Updated on
What did the project achieve?
“This project has helped to pave the way for further laboratory studies now underway in collaboration with Harvard Medical School,” says Mrs Cynthia de Courcey, a surgical trainee at Swansea University. “If successful, this work could ultimately benefit children with facial disfigurements, making a positive difference to many young lives.”
Children and young people born with missing or malformed facial features, as well as those affected by trauma, burns or cancer, can often face long-term emotional or physical problems due to their appearance. While reconstructive surgery can help rebuild facial features, current approaches can be painful and carry significant risks.
The Swansea University team is exploring the use of innovative 3D-bioprinting* technology to create precise, patient-specific cartilage implants using a natural biomaterial loaded with the patient’s own cells. This innovative approach offers the potential to overcome many challenges associated with current surgical procedures.
This research focused on testing a novel multi-component ‘bio-ink’, which includes a core ingredient called nanocellulose. It aimed to ensure that the body would accept it and to refine its properties to improve the chances of successful implantation.
“Three types of nanocellulose showed no harmful effects on cells grown in the laboratory,” says Mrs de Courcey. “We selected the one with the least inflammatory response to take forward for further testing.”
To make the nanocellulose-based bio-ink printable, it needs to remain in a liquid form during the printing process, before being solidified to form the implant through a process called cross-linking.
“We developed a bio-ink formulation consisting of nanocellulose and two other components, and then performed further testing to identify a safe and effective chemical cross-linker,” says Dr de Courcey.
Further testing on an advanced 3D cell model confirmed that nanocellulose-based bio-ink is safe for use in cartilage tissue engineering. The team also performed gene expression analysis on 770 genes, which revealed increased activity in key biological processes related to cartilage regeneration.
“The funding from Action Medical Research and the VTCT Foundation was instrumental to advancing research efforts towards developing a bio-ink for cartilage tissue engineering,” says Mrs de Courcey. “It was incredibly rewarding undertaking scientific research that may transform children’s lives.”
*3D-bioprinting involves applying innovative 3D-printing technologies to print biomaterials combined with living cells and molecules – to build laboratory-engineered complex tissues that closely mimic the natural tissue.
This research was completed on
Over half a million people in the UK are living with a facial disfigurement.[1] This includes children and young people born with missing or malformed features, such as ears – as well as those affected by trauma, burns or cancer. Many will experience long-term emotional or physical problems as a result of looking different. While it’s possible to undergo reconstructive surgery, existing approaches can be painful and risky. Mrs Cynthia de Courcey, a plastic surgery trainee at Swansea University is investigating the use of tissue engineering to create surgical implants formed from a patient’s own cells – which could ultimately provide a safer alternative for rebuilding facial features, improving children’s lives.
This Research Training Fellowship is supported by the VTCT Foundation.
How are children’s lives affected now?
While most people sometimes feel self-conscious and worry about how they look, having a facial disfigurement can intensify these feelings. It can be especially hard for children and young people who may struggle to come to terms with their appearance.
“Looking different from other people may have an impact on a child’s self-confidence and well-being as they grow up,” says Mrs de Courcey. “They may try to avoid certain social situations – and it may also affect their educational achievements and future employment prospects.”
Children and their parents may be offered the option of reconstructive surgery to rebuild their facial features. But this often involves harvesting tissue from other parts of the body – such as cartilage from the child’s ribs – which can cause additional scarring and pain. Another approach involves the use of synthetic (man-made) implants, but these carry a higher risk of infection, rejection, or distortion.
“There is a need for safer, better alternatives for corrective surgery for children who are born with or affected by facial differences,” says Mrs de Courcey.
How could this research help?
“Our ultimate goal is to develop a new approach that will revolutionise reconstructive surgery for children with facial disfigurements,” says Mrs de Courcey.
The team at Swansea University is currently investigating the application of innovative 3D-bioprinting* technology to create precise, patient-specific cartilage implants made out of a natural biomaterial loaded with the patient’s own cells.
“Using implants grown from a child’s own cells offers the potential to overcome many of the challenges associated with current surgical procedures,” says Mrs de Courcey.
Mrs de Courcey will now perform a series of laboratory experiments to establish whether the biomaterial is likely to be well-accepted by the body – and refine its properties to maximise the chance of successful implantation.
“This project will gather crucial biocompatibility data in preparation for future laboratory studies ahead of clinical trials in patients,” says Mrs de Courcey.
If successful, this new approach could help children with facial disfigurements in the future, having a positive impact on many young lives.
*3D-bioprinting involves applying innovative 3D-printing technologies to print biomaterials combined with living cells and molecules – to build laboratory-engineered complex tissues that closely mimic the natural tissue.
References
- Changing Faces, Facts for the Media: https://www.changingfaces.org.uk/for-the-media/facts-figures/ [website accessed 14 October 2022]
Research table
Project details
| Project Leader | Mrs Cynthia H K de Courcey, MBChB BSc FRCS(Plast) |
| Location | Reconstructive Surgery and Regenerative Medicine Research Centre, Swansea University Medical School, Swansea University |
| Project Team |
Professor Iain S Whitaker, BA(Hons) MA Cantab MBBChir
Dr Martin J D Clift, BSc(Hons) PhD PGCert HE MRSB Ms Zara M Jessop, MB BChir, MA (Cantab), Phd, FRCS (plast) |
| Other Locations | In Vitro Toxicology Group, Swansea University Medical School, Swansea University |
| Grant Awarded | |
| Grant Amount | £189,184 |
| Start Date | |
| End Date | |
| Duration | 24 months |
| Grant Code (GN number) | GN2938 |
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