Bioprinted keratinocyte and stem cell laden constructs for skin tissue engineering

Treating large-scale skin wounds continues to be a significant therapeutic challenge. Oftentimes, insufficient autologous material is available to achieve full coverage. Since biofabrication offers the chance of reproducible and precise large-scale production, the aim was to develop a customized 3D bioprinted skin construct containing immortalized HaCaT keratinocytes and ADSC to test the principal feasibility of this approach. Keratinocytes in different hydrogels containing varying concentrations of alginate, fibrin, collagen, gelatin, gelatin methacryloyl (GelMA) and hyaluronic acid as well as on a prefabricated collagen-elastin-matrix were cultured for a period of seven days. The metabolic activity of cultured keratinocytes was then evaluated during the co-cultivation of HaCaT and ADSC in a transwell model. The metabolic activity in all groups increased over the test period. The hydrogels containing alginate/hyaluronic acid/gelatin (Alg/HA/Gel) and GelMA demonstrated a good printability and the highest diffusion rates. There was no significant difference in pore size when comparing all hydrogels with each other. On the basis of the performed printability and diffusion assays as well as on the SEM analysis and rheological measurements Alg/HA/Gel and GelMA were chosen as hydrogels for the bioprinted 3D model. Fibrin hydrogel was integrated into the biofabricated constructs due to its excellent metabolic activity in the transwell model. As a second step, hydrogel stability, cell survival and metabolic activity in bioprinted 3D models containing keratinocytes and ADSC were evaluated over a period of 14 days. On day 14 the metabolic activity as well as the live cell count within the bioprinted constructs of the cocultured groups was significantly higher compared with day 1. The biofabricated constructs made of GelMA showed a higher cell viability compared with those made of Alg/HA/Gel. Additionally, to evaluate the cell migration out of the constructs, the metabolic activity and viability of the cells on the well bottom, was examined. After 14 days, an average of 50% of the well bottom was covered by HaCaT, which were initially printed in coculture into the constructs. These findings indicate that constructs made of GelMA containing keratinocytes and ADSC may offer a promising therapeutic option in the treatment of large chronic wounds.