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International Journal of Bioprinting                              Bioprinting cell-laden protein-based hydrogel




            case of nozzle walls, there may be an increase in shear stress   shear-thinning rheological behavior of silk due to β-sheet
            at the strand’s periphery, leading to lowered cellular viability.   crystallization and gelatin’s high viscosity enhanced the
            It is likely that the peripheral filaments tend to spread and   bioink’s printability, and the bioink viscosity value was the
            form cellular networks more quickly because they are in the   lowest in the range of 25–35°C, enabling printing within
            vicinity of the hydrogel surface and are not encapsulated   this temperature range. Furthermore, high cellular survival
            completely [197] . A functional difference between two cells   was ensured when gelatin and silk concentrations were 7%
            may also be the result of morphological differences between   and 1.5% w/v, respectively.
            their filaments on the exterior and the interior. When   Since compressive and tensile behaviors of the
            this matter is viewed from the perspective of bioprinting   bioprinted hydrogels are critical, Yang  et al. [204]  used
            approaches, for example, in an acoustic bioprinter, a pool of   collagen (15 mg/mL) and alginate (15 mg/mL) mixed
            bioink is directly injected with cell-encapsulated droplets   with  new-born  Sprague  Dawley  chondrocytes  (10  ×  10 6
            and deposited over the surface . Due to its nozzle-free   cells/mL)  as  a  bioink  to  print  3D six-layer  constructs
                                     [67]
            design, this technology avoids clogging issues and prevents   (2 × 2 cm ) and assessed their mechanical features. Uniaxial
                                                                      2
            detrimental shear stresses, heat, and pressure commonly   tension tests were conducted at ambient temperature
            experienced in other bioprinting methods [198,199] .   with  constructs  stretched  at  2  mm/min.  Besides,  cell-
               The bioprinting of embedded cells has previously been   laden gels with a maximum displacement of 1 mm and a
            done employing inkjet and extrusion technologies [200,201] .   speed of 0.1 mm/min were analyzed for their compressive
            For maintaining cell viability, a PBHs was used to suspend   strength.  Compared  with  the  alginate  alone  (~28  kPa),
            cells in the inkjet fluid reservoirs utilized for bubble-  collagen increased the stiffness of collagen/alginate-
            jet technology or closed fluid reservoirs utilized for   printed hydrogel by nearly 1.87 times. Additionally, the
            piezoelectric technologies in order to buffer them from   printed composite hydrogel (~41 kPa) showed remarkable
            temperatures  between  200  and  300°C [202] .  Additionally,   strengthening and toughening effects with 162.08% greater
            inkjet and extrusion technologies subject cells and protein   strength and toughness than the alginate gel (~19 kPa).
            structures to remarkable mechanical and thermal stresses.
            Exhibiting poor directionality of droplets or continuous   4.2. Biocompatibility considerations
            filaments,  achieving  non-uniform  droplet  sizes,  existing   Biocompatibility refers to the material’s ability to respond
            mechanical shear stress of ejected cellular materials at   to a specific host environment [205] ; within this context, it is
            the nozzle, and having routine nozzle clogging problems   essential to consider the biocompatibility of cell-laden PBHs
            are other drawbacks of these techniques; as a result of the   during bioprinting, in vitro maturation, immunogenicity
            mentioned obstacles, large numbers of  “empty”  droplets   of hydrogels, and long-term effects of the gels.
            are generated, contributing to significant inefficiency .   Cellular viability and proliferation can be influenced
                                                      [66]
               Although  the  nozzle  geometry  has  no  impact  on   by the hydrogel composition once  bioinks have been
            the  droplet size or  ejection  directionality, it  has been   deposited. In numerous matrix proteins and as mentioned,
            demonstrated that the geometry can cause damage to cells   the RGD motif improves the cell–matrix interactions and
            or denature protein structures in printing methods like   can promote osteogenic differentiation and cell survival.
            inkjet and extrusion. Since acoustic bioprinting employs   It is also possible to modify hydrogels with other side
            very short durations and low wavelengths, its effects on   groups and sequences like phosphate groups, covalently
            cell membranes and protein structures are negligible. It is   bound GFs, and heparin-binding domains, with the aim of
            also noteworthy to mention that during ejection, no high   increasing the creation of mineralized matrices and bone
                                                                                                        [206,207]
            pressure or heat is applied to the fluid [66,203] .  tissue  possessing  comparable  mechanical  features  .
                                                               Compared with synthetic polymers, protein-based
               Therefore,  optimizing  the  PBHs’  concentration  to   polymers like collagen, silk, keratin, serum albumin, and
            obtain optimal viscoelasticity properties during bioprinting   elastin have cell-adhesive peptide sequences that provide
            is  necessary.  Concerning  this  matter,  the  investigation   conducive  microenvironments suitable for enhancing cell
            conducted by Singh et al. [136]  focused on the development of   survival and proliferation [208] . In addition, physiological
            silk-gelatin bioinks for the cartilage tissue’s microextrusion   and biological cues present in structural proteins play a
            bioprinting. In  the first  step,  silk  (0.5% to  2%  w/v)  and   crucial role in bioink development. Additionally, protein-
            gelatin (1%  to  9%  w/v)  hydrogels  loaded  with  porcine   based materials are not only environmental friendly and
            auricular chondrocytes (1 × 10 cells/mL) were prepared.   renewable but also strong, elongated, tough, and slowly
                                     6
            Afterward, the viscosity and modulus were evaluated in   degradable. As an example, silk fibroin is one of the
            the range of 4–45°C so as to obtain a viscoelastic range for   most popular PBHs used in bioprinting. It undergoes a
            their bioink. They illustrated that the combination of the   remarkable structural transition from a random-coil to a



            Volume 9 Issue 6 (2023)                        484                          https://doi.org/10.36922/ijb.1089
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