Tissue Engineering & 3D Bioprinting
“It is estimated that 569,000 people are living with a facial disfigurement in the United Kingdom” (Changing Faces, 2017).
Recent advances in microsurgery, imaging and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. Three-dimensional (3D) biomanufacturing of tissue would remove the morbidity associated with the use of autologous tissue or long-term immunosuppression.
As a clinical speciality, plastic surgeons are well placed to be leaders in the developing field of 3D biomanufacturer. A growing cohort of research-active plastic surgeons, who are skilled in vascularisation, tissue viability/transfer and the manipulation of cells, will be well placed in the future to transplant tissue-engineered constructs to treat a broad range of reconstructive challenges.
The Medical Research Council states that regenerative medicine and tissue engineering “holds the promise of revolutionizing patient care in the twenty-first century”. The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment.
Previous attempts to engineer cartilage for facial reconstruction have mainly focused on the use of synthetic scaffolds, such as plastics, which can be poorly tolerated by the body and immune system. Furthermore, many groups use readily accessible, non-specific stem cells i.e. from bone marrow or fat, which have a tendency to produce poor quality, brittle or fatty cartilage tissue. As such, our research focusses on tissue-specific stem cells of cartilaginous origin, to better mimic the intended tissue type in combination with a novel natural (biological) biomaterial.
Our particular interests lie in 3D printing custom-made tissue into exact shapes to match the patient’s defects which we believe could become the future gold standard of reconstruction. However, 3D printers, like all printers, need suitable inks. We are developing novel, natural (tree pulp derived) nanocellulose biological inks ‘bioinks’ for this purpose. These inks possess ideal properties for printing but also appear to encourage cells to make more cartilage than they would in other types of bioinks. The tissue engineering and 3D bioprinting project aims to further investigate the ideal combination of cells to grow new cartilage, optimise new bioinks for 3D bioprinting patient-specific cartilage constructs and to show that they are safe, non-toxic and well tolerated by the immune system. This will enable us to create durable cartilage constructs which we hope will demonstrate the safety and efficacy to lead to ground-breaking human clinical trials. If successful, the outcomes could revolutionise our ability to reconstruct form and function in patients affected by facial deformities and negate the need for extensive donor sites, including the scarring and potential complications that accompany these procedures.