Extrusion-based three-dimensional bioprinting relies on bioinks engineered to combine viscoelastic properties for extrusion and shape retention, and biological properties for cytocompatibility and tissue regeneration. To satisfy these conflicting requirements, bioinks often utilize either complex mixtures or complex modifications of biopolymers. In this paper we introduce and characterize a bioink exploiting a dual crosslinking mechanism, where an enzymatic reaction forms a soft gel suitable for cell encapsulation and extrusion, while a visible light photo-crosslinking allows shape retention of the printed construct. The influence of cell density and cell type on the rheological and printability properties was assessed correlating the printing outcomes with the damping factor, a rheological characteristic independent of the printing system. Stem cells, chondrocytes and fibroblasts were encapsulated, and their viability was assessed up to 14 days with live/dead, alamar blue and trypan blue assays. Additionally, the impact of the printing parameters on cell viability was investigated. Owing to its straightforward preparation, low modification, presence of two independent crosslinking mechanisms for tuning shear-thinning independently of the final shape fixation, the use of visible green instead of UV light, the possibility of encapsulating and sustaining the viability of different cell types, the hyaluronan bioink here presented is a valid biofabrication tool for producing 3D printed tissue-engineered constructs.

Biofabrication is enriching the tissue engineering field with new ways of producing structurally organized complex tissues. Among the numerous bioinks under investigation, hyaluronic acid (HA) and its derivatives stand out for their biological relevance, cytocompatibility, shear-thinning properties, and potential to fine-tune the desired properties with chemical modification. In this paper, we review the recent advances on bioinks containing HA. The available literature is presented based on subjects including the rheological properties in connection with printability, the chemical strategies for endowing HA with the desired properties, the clinical application, the most advanced preclinical studies, the advantages and limitations in comparison with similar biopolymer-based bioinks, and future perspectives.

Biofabrication via three-dimensional printing (3DP) is expanding our capabilities of producing tissue engineering constructs for regenerative medicine, personalized medicine, and engineered tissue models of disease and diagnostics. Hydrogel-based materials for extrusion-based printing have been introduced; nevertheless, it is still challenging to combine into a single biomaterial all the requirements of an ink. These inks need to flow for extrusion under low shear, yet have immediate shape retention after deposition, provide a biochemical environment similar to that of physiological extracellular matrix, and a curing mechanism avoiding cell damage. This work introduces a simple and versatile tyramine-modified hyaluronan material (HA-Tyr) for extrusion-based printing, featured by (i) single component yet two distinct cross-linking mechanisms, allowing (ii) shear-thinning tuning independently of the postprinting curing; (iii) no rheological additives or sacrificial components; (iv) curing with visible light for shape stability; (v) possibility to postfunctionalize; and (vi) preservation of hyaluronan structure owing to low modification degree. The ink is based on a hydroxyphenol hyaluronan derivative, where the shear thinning properties are determined by the enzymatic cross-linking, while the final shape fixation is achieved with visible light in the presence of Eosin Y as photosensitizer. The two cross-linking mechanisms are totally independent. A universal rheologically measurable parameter giving a quantitative measure of the “printability” was introduced and employed for identifying best printability range within the parameter space in a quantitative manner. 3DP constructs were postfunctionalized, and cell-laden constructs were produced. Due to its simplicity and versatility, HA-Tyr can be used for producing a wide variety of 3D printing constructs for tissue engineering applications.