Biofabrication gives patients tailor-made solutions to their diseases

3D printing tissues, creating scaffolds that mimic bone and cartilage, or designing vascular grafts for patients following dialysis treatment are just three examples of biofabrication. This research domain focuses on creating tissues and organs by combining cutting-edge technologies, from cell cultivation to 3D printing. Biofabrication allows patients the possibility to have tailor-made treatments for various diseases. 

Lorenzo Moroni is the scientific director of MERLN, Maastricht University’s Institute for technology-inspired regenerative medicine. 120 scientists are affiliated with the institute, a figure that increases to 190 if collaborations with international researchers and visiting scholars are considered. The professor has over 20 years of experience in biofabrication. We discussed his research, role, and career. 

Biofabrication is the main focus of your activities at MERLN. Can you give a simple definition of it? 

“Biofabrication is a set of technologies that allows controlling space and time of biological matter. This matter could be a hydrogel or a printed biomaterial with special properties that can communicate in space and at a different time with the cells of our body. In a way, it is like giving cells a training schedule, guiding them through the work they need to do.”

That’s an interesting analogy. 

“Yes, and as you can instruct the cells properly, you can risk overloading them. The study of biomechanics [the science of movement of a living body, ed.] and how the different mechanical loads impact a given part of the human body plays an essential role in our research.

What are the differences in working with different types of body cells?

“The first differences are in our genetic makeup. Each one of us is a different biological entity. Then, tissues or bones are subjected to different mechanical stimulations. Some of them might be compressed more, while others experience cycles of relaxation and tension. Cardiovascular tissues, for instance, dilate and contract continuously, as do the heart’s ventricles.”

When did you decide to pursue a career in this field?

“When I finished high school, I was undecided between studying engineering and medicine, yet I was not sure if I would be a good doctor. At the same time, I was good at maths and physics. So, I decided to apply for both faculties. I didn’t make the cut for studying medicine, but I passed the test for engineering.

After a year since the start of my studies, my university started a course in biomedical engineering, which combined both of my interests, so I joined that study track. After graduation, I wasn’t convinced to pursue a research career, so I started looking for corporate jobs. They often would tell me: ‘What are you doing here? The way you  approach questions is the one of a scientist: why don’t you apply for a Ph.D?’”

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What happened next? 

“I convinced myself to give it a try. I was then selected for a Ph.D. position in Genoa and Utrecht. The position in Utrecht was at a company which I thought was good as it would still keep me close to the corporate environment I was initially applying to. Since I had to move from Milan anyway, I decided to accept the offer from the Netherlands.” 

Looking back at your career, what moments stayed with you the most?

“The first moment that comes to my mind is the period after my Ph.D. I worked on a project to create scaffolds for the regeneration of skeletal tissues. This research found a clinical application from the lab, as these constructs are now implanted in approximately 250 patients. It doesn’t happen every day that something developed in the lab finds a clinical application. 

More recently, I developed a vascular graft with nephrologist Joris Rotmans from the Leiden University Medical Center. These grafts are for patients who go under dialysis and need their veins and arteries to be punctured every other day. Given the repetitiveness of this process, there is literally no place to puncture them. Oftentimes, a so-called fistula (a shortcut) is created to bridge the artery and the vein to prevent this complication. So, we developed these grafts for a better-performing blood vessel for dialysis treatment. At the moment, this idea is under clinical trials.”

How has this field evolved since you joined it?

“Incredibly. It did not only in terms of personalization but also in terms of technology development. An example that comes to my mind is biological materials, with the possibility of replicating the cell environment of some parts of the human body. This development has created the possibility of creating human in vitro models that are more sensible and reliable than animals to conduct drug development, for instance. As this field progresses, there will be more representative clinical studies and better medications.

When it comes to 3D printing, there has been a lot of development, especially in the speed of producing the porous structures, also called architected materials, which, in the meantime, have also developed.”

You are the head of MERLN, a professor, and still a researcher. How do you combine these different aspects?

“It is not a regular job. For me, it is essential to include activities that keep me excited. Luckily, I see my students constantly across the year, and that is possibly what keeps me motivated. This is probably my favorite part of the job. I enjoy engaging in discussions with them, understanding what challenges they're going through, and listening to the ideas they have. The process of generating new ideas also keeps me quite excited. In the future, we will explore how to build that gym for cells and give them different training protocols to understand the mechanobiology behind regenerative processes better.”

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