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Consideration of the selection of materials used for the supporting bed
During the development stage, there were various characteristics required of the supporting bed. These characteristics included: i) maintaining sufficient structure to suspend the extruded material; ii) shear thinning capacity to allow the printhead to move freely through the supporting material; iii) rapid restructuring (self-healing properties), forming support around the deposited bioink; iv) thermally stable at both room temperature and physiological temperatures; v) neutral (i.e., uncharged) material that is relatively bioinert, across a range of pH and electrolytes (ionic species and concentrations), preventing interactions with cells and charged bioinks; vi) non-toxic; and, vii) preferably from a non-animal source.
Although there are many biopolymer materials that maintain several of these inherent characteristics, with a capacity to perform suspended 3D additive manufacture without conforming to all of these characteristics11,26,27, the intention here was to produce a supporting bed that would overcome certain practical issues associated with other supporting materials. Due to the chemical properties of agarose and, in particular, when formulated as a particulate fluid gel, all of these characteristics could be obtained. This enabled a supporting bed that could be used across a wide variety of bioinks23,24,25,28. Indeed, the bioinert nature of the material provided the potential to maintain the printed structure in situ throughout culture, allowing sufficient timescales for many different bioinks to fully develop, without changes to the biology. Furthermore, the particulate, thinning nature allowed ease of removal from the final printed construct, while the non-toxic, non-animal origin allows the potential for rapid translation toward the clinic, overcoming barriers relating to ethical and regulatory requirements.
Considerations in the selection of materials for the bioinks
In direct-extrusion bioprinting, bioinks are deposited onto a 2D print bed. It is beneficial that monomer bioink solutions have shear-thinning behavior; however, to produce high-fidelity constructs with physiologically relevant dimensions, they must have low thixotropy and recover to sufficiently high viscosities so that they form solid filaments upon deposition29,30,31. With increased viscosity, the pressure required for extrusion is much higher, often negatively influencing the encapsulated cell viability31,32. Suspension bioprinting removes this limitation, as the extruded material is supported by the suspension bath throughout crosslinking. This development hugely increases the range of bioink formulations that can be used. For example, recent work has shown the use of low-concentration collagen solutions being printed into highly complex geometries analogous to the internal structure of the heart33,34,35. In the applications mentioned in this method, embedded printing allowed biomaterial inks to be chosen to best replicate the physiological environment for which they were intended, instead of for their ability to be printed.
Limitations in structure size
Throughout the biofabrication literature, it has been demonstrated that different kinds of bioprinters, driven by alternative printhead technologies, may be incorporated into embedded manufacturing techniques. The technology demonstrated here is no different, with examples that include a pneumatic micro-extrusion-based bioprinter (INKREDIBLE), as demonstrated by Senior et al., and extrusion-based bioprinters with controllable microvalves (3D Discovery)23. Although this makes the technology accessible to a range of users who may already own a bioprinter, limitations on the attainable size of the structure are ultimately dependent on the bioprinter specifications in question. Initially, the main restriction upon the generation of large structures is defined by the size of the print bed, the limits of X, Y, and Z trajectories, and also the size of the vessel in which the supporting fluid gel is contained.
Limitations in resolution
When fabricating intricate, micrometer-sized structures, the resulting resolution is highly dependent on the precision of the printer (control over step size, degree of extrusion), the internal diameter of the print nozzle, and a range of adjustable software parameters, including print speed, print pressure, and flow velocity36. In addition, control over the droplet size appears to be critical to facilitating the generation of high-resolution structures, with the best results observed in extrusion printers with a controllable microvalve. Ultimately, when all parameters are optimized, print resolutions can be achieved to match, or even be less than, the inner diameter of extrusion nozzles, with the deposited filament on the order of the micrometer scale37. This is, however, reliant on the optimization of all the printing parameters previously mentioned, and resolution can be considerably limited by the printing mechanism and precision. Pneumatic extrusion, for example, does not appear to allow for the same printing resolution as extrusion with a controllable microvalve. There is, therefore, a potential cost implication to achieve the maximum printing resolution, as such systems incur a significantly increased expense to the user.
Future outlook and potential
At the moment, there is much interest around the use of suspended manufacturing processes to allow for the production of complex soft structures containing embedded cells, and there will undoubtedly be significant advances in the coming years. Continuous advancement in improving print resolution is given, although it remains to be seen how necessary this will be, given that the majority of biological systems are able to rearrange themselves on a molecular level. While the focus of interest in the media is around the use of 3D printed tissues to directly replace human tissues following injury or disease, any robust medical procedures enabled by these processes are some years away38,39. It is more likely that the impact of these complex culture systems will be in the screening of drugs or even used as tools, to enhance our understanding of biological processes38. In particular, developmental biology could greatly benefit here, where precise control over the special deposition of molecules will allow researchers to explore the role of multifactorial systems on tissue development processes.