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  • Writer's picturePre-Collegiate Global Health Review

3D Bioprinting: Revolutionary or Unethical?

By Zali Y. Akiba, Mounds View High School, Arden Hills, Minnesota, USA

Summary

3D bioprinting involves the utilization of cells and cell-compatible materials stacked on each other to print tissues. This paper examines whether the benefits of 3D bioprinting outweigh its challenges. In this opinion article, we will explore the strengths and weaknesses that elevate and hinder 3D bioprinting. Strengths of 3D bioprinting include addressing organ shortage and advancing medical research. On the other hand, the weaknesses are its high costs, accessibility, and abundance of variables (such as contamination, cell concentration and needle pressure) that can influence its product efficiency. 3D bioprinting, with further study and regulations, can be of benefit to global health as it may advance regenerative medicine.

 

Bioprinting Overview

Despite the wide variety of bioprinters, each have similar processes in terms of the overall printing process. Most bioprinters differ in the way they distribute their bioink (Anupapa, 2022). There are three steps in 3D bioprinting; pre-bioprinting, bioprinting, and post-bioprinting. Pre-bioprinting consists of reading the tissues or organs via various imaging techniques followed by replicating the patient’s cells. Then, cells are mixed with various substances such as polymers to create the “ink”. In bioprinting, the cell bioink mixture produces the desired structure. Finally, the tissues are incubated during post-bioprinting to provide stability and encourage growth (Papaioannou, 2019).

Bioprinting Advantages

One of the applications of 3D bioprinting is organ printing. The world is facing a shortage of organs. In the United States alone, 105,948 individuals are on waiting lists for organs (Health Resources and Services Administration, 2022). Countless people die because of this shortage, and bioprinting may be a solution. Bioengineers have already created complex vascular networks that transport waste and fluids throughout the body and have successfully printed a functional blader (Leon, 2021). Although there is still much progress to be made with organ printing, current research shows promising results (Kent, 2020).


3D Bioprinting also widens the scope of medical research. 3D models made by bioprinters allow scientists to better understand cell and organ functions used in various fields of research. A few frequently recurring topics are cancer and drug use (Vermeulen et al., 2017). Common models such as 2D and animal models have a variety of weaknesses that decrease their representation of real biological environments. The use of these less-accurate 2D models results in many ineffective cancer treatments passing clinical trial phases. Problems surface during treatment because there are many differences between the 2D models and the actual cancer environment (Sbirkov, 2021). Animal models also have various discrepancies among which the most notable is the physiological differences between animals and humans. On the other hand, 3D models made through bioprinting are much more realistic. These models can accurately represent the cancer microenvironment and the complexity of each patient’s particular tumor (Zhang, 2016).

Bioprinting Disadvantages

Although bioprinting has promising benefits to global health, there are many drawbacks. The downside that deters most patients is the price. Companies have to make major investments in bioprinting, and it requires specialized staff to operate and perform maintenance. There is also the cost of the cell-compatible bioink and other inputs. However, with further research, 3D bioprinters will be able to become more cost-effective and help individuals and hospitals to save money in the long run.


A national downside of bioprinting is the United States' monopoly problem as many industries in the United States are heavily centralized. These newly developed healthcare sectors (such as 3D Bioprinting) have high startup costs that prevent the development of competitors (Garber, 2019). 3D Bioprinters alone can cost over $100,000, which encourages consolidation because of the high investment price (Loannidis, 2020). This causes bioprinting to become inaccessible. Both hospitals and patients will be unable to afford bioprinters or their benefits. There are very few solutions to solving the monopolized healthcare industry because The Federal Trade Commission cannot enforce antitrust laws (laws that protect consumers by encouraging competition) on nonprofits. Even so, this issue could be solved through stricter regulations such as implementing harsher antitrust regulations (Garber, 2019).


Another drawback to bioprinting is that various variables such as contamination, cell concentration and pressure affect the efficiency of products. Contamination can come from toxins in the bioink that are not compatible with the initial cells. Cells must also have a specific permeability to prevent apoptosis (cell death). High cell concentration that restricts permeability may cause cell death. The type of needle and pressure may also affect the cell's usability. Smaller needles increase pressure on cell cultures which may damage the cells (Malekpour, 2022). These very small details can decrease product efficiency because cells are incredibly sensitive. Even the slightest change to a cell’s environment can cause apoptosis and attempting to control these variables takes a considerable amount of time.


Author’s Opinion

I believe in 3D bioprinting and its ability to improve and become even better than before. Bioprinting has many weaknesses that could prevent it from delivering its benefits at the maximum capacity, but many technologies have been through this process. If more extensive research helps solve the various problems of bioprinting (such as researching what materials should not be mixed with cells in the bioink and the ideal density of various types of tissues), then it will more efficiently reduce organ shortages and advance medical research. Newly developed technology always has had various failures, but with time researchers have found solutions to improve their product. Generally, 3D bioprinting as a whole is beneficial.


References

Ezze, P. (2017). 3D bioprinting in the process. File:Bioprinting.jpg. Wikimedia Commons. Retrieved July 18, 2022, from https://commons.wikimedia.org/wiki/File:Bioprinting.jpg


Health Resources & Services Administration. (2022, March). Organ Donation Statistics . Learn About Donation. Retrieved May 17, 2022, from https://www.organdonor.gov/learn/organ-donation-statistics

Ioannidis, K., Danalatos, R. I., Champeris Tsaniras, S., Kaplani, K., Lokka, G., Kanellou, A., Papachristou, D. J., Bokias, G., Lygerou, Z., & Taraviras, S. (2020, November 04). A Custom Ultra-low-cost 3D Bioprinter Supports Cell Growth and Differentiation. Tissue Engineering and Regenerative Medicine . Retrieved May 18, 2022, from https://www.frontiersin.org/articles/10.3389/fbioe.2020.580889/full#:~:text=However%2C%20current%20commercially%20available%203D,and%20maintenance%2C%20limiting%20their%20applicability

Judith Garber. (2019, August 16). The Monopolization of Health Care Goes Beyond Hospitals. Lown Reports. Retrieved May 19, 2022, from https://lowninstitute.org/the-monopolization-of-health-care-goes-beyond-hospitals/

Kent Chloe. (2020, March 2). How long before bioprinting replaces the need for donor organs? Medical Device Network: Analysis. Retrieved May 18, 2022, from https://www.medicaldevice-network.com/analysis/bioprinting-replace-donor-organs/

Leon, J. (2021, February 26). 3D organ bioprinting gets a breath of fresh air: UW bioengineering. UW Bioengineering. Retrieved May 20, 2022, from https://bioe.uw.edu/3d-organ-bioprinting-gets-a-breath-of-fresh-air/#:~:text=Bioengineers%20have%20cleared%20a%20major,lymph%20and%20other%20vital%20fluids

Malekpour, A., & Chen, X. (2022). Printability and Cell Viability in Extrusion-Based Bioprinting from Experimental, Computational, and Machine Learning Views. Journal of functional biomaterials, 13(2), 40. https://doi.org/10.3390/jfb13020040

Papaioannou, T. G., Manolesou, D., Dimakakos, E., Tsoucalas, G., Vavuranakis, M., & Tousoulis, D. (2019). 3D Bioprinting Methods and Techniques: Applications on Artificial Blood Vessel Fabrication. Acta Cardiologica Sinica, 35(3), 284–289. https://doi.org/10.6515/ACS.201905_35(3).20181115A

Sbirkov, Y., Molander, D., Milet, C., Bodurov, I., Atanasov, B., Penkov, R., Belev, N., Forraz, N., McGuckin, C., & Sarafian, V. (2021, November 18). A Colorectal Cancer 3D Bioprinting Workflow as a Platform for Disease Modeling and Chemotherapeutic Screening. Biomaterials. Retrieved May 18, 2022, from https://www.frontiersin.org/articles/10.3389/fbioe.2021.755563/full

Vermeulen, N., Haddow, G., Seymour, T., Faulkner-Jones, A., & Shu, W. (2017, September 1). 3D Bioprint Me: A Socioethical View of Bioprinting Human Organs and Tissues. Journal of Medical Ethics. Retrieved May 18, 2022, from https://jme.bmj.com/content/43/9/618

Zhang, Y. S., Duchamp, M., Oklu, R., Ellisen, L. W., Langer, R., & Khademhosseini, A. (2016, October 10). Bioprinting the cancer microenvironment. National Center of Biotechnology Information. Retrieved May 18, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328669/#:~:text=Bioprinting%20the%20Vasculature,of%20in%20vitro%20cancer%20models.&text=Bioprinting%20has%20the%20unique%20capability,structures%20into%20engineered%203D%20tissues


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