Building a tissue in vitro from the bottom up: implications in regenerative medicine

Tissue engineering aims at creating biological tissues to improve or restore the function of diseased or damaged tissues. To enhance the performance of engineered tissues, it is required to recapitulate in vitro not only the composition but also the structural organization of native tissues. To this end, tissue engineering techniques are beginning to focus on generating micron-sized tissue modules having specific microarchitectural features that can be used alone as living filler in the damaged areas or serve as building blocks to engineer large biological tissues by a bottom-up approach. This work discusses the shortcomings related to traditional "top-down" strategies and the promises of emerging ''bottom-up" approaches in creating engineered biological tissues. We first present an overview of the current tissue-building techniques and their applications, with an analysis of the potentiality and shortcomings of different approaches. We then propose and discuss a novel method for the biofabrication of connective-like micro tissues and how this technique can be translated to cardiac muscle fabrication.