What is the future? Perhaps it’s flying cars cruising past technological infrastructure or maybe even the concept of mass teleportation devices for convenience. While we still may not have those ideas actualized within the real world, what if we had something else? What if we had a way of solving our national health crisis at the tip of our finger?
Bioprinting — a mechanism used to artificially manufacture human tissues and structures — is the future of science, public health, and medicinal research. It combines hydrogelatinous biomaterials with living cells to create what is known as bioink. Just like a standard 3D printer, bioink is used to construct models of living tissues which are most prominently used for transplants and regenerative research.
The birth of bioprinting stems directly from cooperation — a key component of an innovative scientific process. From Charles Hull’s invention of stereolithography (SLA) in 1984, which converted digitized blueprints into 3D models, to Robert Klebe’s 1988 formulation of cytoscribing technology, which allowed computers to meticulously place cells and proteins to construct tissues, it is evident to see that bioprinting originated from ideas far before its monumental moment of application in 1999. Other prominent figures in the field, including David Odde, Michael Renn and Rolf Muelhaupt, helped officiate the beginning of a new chapter by incorporating a new perspective: the third dimension.
Since then, many other researchers have built onto this concept of revolutionizing our understanding of biology; in 2019, for example, researcher Nadav Noor customized hydrogel such that bioprinting technology could fabricate completely autonomous organs, including fully functioning hearts. In previous years, namely 2003, the first article displaying the conceptual blueprint of printing organs had been considered but not thoroughly initiated, as seen with Noor’s contributions. It wasn’t until later that researchers concluded that this step of progression could not only be used for patient-specific organ transplantation without triggering immunological responses, but it could allow medical researchers to accurately investigate the effects of specific drugs without needing volunteer donors.
Cell printing has the potential to account for the shortage of donors in recent years by considering the nuances of human health and providing opportunity to those who may need transplants—or at least in theory. For example, in 2016 there were ten times as many organ transplant recipients as willing donors — 160,000 to 16,000 respectively. Though this concept is not a complete solution to the social crisis at hand, its replicative in vivo structure, or research done on living organisms, maximizes the identicality of a naturally occurring microenvironment. On top of this, it transforms the meaning of in vitro research, or research done on a smaller scale with test tubes, by fostering an increasingly effective virtual space. In other words, bioprinting helps disassemble preconceived notions of hesitancy by developing a system that realistically replicates substantive life processes.
In practice, this can be seen with the artificial construction of ovaries in Russia. In an attempt to address ovarian cancer, preserve fertility, and allow families to have genetically related children, this monumental piece of technology has played a key role in restoring the futures of different families. Generally, the risks associated with ovary transplantation are minimal, but, as Anastasia Kirillova mentions in her analysis of bioprinting, any form of “unnatural” manipulation has its own pitfalls. Kirillova specifically focuses on how follicle manipulation could lead to genetic and epigenetic mutations often associated with variations of cancer. Not only would this affect the eggs responsible for future fertility, but it could possibly endanger the baby’s health. Consequently, there have also been other concerns, including the right of sharing information about a baby’s “artificial birth,” who has the right of ownership over the printed organ, and what happens if someone’s body rejects the transplantation. Overall, the complexities of bioprinting poses multifaceted questions about the ethics of this particular medical system due to its immense reliance on technology — something that many are extremely skeptical about.
While many still envision our future as something based on the use of digital space, our willingness to follow such a potential arises from great concerns regarding the corporations responsible now. Namely, between 2009 and 2021, about 95% of the U.S. population had their medical information leaked, raising great concerns about privacy. Not only should the healthcare sector be the most secure, but it is heavily reliant on human operation — which is the leading cause of data breaches in the respective sector. Despite that, bioethicists strongly push for bioprinting due to its preexisting capabilities and planned applications.
As bioengineer Sanjairaj Vijayavenkataraman notes through his research, bioprinting is a sound alternative to animal testing. As a subject to immense controversy, especially amidst recent times of widespread social movements, animal testing not only receives backlash for its ignorance on ethics, but it poses a threat to human health since the most frequent test subjects — often consisting of rodents such as mice — have minor discrepancies with human anatomy. Bioprinting offers a new approach by manufacturing accurately responsive models at a lower cost — both morally and financially. In particular, Vijayavenkataraman highlights the use of bioengineering in pharmaceutical research by observing its timely net positive return in chemotherapy, chemo-resistance treatments, and drug efficacy.
Aside from the direct concerns and praises bioprinting has received, there are underlying sociocultural factors that contribute to its application. Not only can these aspects directly worsen ongoing discrimination, but it may indirectly threaten the future of Americans with specific backgrounds.
For instance, the examinations performed by Patuzzo et al revealed that the high cost of such technologies can inhibit widespread access to necessary and effective treatments — especially for marginalized communities. Across the United States, newly bundled treatments — often subsidized by health insurance plans — can offer financial relief to individuals. A study from 2022 revealed that this is not the case for all; in fact, it racially discriminated against specific communities that had been previously disregarded.
In particular, it became the first official study to evaluate the link between historically marginalized communities and hospital participation in bundled treatments. In their discussion, the researchers concluded that hospitals in communities with individuals of lower socioeconomic status were less likely to participate in bundled payments. Despite that, a distinction was drawn when they found that communities with greater numbers of minority racial and ethnic groups were more likely to engage in bundled payments. In the context of bioprinting, this study reveals that access to up-to-date treatments can be made selectively available to individuals who can afford it or to concentrated groups of individuals of specific backgrounds.
Much like most innovative projects, the growing popularity of bioprinting within the medical sphere can introduce new solutions to ongoing crises. The decade-long organ shortage crisis — in which there are currently over 103,000 men, women, and children on the waiting list — is not only the primary rationale behind such developments of bioprinting, but it has the potential to be de-escalated to great extents with proper applications and accessibility. While previous stigmas and discriminatory attitudes towards specific communities may inhibit its projected effectiveness in application, it is undeniable that bioprinting can revolutionize public health. With adequate attention towards resolving prerequisite social dilemmas — specifically class-based favorability — bioprinting can promote a healthier American Dream in which people of all different ages and backgrounds thrive without worrying about their health.
Bioprinting offers a new approach by manufacturing accurately responsive models at a lower cost—both morally and financially.