarker, and the fluorescent signal of the dye was temporally quenched by the Au NP-derived Förster resonance energy transfer (FRET). When the probe DNA unfolded to bind to the target biomarker, the fluorescence signal was recovered due to the increased distance between the dye and Au NPs. To demonstrate this sensing mechanism, a microbial oligonucleotide was selected as a target biomarker. Consequently, the multifunctional scaffold simultaneously facilitated osteogenic proliferation and the detection of the infection biomarker.

Multifunctional Calcium-Deficient Hydroxyl Apatite-Alginate Core-Shell-Structured Bone Substitutes as Cell and Drug Delivery Vehicles for Bone Tissue Regeneration.

In this work, we fabricated unique coiled-structured bioceramics contained in hydrogel beads for simultaneous drug and cell delivery using a combination of bone cement chemistry and bioprinting and characterized them. The core of the calcium-deficient hydroxyl apatite (CDHA) contains quercetin, which is a representative phytoestrogen isolated from onions and apples, to control the metabolism of bone tissue regeneration through sustained release over a long period of time. The shell consists of an alginate hydrogel that includes preosteoblast MC3T3-E1 cells. Ceramic paste and hydrogel were simultaneously extruded to fabricate core-shell beads through the inner and outer nozzles, respectively, of a concentric nozzle system based on a material-extruding-based three-dimensional (3D) printing system. The formation of beads and the coiled ceramic core is related to both alginate concentration and printing conditions. The size of the microbeads and the thickness of the coiled structure could be controlled by adjusting the nozzle conditions. The whole process was carried out at physiological conditions (37 °C) to be gentle on the cells. The alginate shell undergoes solidification by cross-linking in CaCl2 or monocalcium phosphate monohydrate (MCPM) solution, while the hardening and cementation of the α-tricalcium phosphate (α-TCP) core to CDHA are subsequently initiated by immersion in phosphate-buffered saline solution. This process replaces the typical sintering of ceramic processing to prevent damage to the hydrogel, cells, and drugs in the beads. The cell-loaded beads were then cultured in cell culture media where the cells could maintain good viability during the entire testing period, which was over 50 days. Cell growth and elongation were observed even in the alginate along the CDHA coiled structure over time. Sustained release of quercetin without any initial burst was also confirmed during a test period of 120 days. These novel structured microbeads with multibiofunctionality can be used as new bone substitutes for hard tissue regeneration in indeterminate defect sites.

Bone-targeting carbon dots: effect of nitrogen-doping on binding affinity.

Novel fluorescent carbon dots (CDs) for bone imaging were fabricated via a facile hydrothermal method using alendronate in the absence of a nitrogen-doping precursor to enhance bone affinity. One-step synthesized alendronate-based CDs (Alen-CDs) had strong binding activity for calcium-deficient hydroxyapatite (CDHA, the mineral component of bones) scaffold, rat femur, and bone structures of live zebrafish. This was attributed to the bisphosphonate group present on the CD surface, even after carbonization. For comparison, the surface effects of nitrogen-doped CDs obtained using ethylenediamine (EDA), i.e., Alen-EDA-CDs, were also investigated, focusing on the targeting ability of distinct surface functional groups when compared with Alen-CDs. An in vivo study to assess the impact on bone affinity revealed that Alen-CDs effectively accumulated in the bone structures of live zebrafish larvae after microinjections, as well as in the bone tissues of femur extracted from rats. Moreover, Alen-CD-treated zebrafish larvae had superior toleration, retaining skeletal fluorescence for 7 days post-injection (dpi). The sustainable capability, surpassing that of Alizarin Red S, suggests that Alen-CDs have the potential for targeted drug delivery to damaged bone tissues and provides motivation for additional in vivo investigations. To our knowledge, this is the first in vitro, ex vivo, and in vivo demonstration of direct bone-targeted deliveries, supporting the use of fluorescent CDs in the treatment of various bone diseases such as osteoporosis, Paget's disease, and metastatic bone cancer.

Fast and sensitive near-infrared fluorescent probes for ALP detection and 3d printed calcium phosphate scaffold imaging in vivo.

Alkaline phosphatase (ALP) is a critical biological marker for osteoblast activity during early osteoblast differentiation, but few biologically compatible methods are available for its detection. Here, we describe the discovery of highly sensitive and rapidly responsive novel near-infrared (NIR) fluorescent probes (NIR-Phos-1, NIR-Phos-2) for the fluorescent detection of ALP. ALP cleaves the phosphate group from the NIR skeleton and substantially alters its photophysical properties, therefore generating a large "turn-on" fluorescent signal resulted from the catalytic hydrolysis on fluorogenic moiety. Our assay quantified ALP activity from 0 to 1.0UmL-1 with a 10-5-10-3UmL-1 limit of detection (LOD), showing a response rate completed within 1.5min. A potentially powerful approach to probe ALP activity in biological systems demonstrated real-time monitoring using both concentration- and time-dependent variations of endogenous ALP in live cells and animals. Based on high binding affinity to bone tissue of phosphate moiety, bone-like scaffold-based ALP detection in vivo was accessed using NIR probe-labeled three-dimensional (3D) calcium deficient hydroxyapatite (CDHA) scaffolds. They were subcutaneously implanted into mice and monitored ALP signal changes using a confocal imaging system. Our results suggest the possibility of early-stage ALP detection during neo-bone formation inside a bone defect, by in vivo fluorescent evaluation using 3D CDHA scaffolds.

A simultaneous 3D printing process for the fabrication of bioceramic and cell-laden hydrogel core/shell scaffolds with potential application in bone tissue regeneration.

A novel process was developed to fabricate core/shell-structured 3D scaffolds, made of calcium-deficient hydroxyapatite (CDHA) and alginate laden with pre-osteoblast MC3T3-E1 cells, through a combination of cement chemistry, dual paste-extruding deposition (PED), and cell printing. The cement reaction of calcium phosphates replaced the typical sintering process of the ceramic scaffold fabrication after the simultaneous printing of the ceramics and cell-laden hydrogel. The alginate crosslinking process was divided into two steps using different concentrations of CaCl2, during and after 3D printing, in order to obtain a stable 3D core/shell structure and high cell viability. The whole process was carried out under conditions (neutral pH and a temperature between room temperature and 37 °C) that were gentle to the cells, so the cells incorporated into the shell remained alive throughout the 3D scaffold for the entire culture period (35 days). The core/shell structured scaffold significantly enhanced the mechanical properties when compared with a hydrogel that uses a typical cell-printing process or with a ceramic scaffold, due to the co-operative effect of each material. The compressive strength of the CDHA/alginate scaffolds in the wet state was 3.2 MPa, whereas the compressive strength of alginate could not be determined in the wet state. The 3D structural morphology of CDHA/alginate scaffolds was well retained, even after a compression test, and showed less deformation because the CDHA ceramic-core was encapsulated within the elastic alginate. The process developed in this study suggests a new cell printing model that has excellent potential for application in the field of bone tissue regeneration.