The vascular network throughout the human body functions as a crucial transport barrier by dynamically regulating the exchange of molecules and cells between the blood and surrounding tissues. This regulation is essential for preventing tissue edema and enabling selective nutrient and cell exchange, thus supporting tissue metabolism and homeostasis1. Altered endothelial permeability, a factor in many health conditions, affects both disease severity and treatment efficacy2. Vascular endothelium acts as a selective barrier, facilitating the transfer between vessels, tissues, and organs. This regulation involves several mechanisms, such as the basic filtering of solutes and small molecules, intentional disruption of the vascular barrier, and the influence of molecules such as prostaglandins and growth factors on permeability levels3.
Key factors in this regulation include endothelial cell junctions, the migration of leukocytes, and the functionality of the blood-brain barrier4. Given its complexity, the process varies across different environments, involving various blood vessel types and utilizing distinct anatomical pathways. Comprehending the biological underpinnings of vascular permeability is crucial for devising therapeutic approaches to treat conditions associated with abnormal vascular permeability. Maintaining vascular permeability is crucial for the health of the vascular system and surrounding tissues; consequently, impairment of this function leads to endothelial dysfunction, a state in which the endothelium loses its normal functionality.
Endothelial dysfunction is a precursor to several prevalent human diseases, including hypertension, coronary artery disease, diabetes, and cancer5,6,7. This condition can present in several ways, including decreased vasodilation, increased vessel permeability, and a tendency toward a pro-inflammatory state. This pathological state is the earliest stage of several critical cardiovascular issues, such as coronary artery disease, stroke, and peripheral artery disease8, which continue to be the leading causes of mortality in the United States1. Endothelial dysfunction affects cardiovascular health as well as the blood-brain barrier (BBB) and plays a major role in the progression of various neurological disorders. Dysfunction can increase BBB permeability, thus allowing toxins, pathogens, and immune cells to infiltrate into the central nervous system and contributing to neurological disorders such as stroke, Alzheimer's disease, multiple sclerosis, and brain infections9.
Endothelial dysfunction in diabetes is marked by the compromised ability of the endothelium to regulate vascular tone and produce vasodilator mediators, such as nitric oxide, leading to impaired vasodilation10. This condition is exacerbated by hyperglycemia-induced pathways such as protein kinase C activation and oxidative stress, contributing significantly to the progression of diabetic vascular disease11. Moreover, an inflammatory environment has been found to enhance tumor cell adhesion to brain microvascular endothelial cells while a leaky endothelium has been reported to be a major factor in cancer metastasis12,13. The geometry of blood vessels has been found to directly influence brain cancer metastasis. Tumor cells preferentially attach to areas of greater blood vessel curvature7. This finding underscores the importance of vascular geometry in cancer metastasis. More importantly, in conditions such as fibrosis and cancer, disrupted endothelial barrier function not only plays a role in disease development but also hinders treatment effectiveness by hindering adequate drug delivery14. Research on vascular permeability is crucial for advancing cardiovascular disease treatment and offering insights into managing other diseases involving compromised vascular function.
Given the crucial role of vascular permeability in health and disease, considerable research has focused on examining the selective nature of the endothelial barrier for therapeutic development by using animal models, alongside traditional 2D and 3D in vitro testing platforms. However, animal models have limitations because of species-specific differences and ethical issues, as well as high costs15,16. For instance, Pfizer, in 2004, stated that over the previous 10 years, it had spent over $2 billion on drug developments that showed promising effects in animal models but eventually failed in advanced human testing stages17. Moreover, traditional 2D models do not accurately mimic the three-dimensional (3D) architecture and the complex geometric structure of vascular channels.
With advancements in biofabrication technologies, extensive efforts have been aimed at fabricating vascular channels while recapitulating 3D architecture. Microscale vascular channels can be effectively fabricated within microfluidic chips by using soft lithography, thus offering an advantage of real-time analysis18,19. Alternative methods, such as hydrogel casting or wrapping cell sheets around a mold or mandrel, can be used to create freestanding tubular structures with the desired diameter20,21. However, these methods have limitations; for example, microfluidic chips are restricted to microchannel configurations, and hydrogel casting around a mold does not effectively replicate multiple geometries.
With the emergence of 3D bioprinting technology22, replicating complex geometries by precisely depositing various extracellular matrix (ECM)-based hydrogel materials has become possible23,24. Some bioprinting methods, such as those using concentrically arranged nozzles, e.g., coaxial and triaxial25,26, cannot create bifurcated tubes; however, complex structures can be achieved with sacrificial patterning methods27. None of these bioprinting methods have been demonstrated to enable high-throughput in vitro modeling-a crucial requirement for pharmacological research in drug discovery. Herein, we present a method for efficiently fabricating endothelialized vascular channels with efficient control over dimensions.
We established a straightforward approach using commercially available six-well plates, combined with a sacrificial patterning method in which a bioprinter fabricates vascular channels of desired sizes and patterns within an ECM hydrogel. Human umbilical vein endothelial cells (HUVECs) were seeded to endothelialize these channels and evaluate the functionality of endothelium through a permeability assay. This design enables pumpless perfusion by creating media reservoirs on both sides of the channel and uses gravity-driven flow with the help of a commonly used 2D rocker to mimic the dynamic culture. This approach eliminates the need for peristaltic pumps and facilitates the scalability of this platform for high-throughput applications. The computer-controlled nature of 3D bioprinting technology also streamlines the fabrication process, thus decreasing the likelihood of errors during manufacturing. The VOP model shows promise as a valuable tool for pharmacological testing in drug discovery.