So far, we have only seen living blood vessels, skin and organs from 3D printers in Hollywood movies and hospital series. But what is currently still a dream of the future for us could soon be reality. Where are we at this point? When will it be possible to transplant the first printed organs? Together with Dr. Michael Ausserlechner from the Medical University of Innsbruck, we shed some light on the subject.
Will we soon be able to print viable organs?
Research in 3D bioprinting has grown rapidly in recent years. The aim is to reproduce the complex function and structure of biological systems from human tissue to whole organs and thus, at best, to save human lives, e.g. through transplantation. In this interview with Dr. Michael Ausserlechner, we explore the questions of how this complex system works and what the current state of research is.
About Michael J. Ausserlechner, M.D.
Michael J. Ausserlechner has been Assistant Professor at the Department of Pediatrics I and Head of the Molecular Biology Research Laboratory at the Medical University of Innsbruck since 2014. He studied microbiology and did his MSc thesis at the Institute of Experimental Pathology in Innsbruck in the group of Prof. Dr. Georg Wick. In 2006, he received the venia docendi (habilitation) in pathophysiology. Michael J. Ausserlechner received several scientific awards, including the “Prize of the Principality of Liechtenstein for Scientific Research at the Medical University of Innsbruck 2005″ and the “Otto Kraup Prize 2007”. The main research interests are themolecular function and regulation of FOXO transcription factors and IAPs, their influence on ROS regulation, and approaches to modulate their activity by small drug-like compounds.
Background, research status and a look into the future of bioprinting
Mr. Ausserlechner, first of all, thank you for taking the time to answer a few questions for us.
Before we go into detail, can you explain how bioprinting works in general?
Dr. Michael J. Ausserlechner:Bioprintingcan basically be described as a type of 3D printing in which we use bio-molecules and living cells instead of plastic for printing and arrange them in a pattern to resemble biology-inspired living tissue. These include, for example, simpler organs such as skin. So we are not “building” something out of plastic, but out of living cells and tissue proteins. Of course, 3D printing is a bit more complicated. On the one hand, since one is working with living cells, one must ensure that the pressure conditions allow the survival of these cells, from which a “tissue equivalent” is constructed. In addition, after 3D printing, the living tissue is cultured in nutrient fluid and the cells begin to self-organize and develop. To do this, the 3D-printed human tissue may then need to be mechanically stimulated or subjected to other conditions so that, for example, a functioning muscle or properly constructed skin develops.
When we think about or read about bioprinting, it seems like science fiction to us – but we hear it’s already really possible. Thus, there are different areas in which the results of bioprinting can be used. What do you think is the current state of research and what is the main goal for which we will use bioprinting in the future?
Michael J. Ausserlechner:Well, I think that this technology is driven by more or less two different requirements. On the one hand, we have the limited number of donor organs available for life-saving transplantation.That may be the larger goal – to save more people by making more donor organs available through bioprinting. The other major goal is to eliminate animal testing through human tissue created by the 3D printer.
The state of research or final implementation depends on the complexity of the organ to be transplanted. Currently, for example, it is still challenging to “print” a transplantable kidney because it is very complex, made up of a variety of different cell types, and has a complicated substructure. All these structures would first have to be printed and then assembled in such a way that they really function and all the cells work as they should. It would be simpler at present to generate skin tissue, which is then used for skin burns, for example. Here, skin cells can be taken from the patient, multiplied in cell culture and then used to print a patient-specific, multilayer skin. Since these are the patient’s own cells, the risk of the patient subsequently reacting to and rejecting the new transplanted tissue is minimized. Unlike the usual transplants, in this case there is also no need for lifelong treatment that suppresses the immune system. But it’s all a matter of complexity – creating a living, functioning heart, like a 3D-printed kidney, is obviously much more challenging.
This is an important point. Let’s stay on the subject of organs. In previous years, it was possible to print a heart using the 3D printer in Tel Aviv, but unfortunately it was not functional. How long do you think it will take us to create these complex organs?
Dr. Michael J. Ausserlechner:The problem is still that it is now possible to reproduce the structure of a heart using living heart muscle cells. This applies to the external shape, but not to how individual heart muscle cells, connective tissue cells or nerve cells are arranged, for example. The Tel Aviv team also printed vessels and chambers in the heart, but we have to take into account that the heart or the particular organ in our body grows and develops for many years and decades. In the process, the respective cells also change the protein scaffold accordingly and leave behind “marks” so that the information is available on the protein scaffold of the organ as to how cells “sitting” there should develop and how they perform their function. Such molecular-level markers cannot currently be replicated using 3D printing. One possibility, however, is to prepare the protein scaffold from an animal heart, for example, and to add this “matrix” to the “cell ink” to be printed for the 3D printer, so that at least the existing, organ-specific proteins with the important information can be transferred.
If this were to be possible in the future, it would therefore not only be an opportunity for patients waiting for a donor organ, but also for the abolition of animal experiments. In Russia, according to our research, the new Covid vaccine has reportedly already been tested on printed tissue. Can you explain how this works?
Dr. Michael J. Ausserlechner:Yes, it is possible to produce lung tissue or several functional layers of lung tissue and use them to test whether, for example, antibodies produced with the vaccine prevent the Covid-19 virus from “docking” with the cells. In the course of this, the effect of the respective antibodies can then be investigated in more detail or drugs can be sought that prevent the multiplication of viruses in the cell. Work is also being done on inserting immune cells into the lung tissue, for example, and thus conducting vaccine research on the printed tissue – then one could do without a great deal of animal testing in this area as well.
What exciting projects are you and the Medical University of Innsbruck currently working on?
Dr. Michael J. Ausserlechner:One of our most important projects is 3D printing of skin with the aim of building a very complex, living skin model that contains not only the uppermost skin layers (epidermis and dermis) but also the so-called subdermis. The aim is to recreate the skin with fine blood vessels in order to explore, for example, exactly how the wound healing process takes place and how we can address medical advances and improvements here.
What personal goal is particularly close to your heart when it comes to bioprinting?
Dr. Michael J. Ausserlechner:Our team is particularly interested in using 3D-printed tissue models to develop new patient-specific forms of therapy, especially for childhood cancers, while at the same time reducing animal testing in medical research. In order to better understand disease-related processes in the body, within tissues or organs, and to be able to treat diseases more effectively, bioimprinted tissue constructed from human cells is the ideal way for us.
Thank you very much for the interview, Mr. Ausserlechner.
Video: Learn more about bioprinting
Still science fiction or already reality? Our medsolutTV host Vincent Schneider has taken another closer look at the topic of bioprinting and brings you everything about the function of this innovative technology, the international state of research as well as an exciting outlook into future developments in a new episode! Curious? Discover it for yourself…
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