Stepwise Multi-Cross-Linking Bioink for 3D Embedded Bioprinting to Promote Full-Thickness Wound Healing

The emergence and innovation of three-dimensional (3D) bioprinting provide new development opportunities for tissue engineering and regenerative medicine. However, how to obtain bioinks with both biomimicry and manufacturability remains a great issue in 3D bioprinting. Developing intelligent responsive biomaterials is conducive to break through the current dilemma. Herein, a stepwise multi-cross-linking strategy concerning thermosensitive thiolated Pluronic F127 (PF127-SH) and hyaluronic acid methacrylate (HAMA) is proposed to achieve temperature-controlled 3D embedded bioprinting, specifically pre-cross-linking (Michael addition reaction) at low temperatures (4-20 °C) and subsequently self-assembly (hydrophobic interaction) in a high-temperature (30-37 °C) suspension bath as well as final photo-cross-linking (mainly thiol-ene "click" reaction). The unique stepwise cross-linking mechanism promises the thermosensitive bioink appropriate viscosity at different printing stages, making it possible to print complex structures with excellent shape fidelity and simultaneously maintain the biological activity of cells. In vitro studies reveal that 3D-printed hydrogels are beneficial for enhancing cell viability. Further, in vivo experiments demonstrate that cell-laden printed hydrogels significantly promote wound healing and re-epithelialization by modulating inflammation and accelerating collagen deposition and angiogenesis. Therefore, the proposed stepwise multi-cross-linking strategy is expected to accelerate the development of novel bioinks and promote the clinical applications of 3D bioprinting.