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Three-Dimensional Bioprinting: The Future of Corneal Blindness Treatment?

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Review of “3D bioprinting of a corneal stroma equivalent” from Experimental Eye Research by Stuart P. Atkinson

Estimates from the World Health Organisation suggest that corneal blindness and scarring affects around 15 million people worldwide [1], a problem only worsened by the lack of the corneal donors required for transplantation purposes [2]. However, recent advancements in three-dimensional (3D) bioprinting, a new approach to the production of biological structures for tissue construction [3], may permit the fabrication of artificial transplantable corneal substitutes. 

To this end, a recent study led by Che J. Connon (Newcastle University, Newcastle Upon Tyne, UK) explored the feasibility of pneumatic 3D extrusion bioprinting to generate complex corneal stroma equivalents. Isaacson et al. suggest that their new findings, reported in Experimental Eye Research, may represent the basis for the artificial generation of biological corneal structures for regenerative medicine applications [4].

High-resolution rapid bio-printing [5] followed a geometrical map of the corona as a guide and employed a collagen and alginate-containing low-viscosity bio-ink that contained encapsulated corneal keratocytes (fibroblasts) to create rigid corneal structures and support structures resembling native human corneal stroma. The authors noted the critical nature of the support structure to maintain corneal curvature and a requirement to control print parameters including printing speed, needle diameter, and bio-ink viscosity to ensure mechanical stability and print accuracy. Additionally, the application of low viscosity bio-ink, the prevention of dehydration, and thinness of printed tissue all enhanced keratocyte survival at day 1 (> 90%) and day 7 (83%) post-printing and promoted noticeable keratocyte spreading.

The authors note that the translation of their proof-of-concept study requires further analysis of stromal cell phenotypes, biocompatibility after transplantation, epithelial cell growth support, and, importantly, corneal functionality!

For more on bioprinting and future regenerative approaches to corneal tissue replacement, stay tuned to the Stem Cells Portal!

References

  1. Whitcher JP, Srinivasan M, and Upadhyay MP, Corneal blindness: a global perspective. Bull World Health Organ 2001;79:214-21.
  2. Golchet G, Carr J, and Harris MG, Why don't we have enough cornea donors? A literature review and survey. Optometry 2000;71:318-28.
  3. Mironov V, Reis DN, and Derby B, Review: Bioprinting: A Beginning. Tissue Engineering 2006;12:631-634.
  4. Isaacson A, Swioklo S, and Connon CJ, 3D bioprinting of a corneal stroma equivalent. Experimental Eye Research 2018;173:188-193.
  5. Simonini I and Pandolfi A, Customized Finite Element Modelling of the Human Cornea. PLOS ONE 2015;10:e0130426.