Design and Fabrication of Mature Engineered Pre-Cardiac Tissue Utilizing 3D Bioprinting Technology and Enzymatically Crosslinking Hydrogel.

The fabrication of mature engineered cardiac tissue is one of the major challenges in cardiac tissue engineering. For this purpose, we attempted to apply the 3D bioprinting approach. Aiming to construct an oriented tissue, a fine fiber-shaped scaffold with a support structure was first designed using CAD software. Then, a 3D bioprinter and cell-adhesive bio-inks were utilized to fabricate this structure. The cell-adhesive bio-inks were synthesized by combining sodium alginate and gelatin with tyramine, respectively, to form pre-gel materials that allow enzymatic crosslinking by horseradish peroxidase. By absorbance measurements, we confirmed that the tyramine modification rate of each polymer was 0.535 mmol/g-alginate and 0.219 mmol/g-gelatin. The width of the fiber-shaped scaffold was 216.8 ± 24.3 µm for the fabricated scaffold, while the design value was 200 µm. After 3D printing and adhesion-adding treatment of the scaffold with these bio-ink materials, cardiomyocytes were seeded and cultured. As a result, the cells spread onto the scaffold, and the entire pre-tissue contracted synchronously by day 6 of culture, showing a greater pulsatility than in the early days. Video analysis showed that the beating rate of pre-myocardial tissue on day 6 was 31 beats/min. In addition, we confirmed that the cardiomyocytes partially elongated along the long axis of the fiber-shaped scaffold in the pre-tissue cultured for 15 days by staining actin, suggesting the possibility of cell orientation. Furthermore, treatment with adrenaline resulted in a 7.7-fold increase in peak beating rate compared to that before treatment (from 6 beats/min to 46 beats/min), confirming the responsiveness of the pre-tissues to the drug. These results indicate that 3D bioprinting effectively produces mature cultured myocardial tissue that is oriented, contracts synchronously, and is responsive to drugs.

Cardiotoxicity assessment using 3D vascularized cardiac tissue consisting of human iPSC-derived cardiomyocytes and fibroblasts.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are used for cardiac safety assessment but have limitations for the evaluation of drug-induced contractility. Three-dimensional (3D) cardiac tissues are similar to native tissue and valuable for the assessment of contractility. However, a longer time and specialized equipment are required to generate 3D tissues. We previously developed a simple method to generate 3D tissue in a short period by coating the cell surfaces with extracellular matrix proteins. We hypothesized that this 3D cardiac tissue could be used for simultaneous evaluation of drug-induced repolarization and contractility. In the present work, we examined the effects of several compounds with different mechanisms of action by cell motion imaging. Consequently, human ether-a-go-go-related gene (HERG) channel blockers with high arrhythmogenic risk caused prolongation of contraction-relaxation duration and arrhythmia-like waveforms. Positive inotropic drugs, which increase intracellular Ca2+ levels or myocardial Ca2+ sensitivity, caused an increase in maximum contraction speed (MCS) or average deformation distance (ADD) (ouabain, 138% for MCS at 300 nM; pimobendane, 132% for ADD at 3 µM). For negative inotropic drugs, verapamil reduced both MCS and ADD (61% at 100 nM). Thus, this 3D cardiac tissue detected the expected effects of various cardiovascular drugs, suggesting its usefulness for cardiotoxicity evaluation.

Mechanical activities of self-beating cardiomyocyte aggregates under mechanical compression.

Since the discovery of synchronous pulsations in cardiomyocytes (CMs), electrical communication between CMs has been emphasized; however, recent studies suggest the possibility of mechanical communication. Here, we demonstrate that spherical self-beating CM aggregates, termed cardiac spheroids (CSs), produce enhanced mechanical energy under mechanical compression and work cooperatively via mechanical communication. For single CSs between parallel plates, compression increased both beating frequency and beating energy. Contact mechanics revealed a scaling law on the beating energy, indicating that the most intensively stressed cells in the compressed CSs predominantly contributed to the performance of mechanical work against mechanical compression. For pairs of CSs between parallel plates, compression immediately caused synchronous beating with mechanical coupling. Compression tended to strengthen and stabilize the synchronous beating, although some irregularity and temporary arrest were observed. These results suggest that mechanical compression is an indispensable control parameter when evaluating the activities of CMs and their aggregates.

Supersensitive Layer-by-Layer 3D Cardiac Tissues Fabricated on a Collagen Culture Vessel Using Human-Induced Pluripotent Stem Cells.

Background: The fabrication of artificial cardiac tissue is an active area of research due to the shortage of donors for heart transplantation and for drug development. In our previous study, we fabricated vascularized three-dimensional (3D) cardiac tissue by layer-by-layer (LbL) and cell accumulation technique. However, it was not able to develop sufficient function because it was cultured on a hard plastic substrate. Experiment: Herein, we report the fabrication of high-performance 3D cardiac tissue by LbL and cell accumulation technique using a collagen culture vessel. Results: By using a collagen culture vessel, 3D cardiac tissue could be fabricated on a collagen culture vessel and this tissue showed high functionality due to improved interaction with the vessel. In the case of the plastic culture insert, 3D cardiac tissue was found to be peeled off, but this did not occur on the collagen culture vessel. In addition, the 3D cardiac tissue fabricated on a collagen culture vessel showed contraction that was 20 times larger than the tissue fabricated on a plastic culture insert. As a result of evaluation of cardiotoxicity using E-4031, the sensitivity of arrhythmia detection was increased by using collagen culture vessel. Conclusions: These results are expected to contribute to transplantation and drug discovery research as a 3D cardiac tissue model with a function similar to that of the living heart.

Noninvasive optical coherence tomography imaging of three-dimensional cardiac tissues derived from human induced pluripotent stem cells.

Artificial three-dimensional (3D) tissues have the potential to be used in regenerative medicine or in vitro screening. In particular, the fabrication of 3-D cardiac tissues is greatly anticipated. However, hierarchical organization of 3-D tissues is still unknown. In regenerative medicine and drug discovery, noninvasive evaluation methods of 3-D tissues including inside of it play a key role. In this study, we report on noninvasive methods of analyzing bio-fabricated 3-D cardiac tissues using optical coherence tomography (OCT) and image analysis. Three-dimensional cardiac tissues were fabricated by coating of extracellular matrix nanofilms onto a cell surface using a layer-by-layer (LbL) technique. At first, we investigated the relationship between surface beating and its thickness to assess the value of internal analysis. The results showed that the surface beating was influenced by the thickness. Next, we tried to quantitatively evaluate the internal beating of 3-D cardiac tissues. We also confirmed the methods by changing the beating properties through the administration of isoproterenol. Our results demonstrated that the beating properties of 3-D cardiac tissues differed by depth. The results of this study suggest that information on the internal properties of 3-D cardiac tissue was necessary to understand how it functions. The combination of OCT and image analysis can be used to evaluate the internal beating properties, including changes in beating induced by a drug. It is suggested that OCT and image analysis have the potential to be used as noninvasive methods in regenerative medicine and pharmaceutical applications.

Vascularized cardiac tissue construction with orientation by layer-by-layer method and 3D printer.

Herein, we report the fabrication of native organ-like three-dimensional (3D) cardiac tissue with an oriented structure and vascular network using a layer-by-layer (LbL), cell accumulation and 3D printing technique for regenerative medicine and pharmaceutical applications. We firstly evaluated the 3D shaping ability of hydroxybutyl chitosan (HBC), a thermoresponsive polymer, by using a robotic dispensing 3D printer. Next, we tried to fabricate orientation-controlled 3D cardiac tissue using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) and normal human cardiac fibroblasts (NHCF) coated with extracellular matrix (ECM) nanofilms by layer-by-layer technique. These cells were seeded in the fabricated rectangular shape HBC gel frame. After cultivation of the fabricated tissue, fluorescence staining of the cytoskeleton revealed that hiPSC-CM and NHCF were aligned in one direction. Moreover, we were able to measure its contractile behavior using a video image analysis system. These results indicate that orientation-controlled cardiac tissue has more remarkable contractile function than uncontrolled cardiac tissue. Finally, co-culture with human cardiac microvascular endothelial cells (HMVEC) successfully provided a vascular network in orientation-controlled 3D cardiac tissue. The constructed 3D cardiac tissue with an oriented structure and vascular network would be a useful tool for regenerative medicine and pharmaceutical applications.

Construction of 3D cardiac tissue with synchronous powerful beating using human cardiomyocytes from human iPS cells prepared by a convenient differentiation method.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) as a new source of cardiac cells are expected to find use as tools in high-throughput screening for drug candidates and cardiotoxicity validation without the need for experimentation on animals. In recent years, it has been reported that drug screening using three-dimensional (3D) tissue is better than conventional 2D culture. Various methods have been developed for mass culture of hiPSC-CMs, and embryoid body (EB) formation is necessary in the majority of differentiation methods as this is reported to promote the differentiation of hiPSCs. However, these operations result in increased processing, cost and loss of hiPSCs. Here, we show alternative methods for differentiation to hiPSC-CMs from <100 µm hiPSC-clumps without EB formation and report on a 3D-tissue fabrication using hiPSC-CMs. The 3D cardiac tissue constructed by a layer-by-layer (LbL) cell coating technique (LbL-3D Heart) showed synchronous powerful beating. We conclude that this method enables cost-effective, reproducible and scalable hiPSC-CM production with high activity for tissue engineering, drug screening and regenerative medicine.

A Layer-by-Layer Single-Cell Coating Technique To Produce Injectable Beating Mini Heart Tissues via Microfluidics.

Human induced pluripotent stem cells (hiPSCs) are used as an alternative for human embryonic stem cells. Cardiomyocytes derived from hiPSCs are employed in cardiac tissue regeneration constructs due to the heart's low regeneration capacity after infarction. A coculture of hiPSC-CM and primary dermal fibroblasts is encapsulated in injectable poly(ethylene glycol)-based microgels via microfluidics to enhance the efficiency of regenerative cell transplantations. The microgels are prepared via Michael-type addition of multi-arm PEG-based molecules with an enzymatically degradable peptide as a cross-linker and modified with a cell-adhesive peptide. Cell-cell interactions and, consequently, cell viability are improved by a thin extracellular matrix (ECM) coating formed on the cell surfaces via layer-by-layer (LbL) deposition. The beating strength of encapsulated cardiomyocytes (∼60 BPM) increases by 2-fold compared to noncoated cells. The combination of microfluidics with the LbL technique offers a new technology to fabricate functional cardiac mini tissues for cell transplantation therapies.

Micro Vacuum Chuck and Tensile Test System for Bio-Mechanical Evaluation of 3D Tissue Constructed of Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes (hiPS-CM).

In this report, we propose a micro vacuum chuck (MVC) which can connect three-dimensional (3D) tissues to a tensile test system by vacuum pressure. Because the MVC fixes the 3D tissue by vacuum pressure generated on multiple vacuum holes, it is expected that the MVC can fix 3D tissue to the system easily and mitigate the damage which can happen by handling during fixing. In order to decide optimum conditions for the size of the vacuum holes and the vacuum pressure, various sized vacuum holes and vacuum pressures were applied to a normal human cardiac fibroblast 3D tissue. From the results, we confirmed that a square shape with 100 µm sides was better for fixing the 3D tissue. Then we mounted our developed MVCs on a specially developed tensile test system and measured the bio-mechanical property (beating force) of cardiac 3D tissue which was constructed of human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM); the 3D tissue had been assembled by the layer-by-layer (LbL) method. We measured the beating force of the cardiac 3D tissue and confirmed the measured force followed the Frank-Starling relationship. This indicates that the beating property of cardiac 3D tissue obtained by the LbL method was close to that of native cardiac tissue.

Engraftment and morphological development of vascularized human iPS cell-derived 3D-cardiomyocyte tissue after xenotransplantation.

One of the major challenges in cell-based cardiac regenerative medicine is the in vitro construction of three-dimensional (3D) tissues consisting of induced pluripotent stem cell-derived cardiomyocyte (iPSC-CM) and a blood vascular network supplying nutrients and oxygen throughout the tissue after implantation. We have successfully built a vascularized iPSC-CM 3D-tissue using our validated cell manipulation technique. In order to evaluate an availability of the 3D-tissue as a biomaterial, functional morphology of the tissues was examined by light and transmission electron microscopy through their implantation into the rat infarcted heart. Before implantation, the tissues showed distinctive myofibrils within iPSC-CMs and capillary-like endothelial tubes, but their profiles were still like immature. In contrast, engraftment of the tissues to the rat heart led the iPSC-CMs and endothelial tubes into organization of cell organelles and junctional apparatuses and prompt development of capillary network harboring host blood supply, respectively. A number of capillaries in the implanted tissues were derived from host vascular bed, whereas the others were likely to be composed by fusion of host and implanted endothelial cells. Thus, our vascularized iPSC-CM 3D-tissues may be a useful regenerative paradigm which will require additional expanded and long-term studies.

Fabrication of Orientation-Controlled 3D Tissues Using a Layer-by-Layer Technique and 3D Printed a Thermoresponsive Gel Frame.

Herein, we report the fabrication of orientation-controlled tissues similar to heart and nerve tissues using a cell accumulation and three-dimensional (3D) printing technique. We first evaluated the 3D shaping ability of hydroxybutyl chitosan (HBC), a thermoresponsive polymer, by using a robotic dispensing 3D printer. HBC polymer could be laminated to a height of 1124 ± 14 µm. Based on this result, we fabricated 3D gel frames of various shapes, such as square, triangular, rectangular, and circular, for shape control of 3D tissue and then normal human cardiac fibroblasts (NHCFs) coated with extracellular matrix nanofilms were seeded in the frames. Observation of shape-controlled tissues after 1 day of cultivation showed that the orientation of fibroblasts was in one direction when a short-sided, thin, rectangular-shaped frame was used. Next, we tried to fabricate orientation-controlled tissue with a vascular network by coculturing NHCF and normal human cardiac microvascular endothelial cells. As a consequence of cultivation for 4 days, observation of cocultured tissue confirmed aligned cells and blood capillaries in orientation-controlled tissue. Our results clearly demonstrated that it would be possible to control the cell orientation by controlling the shape of the tissues by combining a cell accumulation technique and a 3D printing system. The results of this study suggest promising strategies for the fabrication of oriented 3D tissues in vitro. These tissues, mimicking native organ structures, such as muscle and nerve tissue with a cell alignment structure, would be useful for tissue engineering, regenerative medicine, and pharmaceutical applications.

Fabrication of 3D-culture platform with sandwich architecture for preserving liver-specific functions of hepatocytes using 3D bioprinter.

The development of new three-dimensional (3D) cell culture system that maintains the physiologically relevant signals of hepatocytes is essential in drug discovery and tissue engineering research. Conventional two-dimensional (2D) culture yields cell growth, proliferation, and differentiation. However, gene expression and signaling profiles can be different from in vivo environment. Here, we report the fabrication of a 3D culture system using an artificial scaffold and our custom-made inkjet 3D bioprinter as a new strategy for studying liver-specific functions of hepatocytes. We built a 3D culture platform for hepatocytes-attachment and formation of cell monolayer by interacting the galactose chain of galactosylated alginate gel (GA-gel) with asialoglycoprotein receptor (ASGPR) of hepatocytes. The 3D geometrical arrangement of cells was controlled by using 3D bioprinter, and cell polarity was controlled with the galactosylated hydrogels. The fabricated GA-gel was able to successfully promote adhesion of hepatocytes. To observe liver-specific functions and to mimic hepatic cord, an additional parallel layer of hepatocytes was generated using two gel sheets. These results indicated that GA-gel biomimetic matrices can be used as a 3D culture system that could be effective for the engineering of liver tissues. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1583-1592, 2017.