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Despite advancements of modern medicine, the number of patients with the the end-stage kidney disease keeps growing, and surgical procedures to establish and maintain a vascular access for hemodialysis are rising accordingly. Surgical access of choice remains autogenous arteriovenous fistula, whereas approach “fistula first at all costs” leads to failure in certain subgroups of patients. Modern synthetic vascular grafts fail to deliver long-term results comparable with AV fistula. With all that in mind, this work has an aim of developing a new alternative vascular graft, which can be used for hemodialysis access using the methods of TE, especially electrospinning technique. It is hypothesized that electrospun scaffold, made of PCL and collagen type I may assemble mechanical properties similar to native blood vessels. Seeding such electrospun scaffolds with human microvascular endothelial cells (hmvECs) and preconditioning with shear stress and continuous flow might achieve sufficient endothelial lining being able to resist acute thrombosis. One further topic considered on-site infections, which represents one of the most spread complications of dialysis therapy due to continuous needle punctures. The main hypothesis was that during electrospinning process, polymers can be blended with antibiotics with the aim of producing scaffolds with antimicrobial properties, which could lead to reducing the risk of on-site infection on one side, while not affecting the cell viability.
This thesis encompasses the development of the additive manufacturing technology melt electrowriting, in order to achieve the improved applicability in biomedical applications and design of scaffolds. Melt electrowriting is a process capable of producing highly resolved structures from microscale fibres. Nevertheless, there are parameters influencing the process and it has not been clear how they affect the printing result. In this thesis the influence of the processing and environmental parameters is investigated with the impact on their effect on the jet speed, fibre diameter and scaffold morphology, which has not been reported in the literature to date and significantly influences the printing quality. It was demonstrated that at higher ambient printing temperatures the fibres can be hampered to the extent that the individual fibres are completely molten together and increased air humidity intensifies this effect. It was also shown how such parameters as applied voltage, collector distance, feed pressure and polymer temperature influence the fibre diameter and critical translation speed. Based on these results, a detailed investigation of the fibre diameter control and printing of scaffolds with novel architectures was made. As an example, a 20-fold diameter ratio is obtained within one scaffold by changing the collector speed and the feed pressure during the printing process. Although the pressure change caused fibre diameter oscillations, different diameter fibres were successfully integrated into two scaffold designs, which were tested for mesenchymal stromal cell suspension and adipose tissue spheroid seeding. Further design and manufacturing aspects are discussed while jet attraction to the printed structures is illuminated in connection with the fibre positioning control of the multilayer scaffolds. The artefacts that appear with the increasing scaffold height of sinusoidal laydown patterns are counteracted by layer-by-layer path adjustment. For the prediction of a printing error of the first deposited layer, an algorithm is developed, that utilizes an empirical jet lag equation and the speed of fibre deposition. This model was able to predict the position of the printing fibre with up to ten times smaller error than the of the programmed path. The same model allows to qualitatively assess the fibre diameter change along the nonlinear pattern as well as to indicate the areas of the greatest pattern deformation with the growing scaffold height. Those results will be used in the later chapters for printing of the novel MEW structures for biomedical applications. In the final chapter the concept of multimodal scaffold was combined with the suspended fibre printing, for the manufacturing of the MEW scaffolds with controlled pore interconnectivity in three dimensions. Those scaffolds were proven to be a promising substate for the control of the neurite spreading of the chick DRG neurons.
Herzschrittmachersysteme sind eine weitverbreitete Möglichkeit Herz-Kreislauf-Erkrankungen zu behandeln. Wegen der natürlichen Reaktion des Immunsystems auf Fremdkörper, erfolgt aber eine fortschreitende Verkapselung der Herzschrittmacherelektrode. Die Folge ist eine ansteigende Verminderung der Stimulationseffizienz durch Erhöhung der Anregungsschwelle. Die Integration der Elektrode in das Gewebe ist dabei mangelhaft und wird bestimmt durch Implantateigenschaften wie Größe, Flexibilität und Dimensionalität. Um die Integration zu verbessern, stellen dreidimensionale (3D) bzw. gewebeartige Elektroden eine Alternative zu den derzeit verwendeten planaren Metallelektroden dar. Zur Entwicklung einer leitfähigen, 3D und faserförmigen Elektrode wurden in dieser Arbeit Kohlenstoff-Nanofaser-Scaffolds über Elektrospinnen hergestellt. Durch die Modifikation des Fasergerüstes mit Natriumchlorid (NaCl) während der Scaffoldherstellung, konnte das Fasernetzwerk aufgelockert und Poren generiert werden. Die Kohlenstofffaser-Elektroden zeigten einen effizienten Energieübertrag, welcher vergleichbar mit heutigen Titannitrid (TiN) -Elektroden ist. Die Auflockerung des Fasergewebes hatte eine verbesserte Flexibilität des Faserscaffolds zu Folge. Neben der Flexibilität, konnte auch die Infiltration von Zellen in das poröse Faserscaffold erheblich verbessert werden. Dabei konnten Fibroblasten durch das gesamte Scaffold migrieren. Die Kompatibilität mit kardialen Zellen, die Grundvoraussetzung von Herzschrittmacherelektroden, wurde in vitro nachgewiesen. Durch die Kombination aus dem 3D-Elektrodengerüst mit einer Co-Kultur aus humanen Kardiomyozyten, mesenchymalen Stammzellen und Fibroblasten, erfolgte eine Einbettung der Elektrode in funktionelles kardiales Gewebe. Dadurch konnte ein lebender Gewebe-Elektroden-Hybrid generiert werden, welcher möglicherweise die Elektrode vor Immunzellen in vivo abschirmen kann. Eine Zusammenführung der hybriden Elektrode mit einen Tissue-Engineerten humanen kardialen Patch in vitro, führte zu Bildung einer nahtlosen Elektronik-Gewebe-Schnittstelle. Die fusionierte Einheit wurde abschließend auf ihre mechanische Belastbarkeit getestet und konnte über einen Elektroden-Anschluss elektrisch stimuliert werden.
Biofabrication is an advancing new research field that might, one day, lead to complex products like tissue replacements or tissue analogues for drug testing. Although great progress was made during the last years, there are still major hurdles like new types of materials and advanced processing techniques. The main focus of this thesis was to help overcoming this hurdles by challenging and improving existing fabrication processes like extrusion-based bioprinting but also by developing new techniques. Furthermore, this thesis assisted in designing and processing materials from novel building blocks like recombinant spider silk proteins or inks loaded with charged nanoparticles.
A novel 3D printing technique called Melt Electrospinning Writing (MEW) was used in Chapter 3 to create tubular constructs from thin polymer fibers (roughly 12 μm in diameter) by collecting the fibers onto rotating and translating cylinders. The main focus was put on the influence of the collector diameter and its rotation and translation on the morphology of the constructs generated by this approach. In a first step, the collector was not moving and the pattern generated by these settings was analyzed. It could be shown that the diameter of the stationary collectors had a big impact on the morphology of the constructs. The bigger the diameter of the mandrel (smallest collector diameters 0.5 mm, biggest 4.8 mm) got, the more the shape of the generated footprint converged into a circular one known from flat collectors. In a second set of experiments the mandrels were only rotated. Increasing the rotational velocity from 4.2 to 42.0 rpm transformed the morphology of the constructs from a figure-of-eight pattern to a sinusoidal and ultimately to a straight fiber morphology. It was possible to prove that the transformation of the pattern was comparable to what was known from increasing the speed using flat collectors and that at a critical speed, the so called critical translation speed, straight fibers would appear that were precisely stacking on top of each other. By combining rotation and translation of the mandrel, it was possible to print tubular constructs with defined winding angles. Using collections speeds close to the critical translation speed enabled higher control of fiber positioning and it was possible to generate precisely stacked constructs with winding angles between 5 and 60°.
In Chapter 4 a different approach was followed. It was based on extrusion-based bioprinting in combination with a hydrogel ink system. The ink was loaded with nanoparticles and the nanoparticle release was analyzed. In other words, two systems, a printable polyglycidol/hyaluronic acid ink and mesoporous silica nanoparticles (MSN), were combined to analyze charge driven release mechanism that could be fine-tuned using bioprinting. Thorough rheological evaluations proved that the charged nanoparticles, both negatively charged MSN-COOH and positively charged MSN-NH2, did not alter the shear thinning properties of the ink that revealed a negative base charge due to hyaluronic acid as one of its main components. Furthermore, it could be shown that the particles did also not have a negative effect on the recovery properties of the material after exposure to high shear. During printing, the observations made via rheological testing were supported by the fact that all materials could be printed at the same settings of the bioprinter. Using theses inks, it was possible to make constructs as big as 12x12x3 mm3 composed of 16 layers. The fiber diameters produced were about 627±31 μm and two-component constructs could be realized utilizing the two hydrogel print heads of the printer to fabricate one hybrid construct. The particle distribution within those constructs was homogeneous, both from a microscopic and a macroscopic point of view. Particle release from printed constructs was tracked over 6 weeks and revealed that the print geometry had an influence on the particle release. Printed in a geometry with direct contact between the strands containing different MSN, the positively charged particles quickly migrated into the strand previously containing only negatively charged MSN-COOH. The MSN-COOH seemed to be rather released into the surrounding liquid and also after 6 weeks no MSN-COOH signal could be detected in the strand previously only containing MSN-NH2. In case of a geometry without direct contact between the strands, the migration of the positively charged nanoparticles into the MSN-COOH containing strand was strongly delayed. This proved that the architecture of the printed construct can be used to fine-tune the particle release from nanoparticle containing printable hydrogel ink systems.
Chapter 5 discusses an approach using hydrogel inks based on recombinant spider silk proteins processed via extrusion-based bioprinting. The ink could be applied for printing at protein concentrations of 3 % w/v without the addition of thickeners or any post process crosslinking. Both, the recombinant protein eADF4(C16) and a modification introducing a RGD-sequence to the protein (eADF4(C16)-RGD), could be printed revealing a very good print fidelity. The RGD modification had positive effect on the adhesion of cells seeded onto printed constructs. Furthermore, human fibroblasts encapsulated in the ink at concentrations of 1.2 million cells per mL did not alter the print fidelity and did not interfere with the crosslinking mechanism of the ink. This enabled printing cell laden constructs with a cell survival rate of 70.1±7.6 %. Although the cell survival rate needs to be improved in further trials, the approach shown is one of the first leading towards the shift of the window of biofabrication because it is based on a new material that does not need potentially harmful post-process crosslinking and allows the direct encapsulation of cells staying viable throughout the print process.