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      Fully Three-Dimensional Bioprinted Skin Equivalent Constructs with Validated Morphology and Barrier Function

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          Abstract

          Development of high-throughput, reproducible, three-dimensional (3 D) bioprinted skin equivalents (BPSEs) that are morphologically and functionally comparable to native skin tissue is advancing research in skin diseases, and providing a physiologically relevant platform for the development of therapeutics, transplants for regenerative medicine, and testing of skin products like cosmetics. Current protocols for the production of engineered skin grafts are limited in their ability to control 3 D geometry of the structure and contraction leading to variability of skin function between constructs. In this study, we describe a method for the biofabrication of skin equivalents (SEs) that are fully bioprinted using an open-market bioprinter, made with commercially available primary cells and natural hydrogels. The unique hydrogel formulation allows for the production of a human-like SE with minimal lateral tissue contraction in a multiwell plate format, thus making them suitable for high-throughput bioprinting in a single print with fast print and relatively short incubation times. The morphology and barrier function of the fully 3 D BPSEs are validated by immunohistochemistry staining, optical coherence tomography, and permeation assays.

          Impact Statement

          This article describes a method for the biofabrication of skin tissue equivalents in a multiwell plate format. The technique and results overcome shortcomings of previously published engineering methods, and show good architecture and barrier function from well to well; thus it may be used for compound functional testing and for the development of disease tissue models for screening.

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          Most cited references36

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          Design and fabrication of human skin by three-dimensional bioprinting.

          Three-dimensional (3D) bioprinting, a flexible automated on-demand platform for the free-form fabrication of complex living architectures, is a novel approach for the design and engineering of human organs and tissues. Here, we demonstrate the potential of 3D bioprinting for tissue engineering using human skin as a prototypical example. Keratinocytes and fibroblasts were used as constituent cells to represent the epidermis and dermis, and collagen was used to represent the dermal matrix of the skin. Preliminary studies were conducted to optimize printing parameters for maximum cell viability as well as for the optimization of cell densities in the epidermis and dermis to mimic physiologically relevant attributes of human skin. Printed 3D constructs were cultured in submerged media conditions followed by exposure of the epidermal layer to the air-liquid interface to promote maturation and stratification. Histology and immunofluorescence characterization demonstrated that 3D printed skin tissue was morphologically and biologically representative of in vivo human skin tissue. In comparison with traditional methods for skin engineering, 3D bioprinting offers several advantages in terms of shape- and form retention, flexibility, reproducibility, and high culture throughput. It has a broad range of applications in transdermal and topical formulation discovery, dermal toxicity studies, and in designing autologous grafts for wound healing. The proof-of-concept studies presented here can be further extended for enhancing the complexity of the skin model via the incorporation of secondary and adnexal structures or the inclusion of diseased cells to serve as a model for studying the pathophysiology of skin diseases.
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            3D bioprinting of functional human skin: production andin vivoanalysis

            Significant progress has been made over the past 25 years in the development of in vitro-engineered substitutes that mimic human skin, either to be used as grafts for the replacement of lost skin, or for the establishment of in vitro human skin models. In this sense, laboratory-grown skin substitutes containing dermal and epidermal components offer a promising approach to skin engineering. In particular, a human plasma-based bilayered skin generated by our group, has been applied successfully to treat burns as well as traumatic and surgical wounds in a large number of patients in Spain. There are some aspects requiring improvements in the production process of this skin; for example, the relatively long time (three weeks) needed to produce the surface required to cover an extensive burn or a large wound, and the necessity to automatize and standardize a process currently performed manually. 3D bioprinting has emerged as a flexible tool in regenerative medicine and it provides a platform to address these challenges. In the present study, we have used this technique to print a human bilayered skin using bioinks containing human plasma as well as primary human fibroblasts and keratinocytes that were obtained from skin biopsies. We were able to generate 100 cm2, a standard P100 tissue culture plate, of printed skin in less than 35 min (including the 30 min required for fibrin gelation). We have analysed the structure and function of the printed skin using histological and immunohistochemical methods, both in 3D in vitro cultures and after long-term transplantation to immunodeficient mice. In both cases, the generated skin was very similar to human skin and, furthermore, it was indistinguishable from bilayered dermo-epidermal equivalents, handmade in our laboratories. These results demonstrate that 3D bioprinting is a suitable technology to generate bioengineered skin for therapeutical and industrial applications in an automatized manner.
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              3D bioprinting of functional tissue models for personalized drug screening and in vitro disease modeling

              3D bioprinting is emerging as a promising technology for fabricating complex tissue constructs with tailored biological components and mechanical properties. Recent advances have enabled scientists to precisely position materials and cells to build functional tissue models for in vit ro drug screening and disease modeling. This review presents state-of-the-art 3D bioprinting techniques and discusses the choice of cell source and biomaterials for building functional tissue models that can be used for personalized drug screening and disease modeling. In particular, we focus on 3D-bioprinted liver models, cardiac tissues, vascularized constructs, and cancer models for their promising applications in medical research, drug discovery, toxicology, and other pre-clinical studies. Schematic diagram showing the use of 3D bioprinting to build in vitro constructs that can be used for drug testing and disease modeling.
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                Author and article information

                Journal
                Tissue Eng Part C Methods
                Tissue Eng Part C Methods
                tec
                Tissue Engineering. Part C, Methods
                Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                1937-3384
                1937-3392
                01 June 2019
                17 June 2019
                17 June 2019
                : 25
                : 6
                : 334-343
                Affiliations
                [ 1 ]Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland.
                [ 2 ]Department of Electrical and Computer Engineering, Bethlehem, Pennsylvania.
                [ 3 ]National Eye Institute, National Institutes of Health, Rockville, Maryland.
                [ 4 ]Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania.
                Author notes
                [*]Address correspondence to: Paige Derr, PhD, Department of Pre-clinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850 paige.derr@ 123456nih.gov
                Article
                10.1089/ten.tec.2018.0318
                10.1089/ten.tec.2018.0318
                6589501
                31007132
                a8ac614d-8aef-4d93-b2b6-c4fff2ec905f
                © Kristy Derr et al. 2019; Published by Mary Ann Liebert, Inc.

                This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are cited.

                History
                : 13 November 2018
                : 16 April 2019
                Page count
                Figures: 7, References: 42, Pages: 10
                Categories
                Methods Articles

                bioprinting,skin,barrier function,keratinocytes,high-throughput screening

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