Gauthier
Menassol
a,
Boudewijn
van der Sanden
*b,
Laetitia
Gredy
a,
Capucine
Arnol
b,
Thibaut
Divoux
c,
Donald K.
Martin
b and
Olivier
Stephan
*a
aMoVe, Laboratoire interdisciplinaire de physique, CNRS UMR 5588, Université Grenoble Alpes, St-Martin d'Hères, France. E-mail: gauthier.menassol@cea.fr; laetitia.gredy@univ-grenoble-alpes.fr; olivier.stephan@univ-grenoble-alpes.fr
bSyNaBi & Platform of Intravital Microscopy, TIMC, CNRS UMR 5525, Université Grenoble Alpes, Grenoble INP, INSERM, Grenoble, France. E-mail: boudewijn.vandersanden@univ-grenoble-alpes.fr; capucinearnol@gmail.com; donald.martin@univ-grenoble-alpes.fr
cENSL, CNRS, Laboratoire de Physique, F-69342 Lyon, France. E-mail: thibaut.divoux@ens-lyon.fr
First published on 12th February 2024
Immediate care of skin wounds and burns is essential to repair this mechanical and chemical barrier to infections. Hydrogels have become one of the standard methods for wound care. Here, gelatine–collagen photo-crosslinkable matrixes or hydrogels were manufactured by two-photon polymerization (TPP) or one-photon UV exposure using a Digital Light Processing (DLP) setup. Both techniques are able to construct matrixes from computer-aided design models, which is important for future clinical applications in which wound dressings should be customized. Although TPP can mimic the 3D dermo-epidermal junction with a high spatial resolution (i.e., ∼6 μm3), the manufacturing time was too slow to produce large wound dressings. Therefore, a DLP setup was explored in this study to fabricate large 2D matrixes of several cm2 using the same photo-resist as for TPP, except for the photoinitiator. The fibroblast viability, adherence, and proliferation were analysed in time on both 3D and 2D matrixes in vitro using two-photon microscopy. For both types of matrixes, the adherence and proliferation of fibroblasts (3T3-NIH) were optimal for stiff structures with a Young's modulus of 191 ± 35 kPa compared to softer matrixes of 37 ± 12 kPa. Fibroblast showed complete confluence on Day 14 after seeding on these matrixes, which may create the granulation tissue composed of fibronectin, collagen, and various proteoglycans in the future dermis before repair of the epidermis and disintegrating of their host matrix. For the monitoring of this repair, gelatine–collagen matrixes can easily incorporate bio-optical sensors for the simultaneous monitoring of inflammation processes and wound healing in time.
Bio-printing using biocompatible hydrogels has emerged recently as a promising technique for producing customized wound dressings.6 Printing techniques such as Digital Light Processing (DLP) and Two-Photon Polymerization (TPP) utilize computer-aided design (CAD) for complete control of the structure and size of the matrixes for the wound dressing. This facilitates the reproducibility of matrix manufacturing, which is not possible with classical methods such as spin-coating.7 Although the macrostructure of the matrix (size and form) is controlled in 3D printing to enable adherence to the native skin, control of the matrix microstructures, which is to mimic the physico-biochemical properties of the skin extracellular matrix (ECM), remains a challenge that needs to be overcome.
Gelatine methacryloyl (GelMA) hydrogels contain some essential properties of native ECM due to the presence of cell-attaching and matrix metalloproteinase-responsive peptide motifs, which allow cells to proliferate and spread.8 GelMA hydrogels have tuneable mechanical strength due to a variable degree of cross-linking and high oxygen and water permeability, which is crucial for cell survival inside the matrix. The tuning of Young's modulus directly influences fibroblast proliferation, which is more efficient on stiffer substrates (>100 kPa) in comparison to softer matrixes (<20 kPa) that induce cell cycle arrest or cell death.8–10 The Young's modulus of the GelMA hydrogel should approach that of the human dermis, which is about 180 kPa, to optimize fibroblast proliferation.11 GelMA hydrogels can further be loaded with antibiotics, antibacterial nanoparticles, and other drugs that stimulate wound healing.5 Furthermore, the hydrogels may contain bio-(optical) sensors for continuously monitoring wound healing, for which local tissue pH and O2 consumption are relevant indicators of the different stages of an inflammation process and skin regeneration. For instance, a skinwound is in an alkaline state before healing and progresses via a neutral to an acidic pH when the wound healing is completed.5
The aim of this study is to produce a printed photo-crosslinkable gelatine–collagen matrix that mimics the dermo-epidermal junction. The dermo-epithelial junction is an important site of attachment in the skin, occurring at the interface between the basal epidermis and dermis. TPP was our first choice for the 3D printing of matrixes to mimic the dermo-epidermal junction, using a GelMA–collagen–ruthenium formulation. To produce larger 2D structures of several cm2, a DLP setup was utilized using a similar GelMA–collagen formulation but involving an alternative photoinitiator. For that, we selected lithium phenyl-2,4,6-trimethyl-benzoyl-phosphinate (LAP), which is well suited to the Anycubic® Mono X DLP 3D printer with a one-photon absorption at 405 nm instead of the ruthenium(II) complex used for TPP. We demonstrate that these matrixes support the adherence and proliferation of viable fibroblasts. These results from in vitro experiments show the usefulness of the microstructured matrixes to mimic the dermo-epithelial junction of the skin ECM and thus provide a good basis for skin regeneration.
The DLP photoresist was obtained by mixing 1 mL of deionized water containing the LAP photoinitiator (2.5 mg mL−1) with 30 mg of collagen and either 50 or 200 mg of gelatine methacryloyl (bloom 300, 80% degree of substitution). In this study, these two GelMA concentrations produce either soft or stiff matrixes, which impact fibroblast adherence and proliferation. After gently mixing the solution at room temperature for 1 hour, the temperature was raised to 40 °C to ensure a complete dissolution of the components. Subsequently, the resulting liquid preparation could be used immediately or stored in a refrigerator as a strong gel. Both the gel and matrix are normally transparent for two-photon microscopic analysis. Therefore, we covalently bonded a fluorescein derivative to the matrixes during DLP cross-linking. A solution of this fluorescein derivative was prepared by adding 1 mg of Fluorescein o-acrylate (Sigma-Aldrich) to 10 mL of deionized water and stirred for at least one hour. The solution was then filtered (0.1 μm pore size) to remove non-dissolved parts. Subsequently, 1 mL of this solution replaced deionized water in the previous formulation. This fluorescein derivative may also be used as a bio-optical sensor for pHmatrix analyses during inflammation and skin regeneration.13
To build large structures exceeding 300 μm2, the Microlight® setup allows replications in the x–y directions using an additional large motorized step-stage of 10 × 10 cm. The small piezoelectric cube (300 μm3) is replicated in this way. The corresponding CAD model of the dermal–epidermal junction elementary block has a 150 × 150 μm base (x–y) with a maximum height of 140 μm (z-direction), as shown in Fig. 1a. Larger assemblies were obtained by replicating this block inside the GelMA–collagen drop. Note that the 3D-TPP always started with a −2 μm offset inside the glass support. In these conditions, the laser process started inside the glass substrate, and the 3D fabrication began subsequently inside the glass, then at the interface between the glass coverslip and the drop, and finally inside the drop. This method ensured the adhesion of the matrix to the glass coverslip after several washing steps in PBS.
Another key parameter is the manufacturing time of these assemblies, which is determined by the number of laser positions (voxels) where crosslinking occurs inside the GelMA drop. The manufacturing time was reduced by using the minimum number of voxels that were sufficient for the fabrication of stable matrixes after the washing step for the in vitro studies. In the x–y plane, the distance between two voxel positions was fixed at 2.5 μm, while for the z-axis, it was set at 3 μm, which corresponds to ∼22.000 positions for the 150 × 150 μm elementary block (Fig. 1b). The real voxel dimensions for TPP are defined by the 40× objective and are estimated at 1 μm × 1 μm × 6 μm = 6 μm3. Although the spatial resolution is higher in the x–y plane than in the z-direction, an overlap of the elementary crosslinked material in the x-y plane for each voxel volume is still possible due to radical diffusion. The theoretical overlap in the z-direction is 50%. The manufacturing time for the elementary block is ∼1 min (Fig. 1a). For the cell culture tests, a 450 × 450 μm matrix (= 0.25 mm2 after swelling in the PBS buffer) with a manufacturing time ∼9 min was used after replicating the elementary block 3 times in both the x and y directions (Fig. 1c). Note that the manufacturing time for large matrixes of 1.5 cm2 would have taken ∼1 week, which is not possible with the TPP setup and too long for artificial skin applications. For the photo-polymerization per voxel, the laser power was set at 3.5 mW with a fixed exposure time of 1 ms for each voxel position.
Mouse 3T3-NIH fibroblast cells (ThermoFisher Scientific) were cultured at 37 °C with 5% CO2 in Dulbecco's Modified Eagle's Medium (DMEM) 4.5 g L−1 glucose + GlutaMax, supplemented with 10% fetal bovine serum and 1% antibiotic solution (10.000 U mL−1 of penicillin–streptomycin). 100.000 cells were seeded on matrixes in 60 × 15 mm cell culture dishes. All cell nuclei were marked either with Hoechst (Sigma-Aldrich) 1 mg mL−1 or with SYTO-13 (ThermoFischer Scientific) 3.3 mg mL−1, or with propidium iodide (PI, Sigma-Aldrich) 1 mg mL−1 to determine the proportion of dead cells. In studies with TPP matrixes, the cell cytoplasm was further marked with AB176735 cyto-painter from Abcam.
The Young's modulus E is derived by fitting the Force–indentation curve (F–δ curves), using E as the fit parameter and constant values for θand v. Here, ν is the Poisson ratio of 0.5 for hydrogels, and θ = 20°. AFM measurements were performed 3 times at 3 different locations (see Fig. 1d) to estimate average values of the Young's modulus.
Fluorescence Recovery After Photobleaching (FRAP) experiments were performed on the two-photon microscope. A Region Of Interest (ROI) for photo-bleaching was selected using Inspector Pro64 Acquisition software on the Trimscope II. A time series of 3000 images (1 image per s) was defined as follows: 30 images were acquired before bleaching at 15% laser power, followed by 30 images with ROI photo-bleaching at 100% laser power (1.2 W) at 900 nm, and 2940 images at 15% laser power to analyse ruthenium or fluorescein fluorescence recovery time. A stage-top incubator (Okolab, Pozzuoli, Italy) was used to maintain a stable environment of O2 (19%), CO2 (5%), and temperature (37 °C) during the two-photon microscopy and FRAP experiments with or without cells on the matrixes. For the control FRAP experiments on matrixes without cells, the CO2 content was set to 0. The gas mixture and temperature were monitored online every 30 s and stored in a datalog file during each entire experiment.
Mice with a minimal weight of 20 g were anesthetized through an intraperitoneal injection with ketamine (100 mg per kg bw; Ketamine™ 10%, Bayer Health Care, Leverkusen, Germany) and xylazine (25 mg per kg bw; Rompun® 2%; Bayer Health Care, Leverkusen, Germany). The entire procedure was done with sterile instruments. Mice were placed on a 36 °C warm plate during surgery. Their backs were shaved and afterward depilated with hair removal cream (Veet Minima™, France). A midline was drawn with a sterile skin pen to obtain a medial position of the skinfold chamber. Both plates of the dorsal skinfold chamber were fixed with 8 sutures. Spacers of 1.8 mm were present between the plates to avoid pressure on the skin and changes in blood perfusion around the window. At the side of the window, the skin was removed, and the subcutaneous tissue was kept moistened with sterile saline. Matrixes were implanted, and a coverslip was finally placed on the observation window and secured with a ring. For recovery after surgery, mice were placed on a 36 °C warm plate until awakening. For the following 7 days after surgery, an analgesic, paracetamol, was added to their water for pain relief. Mice were housed individually, and their weight was measured daily. Mice were only sacrificed if their weight loss exceeded 15%, which occurred in approximately 2% of the cases. The matrix stability was analyzed on the two-photon microscope at D14 following matrix implantation.
Fig. 2 3D Time-lapse studies of 3T3 NIH mouse fibroblasts cell proliferation on the 3D GelMA–collagen matrixes. (a & b) Shows 3D two-photon images of the top view (a) and side view (a) of the red GelMA–collagen matrix with green fibroblast cells at day 1 after cell seeding using the green fluorescent cyto-painter (ab176735) before seeding. The scale bar is 100 μm. The 3D image is the last 3D image of 2 h time series with a Z-stack acquisition every 5 min. The white box size is 469 × 469 × 112 μm. Z-Stack acquisition was performed using a 20× objective with an excitation wavelength of 900 nm. (c) Detail of the white dotted ROI in (a) showing the adherence over time of green fibroblast cells to the rigid base of a dome (white dotted circles). The time between 3D images is 15 min. Fibroblasts showed more adherence on the rigid domes compared to the softer valleys in between the domes (cf.fig. 1e and f). (d & e) Top view (d) and side view (e) of the fibroblast distribution at day 7 after seeding. The box size is 469 × 469 × 344 μm. The domes are more crowded by cells than the valleys. The scale bar is 100 μm. (f & g) Top view (f) and side view (g) of the fibroblast distribution at day 14. The box size is 469 × 469 × 202 μm. The red fluorescence signals inside the fibroblast aggregates in the side view (g) are dead cells stained by PI. The scale bar is 100 μm. |
In the next series of experiments, cell viability was analysed on the 7th day following seeding (Fig. 3). The nuclei of all fibroblasts were stained with Hoechst and propidium iodide (PI), and the proportion of dead cells was determined based on the number of cell nuclei stained with PI (marked by white dotted circles in Fig. 3b, and note that PI only diffuses into the nuclei of dead cells). The mean percentage of dead cells was only 4.0 ± 0.4% compared to a vast majority of live cells of 96 ± 2% (n = 5 matrixes). In Fig. 3a & b, the cell density at the bottom of the Petri dish was compared to the density at the top of the matrix. The mean cell density at the bottom of the Petri dish was 2000 ± 143 cells per mm2, whereas at the top of the matrix, it was 1357 ± 286 cells per mm2. The differences in cell density are significant: p = 0.007 (unpaired two-tailed t-test).
The 3 boxes in Fig. 3c show 3 planes of a z-stack acquisition at the bottom (left box), halfway (middle box), and top (right box) of the matrixes. Fibroblasts remained at the surface of the matrix, probably due to TPP resulting in matrixes with a high cross-linking density, hindering the migration of fibroblasts inside the 3D structures. Similar results were obtained for the 2D DLP matrixes (see section 3.3). The images in the boxes of Fig. 3c demonstrate that fibroblasts prefer stiffer matrixes and surfaces, leading to a heterogeneous distribution at the top of the domes within the matrix, cf. the right box of Fig. 3c.
This second series of experiments showed that fibroblasts adhered, migrated, and proliferated on the surface of 3D GelMA–collagen–ruthenium matrixes. The results showed the preference of fibroblasts for stiffer domes over the softer regions between the domes (cf.Fig. 1d). Importantly, the matrix was not cytotoxic, because the mean percentage of dead cells was only 4.0 ± 0.4% at day 7 after seeding. Taken together with our FRAP results, this confirms that the ruthenium complexes are covalently bonded to the matrixes and do not diffuse freely in the hydrogel.
Fig. 4e & f show the fibroblast density (cell per mm2) on both a soft 2D matrix (Young's modulus: 37 ± 12 kPa) or a stiff 2D matrix (Young's modulus: 190 ± 35 kPa), which were produced using respectively 100 or 200 mg of gelatine methacryloyl in the DLP photoresist formulation. Representative results of Young's modulus distribution of these matrixes determined by microindentation (see section 2.6.2 for details) are shown in Fig. 2S.† Note that those Young's moduli are comparable to the soft (valleys) and stiff areas (domes) of the 3D TPP matrixes. On Day 14 after cell seeding, the mean fibroblast density was significantly higher (1963 ± 159 cells per mm2, p < 0.0001, unpaired two-tailed t-test) on the stiff DLP matrixes compared to the soft ones (329 ± 52 cells per mm2). These results corroborate the previous analysis of 3D TTP matrixes with better fibroblast adherence and proliferation on the stiffer domes (∼130 kPa) compared to the softer parts of the matrix (∼20 kPa).
The stability of the stiff (190 kPa) DLP matrixes was tested in vivo on a mouse model that expressed GFP in all mono-nuclear phagocytes, see Fig. 5. This matrix was chosen because it showed the highest fibroblast density at Day 14, see Fig. 4f. On Day 14, after implantation of the matrix, the stiff DLP matrix was stable without any signs of degradation. Otherwise, MacrophagesGFP+ would have penetrated inside the matrix. Here, they were only present at the surface of the matrix at a low density: 51 ± 9 n mm−2.
Various natural polymers are used for skin tissue engineering, such as alginate, hyaluronic acid, chitosan, silk fibroin, poly-caprolactone, and poly(lactic-co-glycolic acid). However, these polymers lack cell adhesion motifs like ArginylGlycylAspartic acid (Arg-Gly-Asp or RGD) and, therefore, need additional chemical modifications.17 While most of these polymers are biocompatible, they are not bioactive in the skin, a characteristic seen in collagen and gelatine hydrogels. In a recent study, a combination of silk glycidyl methacrylate (GMA) and GelMA was explored to simultaneously enhance the stability and the tensile strength of the matrix and preserve cell adhesion motifs.18 Leveraging the soft gelation property and an improved tensile strength using silk GMA, will help to rapidly cover the wound, improving scar quality, and enhancing functional outcomes. 3D (Bio)printing techniques that are used in skin regeneration were recently reviewed.17,19
Here, TPP produced a GelMA that mimicked the dermal–epidermal junction, achieving a remarkable 3D spatial resolution. Our TPP protocol allowed us to modulate the voxel density, essential for controlling the matrix microstructures. This capability allowed us to generate high-stiffness matrixes that optimized the adherence and proliferation of fibroblasts. To illustrate this point, we engineered a matrix featuring micro-structured domes, controlled by a high voxel density (resulting in Young's modulus of 130 ± 4 kPa), and valleys, controlled by a lower voxel density (yielding Young's modulus of 20 ± 1 kPa). Our cell-culture experiments clearly demonstrated that fibroblasts had better adherence, proliferation, and viability on the stiffer domes compared to the softer valleys within the TPP matrixes. However, despite the ability to craft high-resolution microstructures of different stiffness levels, the manufacturing speed of TPP matrixes was slow: 0.002 mm2 min−1. For example, TPP matrixes to cover large wound areas of several cm2 will take at least one week using this photo-polymerization technique. Moreover, achieving an overall stiffness of around 150 kPa needed for optimal adherence and proliferation of fibroblasts would require a higher voxel density for photo-polymerization, inevitably elongating the manufacturing time.
To overcome this problem of manufacturing speed, we utilized a DLP setup to decrease considerably the manufacturing time of large 2D GelMA matrixes. DLP is a highly efficient method of layer-by-layer printing compared to point-by-point printing using TPP.20 Note that Saha et al. combined the advantages of TPP and DLP printing and developed a femtosecond projection TPP technique, where they could print complex 3D structures that maintained μm features at a speed 3× faster than classical TPP.21 However, their speed is still far beyond the speed for matrix fabrication using a DLP setup.
Using one-photon crosslinking in our DLP setup, we were able to tune the stiffness to the high Young's modulus (190 ± 35 kPa) required for optimal fibroblast responses by using the same amount of gelatine methacryloyl as for TPP. The 2D matrixes have a simple configuration in this study (direct exposure of a thin layer, cf.Fig. 4d). Still, we increased the surface area to provide better adherence to the dermis by incorporating honeycomb-like structures (cf. Fig. 3S in ESI†). Our ongoing work will explore 3D layer-by-layer DLP techniques to manufacture real 3D structures.22 With our setup, crosslinking is performed using LED sources at 405 nm, which may be replaced by LED sources at longer wavelengths to increase the penetration depth inside the photoresist. This should result in a more homogeneous crosslinking and achieve higher cell compatibility and wider application prospects, including the use of bioink materials in tissue engineering.17–19
GelMA–collagen matrixes can be easily transformed into smart matrixes, including bio-optical sensors for monitoring inflammation and wound healing processes.5,20,23 Smart wound dressings help distinguish between wounds with transient or chronic inflammation, which often occur in diabetes.19 The latter should be treated as early as possible to avoid permanent tissue damage and wounds failing to achieve closure. Indeed, in diabetic patients, the glycation of proteins reduces the process of angiogenesis and consequently limits cell proliferation and wound repair in hypoxic conditions.24 The stiffness of gelatine hydrogels can be tuned to stimulate the adherence, proliferation, and migration of vascular endothelial cells during angiogenesis.25 Furthermore, smart gelatine hydrogels with optical biosensors for local measurements of pO2tissue and pHtissue will help in online monitoring of the wound healing process and reoxygenation.
In TTP, a ruthenium complex was used as a photoinitiator: the red fluorescence of these complexes was used for analysis of the matrix structure on a two-photon microscope, and changes in the fluorescence intensity of these complexes can be used for local pO2tissue analysis, see previous study.16 During inflammation processes, the O2 consumption of mononuclear phagocytes increases in the acute phase, which results in transient hypoxia inside the wound until the end of the resolution phase.21 In chronic inflammation, the hypoxia status of the wound will be maintained if the mononuclear phagocyte density remains high. Thus, monitoring the pO2tissue in wound dressings helps distinguish between transient and chronic inflammation processes. In the present study, FRAP analysis confirmed that ruthenium complexes became covalently bonded to materials during crosslinking and are therefore ideal bio-optical sensors for local pO2matrix measurements in time. We obtained similar results for the DLP GelMA matrixes, which will be published in a future paper.
Here, our protocol for preparing the large matrixes using the DLP setup included a modified photo-resist with fluorescein-acrylate. This had the advantage of rendering the matrixes visible on a two-photon microscope. An additional benefit is that the fluorescein can be used for online pHtissue analysis in a wound dressing, which is, like the pO2tissue, an important physiological parameter for following inflammation processes and wound healing. A skinwound is in an alkaline state before healing and progresses via a neutral to an acidic pH when the wound healing is completed.20,22,26 On the contrary, the pHtissue in wounds with a chronic inflammation will oscillate around basic pH values, thus, a distinction between wounds with a transient or chronic inflammation would be possible. The presence of both optical biosensors for pO2tissue and pHtissue analysis will provide a more complete picture of the wound healing processes.
In our in vivo pilot studies on mice, 2D GelMA collagen LAP matrixes with a Young's modulus of 190 kPa were stable for a minimum of 14 days. In the present study, fibroblasts reached a state of complete confluence at D14 on these matrixes, which means that they can probably produce the new extracellular matrix before total degradation of their host matrix and ensure skin repair.
Footnote |
† Electronic supplementary information (ESI) available. See DOI: https://doi.org/10.1039/d3bm01849k |
This journal is © The Royal Society of Chemistry 2024 |