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Bioprinting cartilage into people is doctor's goal
The San Diego Union-Tribune ^ | February 7, 2014 | Bradley J. Fikes

Posted on 02/08/2014 4:46:42 PM PST by 2ndDivisionVet

Researcher Darryl D'Lima of Scripps Clinic with his "bioprinter" adapted from an HP inkjet printer that can produce cartilage.

California’s stem cell agency, the California Institute for Regenerative Medicine, awarded him $3.1 million to research the use of embryonic stem cells and artificial embryonic stem cells to generate replacement cartilage.

Stem cell researcher Jeanne Loring has collaborated with D’Lima on growing cartilage from stem cells. She described him as “unique” in the ability to incorporate many disciples of science and medicine.

“He’s the only orthopedic surgeon I know who has the bandwidth to start thinking way outside the box,” said Loring, of The Scripps Research Institute. “He’s one of those people who may actually make a breakthrough. He may end up doing something that doesn’t work at all, but he’s going to throw himself completely into it.”

Shaochen Chen, a professor in the department of nanoengineering at UC San Diego, also collaborated on research with D’Lima. While both work in bioprinting, they take different approaches, said Chen, who specializes in adapting nanomaterials.

Chen described D’Lima as a skilled scientist with the foresight to know which tools will prove useful.

“He has a good vision for those new technologies. The impact could be pretty high.” Chen is also a faculty member of the Institute of Engineering in Medicine and the Clinical Translational Research Institute at UCSD.

Inkjet printer

D’Lima and colleagues began their work with an HP Deskjet 500 inkjet printer, a model that went on the market in 1990. Getting printer cartridges for it proved a challenge; they eventually located one in China. HP itself helped by sending the researchers a much-prized universal printer head; it can emulate any of HP’s inkjet printers.

D’Lima has demonstrated the basic technology with cow knee tissue and human bone chips kept alive in a nutrient bath. Over a period of months, the bioprinted cartilage stem cells mature and secrete a network of supporting fibers that give cartilage its smoothness and flexibility.

But no device now exists to print cartilage into human knee joints in an operating room environment. So D’Lima is talking with Invetech, an Australian company with a branch office in San Diego. Invetech is familiar with the field, having designed a bioprinter used by San Diego’s Organovo.

It will take a couple of years to produce a working model, D’Lima said. During that time, his work is being funded by the Shaffer Family Foundation. The goal is to show proof of concept in an animal.

Bioprinting the three-dimensional structure of most tissues, such as muscle, is extremely challenging. Not only are several types of cells often present, but they are nourished through blood flowing through a complex network of arteries, capillaries and veins. That network requires an entirely different set of cells that must be precisely laid down inside the surrounding cells.

Organovo has avoided that problem by limiting the thickness of its tissue. The company’s 3D liver tissue is 20 cells wide, still thin enough to be supplied through diffusion. This tissue is intended to be used for toxicology screening of drugs to assess their safety before being tested in people. Organovo says the tissue reproduces major metabolic functions of the liver for 30 days or more. It intends to make it available to drug companies by the end of this year.

Putting a slurry of cardiac cells into a 3D printer and making a functional human heart remains well in the realm of science fiction. But at Scripps Clinic in La Jolla, Dr. Darryl D’Lima and colleagues say they’ve pretty much figured out the process of “bioprinting” a humbler but still necessary tissue, cartilage.

A physician who holds a doctorate in bioengineering from UC San Diego, D’Lima has designed a prototype bioprinter that makes living cartilage. The bioprinter, adapted from an old Hewlett-Packard inkjet printer, sprays out a mixture of cartilage progenitor cells and a liquid that congeals under ultraviolet light. It also bioprints bone cells, to be deposited where cartilage attaches to bone.

D’Lima’s goal is to turn this technology into a true fix for knee injuries associated with cartilage damage or injuries. The tough and slippery tissue that cushions joints, cartilage doesn’t regenerate well. As those with arthritis or a knee injury will attest, the lack of cartilage allows bone to grind on bone, causing excruciating pain.

The best medical technology can do now is to install artificial knee joints, a painful procedure that is not necessarily permanent. Even so, there’s a multibillion-dollar market for knee replacements. And thanks to aging baby boomers and obesity, that market is projected to grow. The global knee replacement market brought in $6.9 billion in 2010, and is projected to reach nearly $11 billion by 2017.

D’Lima says several more years of work will be needed before his idea can be tried in people, but the main scientific challenges have been solved. What’s left is engineering. Instead of printing cartilage in a laboratory, D’Lima wants to print it directly into patients in the operating room.

Printing into the knee joint ensures a much closer fit between the new cartilage and existing cartilage than by attaching lab-grown cartilage that must be cut to fit, D’Lima said.

The cell-containing droplets are on the order of one picoliter, or one-billionth of a liter. That’s small enough to fill microscopic irregularities in the patient’s cartilage or bone.

“It would be the equivalent of filling a pothole,” he said. “It would automatically fill the defect as you’re printing it. You’re getting a fairly good mechanical integration into the tissue, which is very difficult for us to do when we do traditional transplants.”

Another advantage would be that surgery could be done as needed.

“We wouldn’t have to store something off the shelf,” D’Lima said. “We wouldn’t have to prepare it in advance, if it takes three to six weeks to make the tissue and plan for the day of surgery. All of this would be done on the day of surgery, on demand.”

Creative thinker

D’Lima brings expertise from a number of medical and research roles. He’s director of orthopedic research at Scripps’ Shiley Center for Orthopaedic Research and Education. He’s also an assistant professor in the division of arthritis research at The Scripps Research Institute and an associate professor at the Scripps Translational Science Institute, a unit of Scripps Health.

Cartilage is easier to bioprint because it lacks blood vessels, D’Lima said. The cells are nourished by diffusion through the surrounding fluid. That lack of blood supply is the reason cartilage has only a limited ability to repair itself.

“It’s complex enough that you need technology like 3D printing, but at the same time it’s not so complex that it’s extremely challenging,” D’Lima said.

Moreover, the technology is “somewhat agnostic” as to which cells are used, he said. That means it might work with other types of cells.

“We’ve gotten interest from other researchers, wanting to print retinal cells,” he said. “The retina has some similarities to cartilage in that the photoreceptors and the neural cells of the retina don’t require a blood supply. So we don’t have to print microvasculature. And the retina is a mature tissue in that if you lose a photoreceptor, that’s it. You don’t grow a new one. So it’s fairly attractive for 3D printing.”

TOPICS: Business/Economy; Culture/Society
KEYWORDS: 3dprinter; 3dprinting; bodyparts3dprinting; cartilage; medicine; stemcells
1 posted on 02/08/2014 4:46:42 PM PST by 2ndDivisionVet
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To: 2ndDivisionVet

y knees hope it works.

My guess right now is that the only thing he will accomplish is the wasting of tax dollars, just because wasting seems to be the main thing ever done with tax dollars.

2 posted on 02/08/2014 4:57:16 PM PST by Gil4 (And the trees are all kept equal by hatchet, ax and saw)
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To: Gil4

y = My.

Stupid keyboard.

3 posted on 02/08/2014 4:58:47 PM PST by Gil4 (And the trees are all kept equal by hatchet, ax and saw)
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To: 2ndDivisionVet

Maybe they can “bioprint” us some decent, moral people to run our government!

4 posted on 02/08/2014 5:07:58 PM PST by vette6387
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To: 2ndDivisionVet

If it works I’m in. Left knee is trashed, can’t walk without pain the nexrt day.

5 posted on 02/08/2014 5:08:25 PM PST by GQuagmire
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To: GQuagmire; Gil4

Did you see the part about the retinas?

6 posted on 02/08/2014 5:09:21 PM PST by 2ndDivisionVet (Jealousy is when you count someone else's blessings instead of your own.)
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To: 2ndDivisionVet

I did. All for it in either case. Unless they’re using embroyonic stem cells.

7 posted on 02/08/2014 5:15:23 PM PST by GQuagmire
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To: Gil4

My guess is that it will be a decent fix for right now.

Printing up a true replacement equal to original cartilidge may be 5 years away but printing up a thin but respectable piece of cartilidge that lasts 3-4 years should be doable right now.

I think thick true replacement is hard, but thin temporary should be easy.

8 posted on 02/08/2014 5:23:22 PM PST by staytrue
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9 posted on 02/08/2014 5:38:21 PM PST by RedMDer (Happy with this, America? Make your voices heard. 2014 is just around the corner. ~ Sarah Palin)
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To: 2ndDivisionVet

Please, please let this be successful! My left knee is so bad and I cannot even think about a knee replacement!!!

10 posted on 02/08/2014 6:27:30 PM PST by jch10 (John Beohner has got to be removed from the Speaker position.)
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To: 2ndDivisionVet

You know, you think to yourself, what on earth can they come up with next? It seems like that have gone about as far as they can go, and then they come up with something like this.

11 posted on 02/08/2014 8:13:58 PM PST by fhayek
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To: 2ndDivisionVet

Let’s hope it works! Apparently a Japanese company is perfecting a way to stimulate non-embryonic cells to “behave” like embryonic stem cells. Let’s pray that will end the use of embryonic stem cells once and for all.

12 posted on 02/08/2014 9:14:44 PM PST by Pining_4_TX (All those who were appointed to eternal life believed. Acts 13:48)
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To: 2ndDivisionVet

Bad knee, hip, and L5 here. I’ll keep them until they go adult stem cell. I don’t even like them using this for the research portion.

“to research the use of embryonic stem cells and artificial embryonic stem cells to generate replacement cartilage.”

13 posted on 02/09/2014 1:14:49 PM PST by CH3CN (Gone Galt 05/25/13)
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