[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/6863\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003E3D-printed living tissues could spell the end of arthritis\u003C\/h2\u003E\u003Cp\u003EIt\u2019s a development that could reduce the discomfort and pain of the one in 10 people who will suffer from arthritis over their lifetime. Arthritis acts by breaking down the rubbery cartilage tissue found in joints, leading to pain, stiffness and swelling.\u003C\/p\u003E\u003Cp\u003EBut 3D printing technology could enable new cartilage to be printed on demand using patients\u2019 own cells as the building blocks \u2013 a technique known as bioprinting.\u003C\/p\u003E\u003Cp\u003EProfessor Jos Malda is working with such 3D bioprinting in his lab at the University Medical Centre Utrecht in the Netherlands. As part of a project called 3D-JOINT, his team is working to make bioprinted tissues that can be implanted into a living joint to replace the damaged part. These would eventually mature into a tissue that is the same as the original healthy cartilage.\u003C\/p\u003E\u003Cp\u003EAlready, stem cells can be deposited by 3D printers according to a precise blueprint, creating complex tissues layer by layer. Yet that doesn\u2019t mean they can instantly transform into new organs or body parts.\u003C\/p\u003E\u003Cp\u003E\u2018Printing is not the last step in biofabrication, since\u0026nbsp;printing something in the shape of a heart does not make it a heart,\u2019 said Prof. Malda. \u2018The printed construct needs time and the correct chemical and biophysical cues to mature into a functional tissue.\u2019\u003C\/p\u003E\u003Cp\u003EOne challenge is maintaining the right conditions for the cellular building material.\u003C\/p\u003E\u003Cp\u003ETraditional 3D printing uses plastics, which are flexible enough to be pushed through a printer nozzle, but are also solid enough to keep their shape afterwards.\u003C\/p\u003E\u003Cp\u003EBut because bioinks contain living cells, scientists are having to develop new solutions. One option is to use a hydrogel - a type of material that consists of networks of large molecules known as polymers, swollen with water.\u003C\/p\u003E\u003Cp\u003E\u2018For bioprinting, the material has to be able to keep cells alive. This demands aqueous conditions and processing under a\u0026nbsp;relatively low temperature, which makes hydrogel-based materials ideal candidates,\u2019 Prof. Malda said.\u003C\/p\u003E\u003Cp\u003EBut while the squishy nature of such hydrogels makes them very good at delivering cells, it is also their weakness. They are unable to withstand the mechanical\u0026nbsp;load certain tissues undergo in the body.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EStrong\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003ETo solve that, Prof. Malda and his team are experimenting with additive materials, which can make the hydrogels strong enough to act as replacement cartilage.\u003C\/p\u003E\u003Cp\u003E\u2018Reinforcing the hydrogel makes it stronger \u2013 just like steel rods are combined with soft cement to create the reinforced concrete that makes the foundations of our\u0026nbsp;homes,\u2019 Prof. Malda explained.\u003Cbr\u003E \u0026nbsp;\u003Cbr\u003E His team is using melt electrowriting, a 3D-printing technique that combines melted polycaprolactone, a type of polyester, with an electrical field that creates fibres as thin as a hair.\u003C\/p\u003E\u003Cp\u003EUsing these microfibres, the team creates scaffolding to be combined with the cell-containing hydrogel \u2013 already with good results.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u0026#039;Printing something in the shape of a heart does not make it a heart.\u0026#039;\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProfessor Jos Malda, University Medical Centre Utrecht, the Netherlands\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003Cbr\u003E \u0026nbsp;\u003Cbr\u003E \u2018The combination of the hydrogel with\u0026nbsp;the fibres acts in synergy, increasing the strength of the composite over 50 times while still allowing the cells to generate extracellular matrix and mature into a cartilage-like tissue,\u2019 Prof. Malda said.\u003C\/p\u003E\u003Cp\u003EHis team is working on upscaling that process to create larger constructs, while bringing together different materials for combined bone and cartilage tissue replacements. The ultimate goal is to eventually 3D print a complete joint.\u003C\/p\u003E\u003Cp\u003EIn addition to acting as a replacement for lost cartilage and bone, printing cells in this way can also help the body to repair damaged tissues.\u003C\/p\u003E\u003Cp\u003EProfessor Daniel Kelly at Trinity College in Dublin, Ireland, is working as part of a project called JointPrinting\u0026nbsp;to develop such a system \u2013 quite a challenge given that the field is still emerging.\u003C\/p\u003E\u003Cp\u003E\u2018There are relatively few examples in the literature demonstrating the capacity of bioprinted tissues to actually regenerate damaged tissues in appropriate pre-clinical (animal) models,\u2019 Prof. Kelly said.\u003C\/p\u003E\u003Cp\u003EHe is working to develop bioinks that are not only printable but which also spur stem cells to make new cartilage by altering the molecules that support and surround the printed cells, instructing them to generate the correct type of tissue.\u003C\/p\u003E\u003Cp\u003EThe idea is that these newly printed stem cells can help repair damaged tissue after they are implanted in the body.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EProf. Kelly\u2019s team is also working with using substances known as growth factors to stimulate the formation of new blood vessels in injured tissues.\u003C\/p\u003E\u003Cp\u003E\u2018We sometimes incorporate VEGF (vascular endothelial growth factor) into our bioprinted tissues \u2026 to encourage new blood vessels to form in regions of a damaged bone or joint where we want bone to grow,\u2019 he said.\u003C\/p\u003E\u003Cp\u003E\u2018We introduce gradiants of VEGF into the bioprinted tissues that directs host blood vessels (to form) into the appropriate regions of our implants.\u2019\u003C\/p\u003E\u003Cp\u003EThough scientists are focusing on cartilage and bone, demands on joints can differ dramatically depending on where they are located in the body.\u003C\/p\u003E\u003Cp\u003ETo test the printed tissues, Prof. Kelly uses specialised mechanical testing machines to determine their stiffness and elasticity, as well as computational modelling to better understand how the structure and composition of the implants can be tuned to function within specific environments.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EAll in all, Prof. Kelly is optimistic about the future applications of bioprinting.\u003C\/p\u003E\u003Cp\u003E\u2018I think bioprinting will have two main applications. Firstly, as a source of new tissues and organs in regenerative medicine. Secondly, as a tool to better understand human disease and to test the safety and efficacy of new drugs targeting such diseases.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EThe research in this article was funded by the EU. 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