Bioprinting maps out Dubai’s medical future

Cutting-edge technology using 3D printers to produce living human organs, joints and tissue is set to change surgery and speed the development of new medicines. This country aims to be at the forefront of these techniques.

The health care market in the Mena region is set to soar by 60 per cent in five years. Courtesy Al Qassimi Hospital

The development of 3D printing in the medical sector, known as bioprinting, will radically alter transplant and reconstructive surgery as well as drug development, experts say, and the UAE hopes to be in the front line of the revolution.

The Dubai Health Authority (DHA) and Arab Health Exhibition and Congress in February forged a strategic partnership to give healthcare professionals in the region an insight into the future of 3D bioprinting.

“The DHA has prioritised fostering the development of future technologies such as 3D printing in health care,” says Dr Mohammad Al Redha, the director of the executive office for organisational transformation at the DHA.

He says there are “three core pillars of 3D printing: awareness; regulation; and implementation”.

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At a glance:

■ What: A high-tech approach to treatment is set to reap significant commercial rewards.

■ Why: Advanced 3D medical technology will increase the success of transplants and fast-track new medicines.

■ Further reading: While you're printing your new organs, why not print a new home as well?

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Advanced technology in medicine is a market with huge potential. In this country, the healthcare market is set to soar by 60 per cent in five years, according to a study in March by Mena Research Partners (MRP).

The current Dh64 billion market will surge to more than Dh103bn in 2021, driven by a shift in demand for preventive care, a rise in specialist medical services, and more efficiently integrated healthcare solutions, according to the report. And 3D printing will play a major role.

Erik Gatenholm and Dr Hector Martinez, the co-founders of Cellink, a Sweden-based biotech company that commercialises bio-inks for 3D bioprinting of human organs and tissue – the first such company in the world – say the technology will radically change the medical landscape.

"Bioprinting offers a vast range of possibilities to make an impact on different areas such as drug development, organ transplants and cosmetics," Dr Martinez, who is the firm's chief technical officer, tells The National.

“Bioprinting allows for the precise positioning of multiple cell types within a construct, thus imitating or mimicking the native tissue. Like other biofabrication methods, the integration of capillary size vessels is a big challenge,” adds Dr Martinez.

Bioprinting utilises 3D-printing technology combined with bio-ink to create complex three-dimensional structures. A bio-ink provides a temporary support to the cells while they produce their own extracellular matrix (EM). An EM is a non-cellular component present within all tissues and organs, and provides not only the essential physical “scaffolding” for the cellular constituents but also initiates crucial biochemical and biomechanical cues that are required for normal growth of the various tissues. Bio-inks based on biopolymers such as collagen, gelatin and silk, among others, are known for their favourable biocompatible properties and are useful biomaterials for cell encapsulation and 3D bioprinting.

The main motive of cell encapsulation technology is to overcome the existing problem of graft rejection in tissue engineering applications and thus reduce the need for long-term use of immunosuppressive drugs.

By using bio-ink the structures can be built with living cells to create real, living tissue.

Steve Kunszabo, the vice president for investor relations and corporate communications, at the US-based bioprinting company Organovo, points to other commercial applications for 3D medical printing. "One is drug discovery and development such as preclinical safety/toxicity testing and efficacy/disease modelling," he tells The National. Because new pharmaceuticals can be tested on living organs created outside the human body, the speed of medicinal development could be hugely increased at no risk to patients.

“Another is therapeutic tissues such as liver patches as a ‘bridge to transplant’,” Mr Kunszabo adds.

In the drugs sector alone, the commercial opportunities are enormous. The worldwide market for pharmaceuticals is projected to grow from around $1 trillion in 2015 to $1.3 trillion by 2020, representing an annual growth rate of 4.9 per cent, according to a report by the US department of commerce.

Meanwhile, the report adds, market growth is shifting toward emerging markets in Asia, Latin America and elsewhere, where pharmaceutical sales are forecast to expand at double digit rates.

“3D printing is revolutionising health care, from the possibilities of printing medication to radically changing the design behind prosthetics,” says Dr Al Redha. “The capability to print such fine and intricate details is not available on any other technology.

“By producing 100 per cent identical models of organs, additive manufacturing helps improve patient outcomes in so many ways such as preoperative surgical planning, especially for complicated surgeries.”

In other words, surgeons could practice on living organs without worrying about whether the patient will survive or not.

To further boost development, this country is putting significant investment into leading the adoption of 3D printing.

Dr Peter Kim, is the vice-president and associate surgeon-in-chief of the Joseph E Roberts Jr Centre for Surgical Care at Washington DC’s Children’s National – which has received millions of dollars in donations from the UAE Government.

Dr Kim foresees a time when patients needing replacement organs such as kidneys, livers or eyes, for instance, doctors will simply order them.

“This is where we are going. You will [in the future] be able to have organs on the shelf. Instead of harvesting it, you can print it,” he says.“Initially, we are starting with structural tissues like knee joints, meniscus, bones. But ultimately, you’ll be able to incorporate functional tissue into it,” he adds. “We’re probably five to seven years away from that. It’s like an inkjet, and you can put different cartridges for different cell types.”

In addition to testing and biological replacement, reconstructive medicine is an area that is likely to be significantly changed by the advent of bioprinting.

Even minor deformities, whether it is an actual or perceived defect, bring psychological distress upon the affected individuals, especially children, Cellink says.

An outer appearance with lifelike limbs and tissues is important for their psychological and emotional well-being.

For these reasons, tissue engineers, biologists, material scientists and clinicians are working to develop successful clinical therapies for reconstruction through a tissue engineering approach using the patient’s own cells.

As techniques and equipment improves, the procedures will also become more affordable, says Mr Gatenholm, who is the chief executive of Cellink.

Is it possible then that an entire human could be bioprinted in the future?

“Sort of,” says Mr Gatenholm “Scientist are already working on human [cells] on a chip. Scientist at Wake Forest University are working, essentially, with small pieces of organs and connecting them to a human system. This could lead to drug discovery and testing of new products.”

That may throw up some non-technical challenges, he says. “Regulatory, [for instance] how will this be regarded from a regulatory standpoint?”

Whatever the hurdles ahead, Dr Al Redha says bioprinting will ultimately benefit the medical well-being of the UAE’s residents.

“Whether it’s through showing a patient a 3D printed replica of their malignant kidney to convince them to undergo life-saving surgery, or giving a child new hope through a prosthetic arm, 3D printing is set to touch the lives of many patients in the UAE.”

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