Materials
The COBICS technique involves using a 3D printer that deploys a special ink made of calcium phosphate.
the ideal frequency. In 2011, when these collaborations on nanovibration in biological systems began, the first detection of gravitational waves was still in the future. Since their discovery, these links between gravitational-wave research and biology have given huge impetus to the work being carried out in Glasgow, and has enabled Salmeron-Sanchez and his research team to reach the stage they’re at now. “We are currently working with a company based in the Basque region of Spain to manufacture PEA in a way that is compatible with medical devices and so that we can go to the regulators and apply for clinical trials,” he says, adding that he is hopeful for the start of trials in the next three years if the project can secure funding from the EU amid the post-Brexit politics.
“We fi nd that low levels of BMP-2 bound to PEA+FN to allow local presentation of BMP-2 in a way that is highly bioactive yet does not compromise safety. Local BMP-2 triggers stem cells in the bone marrow to differentiate into osteoblasts, it is the trigger of the process of bone formation, and we’ve shown that it leads to bone regeneration.”
Manuel Salmeron-Sanchez Bone on demand
In Australia, research addressing the challenge of bone replacement is on a different track, using ceramic inks and 3D printing technology. By blending a ceramic ink that mimics bone architecture, scientists have found a way to create composites to replace sections of diseased or missing bone and encouraging existing structures to bind with the new artificial composite. The method, if successful, could lead to reduced pain and speedier recoveries. “Our method has the potential
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to radically change current practice, reducing patient suffering and ultimately saving lives,” says Kristopher Kilian, scientia associate professor and co-director of the Australian Centre for Nanomedicine, University of New South Wales. “It paves the way for numerous opportunities that could prove transformational.” The method he speaks of is called ceramic omnidirectional bioprinting in cell-suspensions (COBICS). In layman’s terms, that means printing bone-like structures directly into cavities in bone. The bioink is made of calcium phosphate and hardens when placed in water, meaning to replace a lost bone using COBICS would be much faster than relying on the natural process of osteogenesis. The ability to 3D print bone-like structures isn’t the novel aspect of Kilian’s research however, it’s the in-vivo 3D printing application. Still in its infancy, 3D bone printing has depended on designing and building the structure material outside of a patient’s body, relying on laboratory-based printers which are unable to operate at room temperature and need toxic chemicals to sterilise the new bone material. But using COBICS, which Kilian claims is the first method that can integrate living cells and operate at room temperature, he foresees a lightweight, portable 3D printer that can be taken into the operating rooms. “This opens up the opportunity for us to directly print a patient’s bone within a cavity during surgery,” he explains. “If proven, the system could apply for patients if they have some bone resected for disease, or if they have a tumour taken out. We can take scans of that bone, digitalise it for output to a printer and directly print within the cavity of a patient.” Kilian and his fellow researchers at the university have tested the COBICS technique, producing “excellent performance” in a rabbit model when compared with materials used in the current standard of care. The next stage is testing in larger animal models and eventually starting the regulatory approval process to move toward conducting in-human trials. There’s also the fact that the bioink is currently manufactured in-house, which limits the scale of production. “Currently, we make the ‘ink’ ourselves, but there is a lack of assistance on the manufacturing side. Support from investors would help us move forward more rapidly,” says Kilian. With both Kilian and Salmeron-Sanchez reliant on funding to continue the journey with their technologies, the holy grail remains out of reach, at least for patients. Kilian remains optimistic, however, for a better standard of care: “I imagine a day soon where a patient needing a bone graft can walk into a clinic and the anatomical structure of their bone is imaged on the computer, translated to a 3D printer, and directly printed into the cavity with their own cells.” ●
Medical Device Developments /
www.nsmedicaldevices.com
Australian Centre for Nanomedicine, University of New South Wales
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