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International Journal of Bioprinting                                     Bioprinting of a multicellular model


            two models were mainly focused on cell proliferation,   checkpoint pathway is an important mechanism of tumor
            apoptosis, cell cycle regulation, and drug resistance.   immune escape. The PD-L1 in tumor cells and the TME
            Therefore, it is reasonable to use more physiological models   binds to PD-1, restricting the host immune response. The
            for subsequent functional verification and drug screening.  expression of PD-L1 is dependent on tumor-associated M2
              Compared with colorectal cancer cells in sandwich   macrophages in the TME, which promotes the apoptosis of
            culture, the differences in upregulated genes of colorectal   antitumor T cells and the growth of colorectal cancer cells.
                                                               Tyrosine kinase inhibitors are small-molecule antitumor
            cancer cells in the 3D printing-S were mainly concentrated   drugs that can cross the cell membrane and block the
            in cell composition, followed by biological process, and
            there was little difference in molecular function.  signaling pathway of tumor cell growth and division.
                                                               Resistance to tyrosine kinase inhibitors produces a pro-
              Different types of 3D culture models have varying   cancer effect . KEGG enrichment analysis suggested that
                                                                         [46]
            effects on the proliferation and signal communication   the upregulation of the PD-1/PD-L1 checkpoint pathway
            of colorectal cancer cells. The 3D bioprinted model has   and EGFR  receptor  tyrosine  kinase  inhibitor  resistance
            a unique spatial structure. KEGG enrichment analysis   pathway in colorectal cancer cells in the 3D printing-M
            showed that focal adhesion and adhesion junctions were   was reflected in our 3D bioprinted multicellular co-culture
            the most significant pathways enriched by downregulated   model to a certain extent. The influence of the TME on tumor
            gene in the 3D printing-S and sandwich culture groups .   cells has been verified at the transcriptomic level. The hub
                                                        [43]
            The results suggest that the same bio-ink material and   differential genes between the two models (3D printing-S
            colorectal cancer cells, the 3D bioprinted model, and the   and 3D  printing-M)  include  IL1B,  FCGR2A,  FCGR3A,
            sandwich model have different cell-cell communication   CYBB, SPI1, CCL2, and other functional genes related to
            and  adhesion  mechanisms.  The  functions  of  the  hub   immune response, immune regulation, and inflammatory
            differential  genes  between  the  two  models  were  mainly   response [47,48] . The hub differential genes between the two
            focused on signal transduction, immune response, cell   models (3D printing-S and 3D printing-M) also included
            proliferation, apoptosis, lipid metabolism, etc. Cell cycle   genes  such  as  ITGAM,  ITGB2,  and other  genes  related
            regulation and signal transduction were also significantly   to cell conduction and cell adhesion [49,50] . By analyzing
            different in 3D culture of different types.        hub genes, we found that in the constructed co-culture
              In this study, we explored the influence of tumor-  model of tumor cell-mesenchymal cells, the influence
            associated macrophages M2 and endothelial cells on   of mesenchymal cells on tumor cells was implicated in
            colorectal cancer cells. The multicellular model constructed   biological processes such as cell growth, cell metabolism,
            by the concentric axis dual-nozzle 3D bioprinter is   protein modification, signal regulation, intracellular signal
            conducive to the mechanistic study of the influence of the   transduction, and intercellular communication. The TME
            TME on tumor cells. To analyze the effect of mesenchymal   composed of intermediate cells in the 3D printing-M may
            cells on the tumor cell signaling pathway, we screened for   have an impact on colorectal cancer cells, which reveals
            important hub differential genes. Compared with colorectal   the potential value of the 3D printing-M in the functional
            cancer cells in the 3D printing-S, the upregulated DEGs in   study of the effect of TME on tumor cells.
            the 3D printing-M were mostly concentrated in biological   There are also great differences between 2D culture
            processes. In terms of cell composition, the differences   models and 3D printing-S, and between 3D printing-S and
            between them were small, considering that both were   3D printing-M in the experimental results of antitumor
            3D bioprinted models. The difference between the two   drug screening. The IC  values for 5-FU in 2D culture
                                                                                  50
            models lies in the influence of the microenvironment   group and 3D printing-S group were 12.79  µM and
            on  interstitial  cells.  KEGG  enrichment  analysis  of  the   31.13 µM, respectively. The IC  value of the 3D printing-S
                                                                                       50
            enrichment pathways of DEGs in biological functions of   group was three times that of the 2D culture group, which
            colorectal cancer cells in 3D printing-M group and 3D   was more resistant to drugs. For oxaliplatin, the IC  of 2D
                                                                                                       50
            printing-S group showed that in tumor cell-mesenchymal   culture group and 3D printing-S group was 0.80 µM and
            cell co-culture model, the effects of mesenchymal cells on   26.79 µM, respectively. The concentration of 0.80 µM in
            colorectal cancer cells involve biological processes such   the 2D culture model has a significant inhibitory effect
            as cell growth, cell metabolism, protein modification,   on colorectal cancer cells, which is obviously not in line
            signal  regulation,  intracellular  signal  transduction,  and   with the actual situation of human body. In the drug
            intercellular communication. Pathways with significant   screening experiments of three chemotherapeutic drugs,
            enrichment of upregulated DEGs include the PD-1/PD-L1   the IC  measured by the 3D printing-S group was closer
                                                                    50
            checkpoint pathway and  the  EGFR  receptor  tyrosine   to the effective blood drug concentration in the human
            kinase inhibitor resistance pathway [44,45] . The PD-1/PD-L1   body, indicating that the 3D bioprinted colorectal cancer


            Volume 9 Issue 3 (2023)                        394                         https://doi.org/10.18063/ijb.694
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