Advancements and Challenges in 3D Printing of Electroconductive Hydrogels for Cardiovascular Bioprinting

Document Type : Systematic Review

Authors
1 Modern technologies in engineering Group, Faculty of Interdisciplinary Science and Technology, Tarbiat Modares University, Tehran, Iran
2 Tissue Engineering and Applied Cell Sciences Division, Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 1411713116, Iran
Abstract


Cardiovascular diseases (CVDs) are the most prevalent cause of fatalities worldwide, affecting both cardiac and vascular tissues. Tissue engineering is a promising treatment alternative for people with end-stage CVDs; however, it has disadvantages such as poor scaffold design control and insufficient vascularization. 3D bioprinting, a recent advancement, has overcome these restrictions by creating layer-by-layer structures such as organs, scaffolds, and blood vessels. This method enables precise control over cell distribution, architectural structure, and compositional correction. Furthermore, since cardiac tissue is electroactive, incorporating electroconductive nanomaterials into the scaffold facilitates intracellular communication, mimics the heart's biochemical and biomechanical microenvironment, and prevents arrhythmia in the heart. In addition, these electroconductive materials can improve the quality of 3D-printed scaffolds. In this study, we will review the different techniques of 3D printing hydrogels after evaluating the many types of hydrogels employed for cardiac tissue engineering (CTE). Then, we will discuss the influence of incorporating electroconductive fillers into hydrogels on printed scaffold quality. Finally, we will briefly discuss the challenges and potentials.

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1. Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation. 2024;149(8):e347-e913.
2. White HD, Chew DP. Acute myocardial infarction. Lancet. 2008;372(9638):570-84.
3. Mandla S, Radisic M. Cardiac tissue. Principles of Regenerative Medicine: Elsevier; 2019. p. 1073-99.
4. Jang J. 3D bioprinting and in vitro cardiovascular tissue modeling. Bioengineering. 2017;4(3):71.
5. Cui H, Miao S, Esworthy T, Zhou X, Lee S-j, Liu C, et al. 3D bioprinting for cardiovascular regeneration and pharmacology. Adv Drug Deliv Rev. 2018;132:252-69.
6. Tallawi M, Rosellini E, Barbani N, Cascone MG, Rai R, Saint-Pierre G, et al. Strategies for the chemical and biological functionalization of scaffolds for cardiac tissue engineering: a review. Journal of the Royal Society Interface. 2015;12(108):20150254.
7. Valls Margarit M. Development of an advanced 3D culture system for human cardiac tissue engineering. [PHD's thesis]. Barcelona: Barcelona University; 2017.
8. Chong JJ, Yang X, Don CW, Minami E, Liu Y-W, Weyers JJ, et al. Human embryonic-stem-cell-derived cardiomyocytes regenerate non-human primate hearts. Nature. 2014;510(7504):273-7.
9. Behfar A, Crespo-Diaz R, Terzic A, Gersh BJ. Cell therapy for cardiac repair—lessons from clinical trials. Nat Rev Cardiol. 2014;11(4):232-46.
10. Qasim M, Haq F, Kang M-H, Kim J-H. 3D printing approaches for cardiac tissue engineering and role of immune modulation in tissue regeneration. Int J Nanomedicine. 2019:1311-33.
11. Subia B, Kundu J, Kundu S. Biomaterial scaffold fabrication techniques for potential tissue engineering applications. Tissue Eng. 2010;141(13-18).
12. Murphy SV, Atala A. 3D bioprinting of tissues and organs. Nat Biotechnol. 2014;32(8):773-85.
13. Do A-V, Khorsand B, Geary SM, Salem AK. 3D Printing of Scaffolds for Tissue Regeneration Applications. Adv Healthc Mater. 2015;4(12):1742-62.
14. Liu W, Zhang YS, Heinrich MA, De Ferrari F, Jang HL, Bakht SM, et al. Rapid Continuous Multimaterial Extrusion Bioprinting. Adv Mater. 2017;29(3):1604630.
15. Skylar-Scott MA, Uzel SGM, Nam LL, Ahrens JH, Truby RL, Damaraju S, et al. Biomanufacturing of organ-specific tissues with high cellular density and embedded vascular channels. Science Advances. 2019;5(9):eaaw2459.
16. Noor N, Shapira A, Edri R, Gal I, Wertheim L, Dvir T. 3D Printing of Personalized Thick and Perfusable Cardiac Patches and Hearts. Advanced Science. 2019;6(11):1900344.
17. Liu N, Ye X, Yao B, Zhao M, Wu P, Liu G, et al. Advances in 3D bioprinting technology for cardiac tissue engineering and regeneration. Bioact Mater. 2021;6(5):1388-401.
18. Baheiraei N, Yeganeh H, Ai J, Gharibi R, Azami M, Faghihi F. Synthesis, characterization and antioxidant activity of a novel electroactive and biodegradable polyurethane for cardiac tissue engineering application. Mater Sci Eng, C. 2014;44:24-37.
19. He S, Song H, Wu J, Li S-H, Weisel RD, Sung H-W, et al. Preservation of conductive propagation after surgical repair of cardiac defects with a bio-engineered conductive patch. The Journal of Heart and Lung Transplantation. 2018;37(7):912-24.
20. Baheiraei N, Razavi M, Ghahremanzadeh R. Reduced graphene oxide coated alginate scaffolds: potential for cardiac patch application. Biomaterials Research. 2023;27(1):109.
21. Malki M, Fleischer S, Shapira A, Dvir T. Gold Nanorod-Based Engineered Cardiac Patch for Suture-Free Engraftment by Near IR. Nano Lett. 2018;18(7):4069-73.
22. Roshanbinfar K, Vogt L, Greber B, Diecke S, Boccaccini AR, Scheibel T, et al. Electroconductive Biohybrid Hydrogel for Enhanced Maturation and Beating Properties of Engineered Cardiac Tissues. Adv Funct Mater. 2018;28(42):1803951.
23. Doustvandi B, Imani R, Yousefzadeh M. Study of Electrospun PVDF/GO Nanofibers as a Conductive Piezoelectric Heart Patch for Potential Support of Myocardial Regeneration. Macromol Mater Eng. 2024;309(1):2300243.
24. Kai D, Prabhakaran MP, Jin G, Ramakrishna S. Biocompatibility evaluation of electrically conductive nanofibrous scaffolds for cardiac tissue engineering. J Mater Chem B. 2013;1(17):2305-14.
25. Schmidt V, Wittemann JV, Senz S, Gösele U. Silicon nanowires: a review on aspects of their growth and their electrical properties. Adv Mater. 2009;21(25‐26):2681-702.
26. Nazari H, Azadi S, Hatamie S, Zomorrod MS, Ashtari K, Soleimani M, et al. Fabrication of graphene‐silver/polyurethane nanofibrous scaffolds for cardiac tissue engineering. Polym Adv Technol. 2019;30(8):2086-99.
27. Kalishwaralal K, Jeyabharathi S, Sundar K, Selvamani S, Prasanna M, Muthukumaran A. A novel biocompatible chitosan–Selenium nanoparticles (SeNPs) film with electrical conductivity for cardiac tissue engineering application. Mater Sci Eng, C. 2018;92:151-60.
28. Lu TY, Xiang Y, Tang M, Chen S. 3D Printing Approaches to Engineer Cardiac Tissue. Curr Cardiol Rep. 2023;25(6):505-14.
29. Kalhori D, Zakeri N, Zafar-Jafarzadeh M, Moroni L, Solati-Hashjin M. Cardiovascular 3D bioprinting: A review on cardiac tissue development. Bioprinting. 2022;28:e00221.
30. Wang Z, Wang L, Li T, Liu S, Guo B, Huang W, et al. 3D bioprinting in cardiac tissue engineering. Theranostics. 2021;11(16):7948-69.
31. Unagolla JM, Jayasuriya AC. Hydrogel-based 3D bioprinting: A comprehensive review on cell-laden hydrogels, bioink formulations, and future perspectives. Applied Materials Today. 2020;18:100479.
32. Bejleri D, Davis ME. Decellularized Extracellular Matrix Materials for Cardiac Repair and Regeneration. Adv Healthc Mater. 2019;8(5):e1801217.
33. Wang Z, Lee SJ, Cheng H-J, Yoo JJ, Atala A. 3D bioprinted functional and contractile cardiac tissue constructs. Acta Biomater. 2018;70:48-56.
34. Khoshnood N, Zamanian A. Development of novel alginate-polyethyleneimine cell-laden bioink designed for 3D bioprinting of cutaneous wound healing scaffolds. J Appl Polym Sci. 2022;139(21):52227.
35. Lee A, Hudson AR, Shiwarski DJ, Tashman JW, Hinton TJ, Yerneni S, et al. 3D bioprinting of collagen to rebuild components of the human heart. Science. 2019;365(6452):482-7.
36. Alave Reyes-Furrer A, De Andrade S, Bachmann D, Jeker H, Steinmann M, Accart N, et al. Matrigel 3D bioprinting of contractile human skeletal muscle models recapitulating exercise and pharmacological responses. Communications biology. 2021;4(1):1183.
37. Noh I, Kim N, Tran HN, Lee J, Lee C. 3D printable hyaluronic acid-based hydrogel for its potential application as a bioink in tissue engineering. Biomaterials research. 2019;23(1):3.
38. Stapenhorst França F, Garrido dos Santos M, Prestes J, Alcantara B, Borges M, Pranke P. Bioprinting: A promising approach for tissue regeneration. Bioprinting. 2021;22:e00130.
39. Liu N, Ye X, Yao B, Zhao M, Wu P, Liu G, et al. Advances in 3D bioprinting technology for cardiac tissue engineering and regeneration. Bioactive Materials. 2021;6(5):1388-401.
40. Morgan FL, Moroni L, Baker MB. Dynamic bioinks to advance bioprinting. Adv Healthc Mater. 2020;9(15):1901798.
41. Konta AA, García-Piña M, Serrano DR. Personalised 3D printed medicines: which techniques and polymers are more successful? Bioengineering. 2017;4(4):79.
42. Ji S, Almeida E, Guvendiren M. 3D bioprinting of complex channels within cell-laden hydrogels. Acta Biomater. 2019;95:214-24.
43. Datta LP, Manchineella S, Govindaraju T. Biomolecules-derived biomaterials. Biomaterials. 2020;230:119633.
44. Zhao P, Gu H, Mi H, Rao C, Fu J, Turng L-s. Fabrication of scaffolds in tissue engineering: A review. Frontiers of Mechanical Engineering. 2018;13(1):107-19.
45. Christensen K, Xu C, Chai W, Zhang Z, Fu J, Huang Y. Freeform inkjet printing of cellular structures with bifurcations. Biotechnology and Bioengineering. 2015;112(5):1047-55.
46. Bejleri D, Streeter BW, Nachlas ALY, Brown ME, Gaetani R, Christman KL, et al. A Bioprinted Cardiac Patch Composed of Cardiac-Specific Extracellular Matrix and Progenitor Cells for Heart Repair. Adv Healthc Mater. 2018;7(23):1800672.
47. Stark BL. Development of a 3D printed conductive biopolymer for cardiac tissue engineering: The University of Texas at El Paso; 2023.
48. Yuk H, Lu B, Lin S, Qu K, Xu J, Luo J, et al. 3D printing of conducting polymers. Nature Communications. 2020;11(1):1604.
49. Jakus AE, Secor EB, Rutz AL, Jordan SW, Hersam MC, Shah RN. Three-Dimensional Printing of High-Content Graphene Scaffolds for Electronic and Biomedical Applications. ACS Nano. 2015;9(4):4636-48.
50. Spencer AR, Shirzaei Sani E, Soucy JR, Corbet CC, Primbetova A, Koppes RA, et al. Bioprinting of a Cell-Laden Conductive Hydrogel Composite. ACS Appl Mater Interfaces. 2019;11(34):30518-33.
51. Tran TS, Dutta NK, Choudhury NR. Poly(ionic liquid)-Stabilized Graphene Nanoinks for Scalable 3D Printing of Graphene Aerogels. ACS Applied Nano Materials. 2020;3(11):11608-19.
52. Kačarević ŽP, Rider PM, Alkildani S, Retnasingh S, Smeets R, Jung O, et al. An introduction to 3D bioprinting: possibilities, challenges and future aspects. Materials. 2018;11(11):2199.
53. Cui X, Boland T, D.D, apos, Lima D, Martin KL. Thermal Inkjet Printing in Tissue Engineering and Regenerative Medicine. Recent Patents on Drug Delivery & Formulation. 2012;6(2):149-55.
54. Zhang B, Gao L, Ma L, Luo Y, Yang H, Cui Z. 3D bioprinting: a novel avenue for manufacturing tissues and organs. Engineering. 2019;5(4):777-94.
55. Hewes S, Wong AD, Searson PC. Bioprinting microvessels using an inkjet printer. Bioprinting. 2017;7:14-8.
56. Agarwal T, Fortunato GM, Hann SY, Ayan B, Vajanthri KY, Presutti D, et al. Recent advances in bioprinting technologies for engineering cardiac tissue. Mater Sci Eng, C. 2021;124:112057.
57. Wu Y, Chen YX, Yan J, Quinn D, Dong P, Sawyer SW, et al. Fabrication of conductive gelatin methacrylate–polyaniline hydrogels. Acta Biomater. 2016;33:122-30.
58. van Kampen K, Scheuring R, Terpstra M, Levato R, Groll J, Malda J, et al. Biofabrication: From Additive Manufacturing to Bioprinting. 2019.
59. Mandrycky C, Wang Z, Kim K, Kim D-H. 3D bioprinting for engineering complex tissues. Biotechnol Adv. 2016;34(4):422-34.
60. Guvendiren M, Molde J, Soares RMD, Kohn J. Designing Biomaterials for 3D Printing. ACS Biomater Sci Eng. 2016;2(10):1679-93.
61. Zhu W, Qu X, Zhu J, Ma X, Patel S, Liu J, et al. Direct 3D bioprinting of prevascularized tissue constructs with complex microarchitecture. Biomaterials. 2017;124:106-15.
62. Moroni L, Boland T, Burdick JA, De Maria C, Derby B, Forgacs G, et al. Biofabrication: A Guide to Technology and Terminology. Trends Biotechnol. 2018;36(4):384-402.
63. Edrisi F, Baheiraei N, Razavi M, Roshanbinfar K, Imani R, Jalilinejad N. Potential of graphene-based nanomaterials for cardiac tissue engineering. J Mater Chem B. 2023.
64. Mousavi A, Vahdat S, Baheiraei N, Razavi M, Norahan MH, Baharvand H. Multifunctional conductive biomaterials as promising platforms for cardiac tissue engineering. ACS Biomater Sci Eng. 2020;7(1):55-82.
65. Zhang Y-Z, El-Demellawi JK, Jiang Q, Ge G, Liang H, Lee K, et al. MXene hydrogels: fundamentals and applications. Chem Soc Rev. 2020;49(20):7229-51.
66. Yan J, Lu Y, Chen G, Yang M, Gu Z. Advances in liquid metals for biomedical applications. Chem Soc Rev. 2018;47(8):2518-33.
67. Athukorala SS, Tran TS, Balu R, Truong VK, Chapman J, Dutta NK, et al. 3D Printable Electrically Conductive Hydrogel Scaffolds for Biomedical Applications: A Review. Polymers (Basel). 2021;13(3).
68. Choe G, Oh S, Seok JM, Park SA, Lee JY. Graphene oxide/alginate composites as novel bioinks for three-dimensional mesenchymal stem cell printing and bone regeneration applications. Nanoscale. 2019;11(48):23275-85.
69. Izadifar M, Chapman D, Babyn P, Chen X, Kelly ME. UV-assisted 3D bioprinting of nanoreinforced hybrid cardiac patch for myocardial tissue engineering. Tissue Engineering Part C: Methods. 2018;24(2):74-88.
70. Malda J, Visser J, Melchels FP, Jüngst T, Hennink WE, Dhert WJA, et al. 25th Anniversary Article: Engineering Hydrogels for Biofabrication. Adv Mater. 2013;25(36):5011-28.
71. Olate-Moya F, Arens L, Wilhelm M, Mateos-Timoneda MA, Engel E, Palza H. Chondroinductive alginate-based hydrogels having graphene oxide for 3D printed scaffold fabrication. ACS Appl Mater Interfaces. 2020;12(4):4343-57.
72. Serafin A, Culebras M, Oliveira JM, Koffler J, Collins MN. 3D printable electroconductive gelatin-hyaluronic acid materials containing polypyrrole nanoparticles for electroactive tissue engineering. Advanced Composites and Hybrid Materials. 2023;6(3):109.
73. Basara G, Saeidi-Javash M, Ren X, Bahcecioglu G, Wyatt BC, Anasori B, et al. Electrically conductive 3D printed Ti(3)C(2)T(x) MXene-PEG composite constructs for cardiac tissue engineering. Acta Biomater. 2022;139:179-89.
74. Ul Haq A, Montaina L, Pescosolido F, Carotenuto F, Trovalusci F, De Matteis F, et al. Electrically conductive scaffolds mimicking the hierarchical structure of cardiac myofibers. Sci Rep. 2023;13(1):2863.
75. Mei T, Cao H, Zhang L, Cao Y, Ma T, Sun Z, et al. 3D Printed Conductive Hydrogel Patch Incorporated with MSC@GO for Efficient Myocardial Infarction Repair. ACS Biomater Sci Eng. 2024;10(4):2451-62.
76. Luque GC, Picchio ML, Daou B, Lasa-Fernandez H, Criado-Gonzalez M, Querejeta R, et al. Printable Poly(3,4-ethylenedioxythiophene)-Based Conductive Patches for Cardiac Tissue Remodeling. ACS Appl Mater Interfaces. 2024;16(27):34467-79.
77. Ajdary R, Ezazi NZ, Correia A, Kemell M, Huan S, Ruskoaho HJ, et al. Multifunctional 3D‐printed patches for long‐term drug release therapies after myocardial infarction. Adv Funct Mater. 2020;30(34):2003440.
78. Serafin A, Murphy C, Rubio MC, Collins MN. Printable alginate/gelatin hydrogel reinforced with carbon nanofibers as electrically conductive scaffolds for tissue engineering. Mater Sci Eng, C. 2021;122:111927.
79. Zhao Y-D, Lai J-H, Wang M. 4D Printing of Self-Folding Hydrogel Tubes for Potential Tissue Engineering Applications. Nano LIFE. 2021;11(04):2141001.
80. Senatov FS, Niaza KV, Zadorozhnyy MY, Maksimkin A, Kaloshkin S, Estrin Y. Mechanical properties and shape memory effect of 3D-printed PLA-based porous scaffolds. J Mech Behav Biomed Mater. 2016;57:139-48.
81. Peralta Ramos ML, González JA, Fabian L, Pérez CJ, Villanueva ME, Copello GJ. Sustainable and smart keratin hydrogel with pH-sensitive swelling and enhanced mechanical properties. Mater Sci Eng, C. 2017;78:619-26.