Regenerative Medicine Utrecht


Inaugural Lecture of Professor Jos Malda: A Perspective on Dimensions


“As a professor, you know so much about so little… and that’s why you need to collaborate!” This statement wasn’t made by our Professor of Biofabrication in Translational Regenerative Medicine, Jos Malda, but by his 7-year-old son Ayso. These wise words reflect the vision of professor Malda, namely that connecting the dots is the key to innovation and development. In his work, he is continuously setting up valuable connections, whether that is in research, clinic, business or education.


The Orthopaedic Perspective
His status as a connector was exemplified by the presence of international leading colleagues at the symposium “Biofabrication – The Orthopaedic Perspective” prior to the inaugural lecture on Thursday 15 March 2018.

Professor René van Weeren of the Department of Equine Sciences at Utrecht University opened the symposium by explaining the historical bond between humans and horses. In the “One Health – One Medicine” vision, interdisciplinarity is the key in finding answers to the similar challenges we are facing in both human and veterinary medicine. Jos Malda’s dual appointment (70% at UMC Utrecht and 30% at the Faculty of Equine Sciences of Utrecht University) stresses his support of this vision and facilitates collaboration and translation of animal and human research.

Pioneer in the field of biofabrication, Vladimir Mironov of the Sechenov First Moscow State Medical University, intrigued the audience with his research on fusing tissue spheroids and especially the acoustic levitation technique to create scaffold-free mini-tissues in an extremely short time-frame.

Moving towards orthopedics, Professor Daniel Kelly of Trinity College Dublin discussed how we can be inspired by the development of native bone to design smart bioprinting strategies, and Professor Michael Gelinsky of Technische Universität Dresden discussed the search for appropriate biomaterials in creating osteochondral constructs and securing the tissue interfaces.

Dimensions in Perspective
Later that day, in the impressive Auditorium of the University Hall, professor Malda discussed the importance of dimensions for the creation of new living tissue. He explains that a dot is 0-dimensional, as it doesn’t comprise any length, height or width. As such, a line is 1-dimensional (1D), a plane 2-dimensional (2D), and a cube 3-dimensional (3D). Since the early 20th century, we are able to culture cells in 2D. Nevertheless, this situation doesn’t reflect the circumstances in the body. In order to maintain the normal functions of the cell, it requires a 3D environment that mimics the complexity of the native situation.

The revolutionary technology of biofabrication allows us to create such complex 3D structures. It uses 3D printing techniques to build structures in a layer-by-layer fashion using bioactive building blocks, such as living cells. The immediate result does not have the native complexity yet, but after a period of maturation (time, the 4th dimension) we can attain pieces of functional tissue.

Malda explained that these tissue pieces can be used as diagnostical tools or models for pharmaceutical testing. Within the new Utrecht Hub “Advanced In In Vitro Models”, in which Malda is involved together with professor Roos Masereeuw (Pharmacology, UU), a multidisciplinary network is established for the development, validation and implementation of such in vitro models. These models can contribute to a reduction in the use of animals for experimentation.

Biofabricated tissues could even be used as tissue substitutes in regenerative strategies. With his research group, Malda works on printing new cartilage for degenerated knee joints. In order to create broader impact for the technology, the Utrecht Biofabrication Facility was brought to life. Collaborations include heart muscle with the Heart Collective of professor Joost Sluijter (Cardiology, UMCU), liver tissue for toxicity tests with dr. Bart Spee (Veterinary Medicine, UU), auricular cartilage implants with dr. Corstiaan Breugem (Plastic & Reconstructive Surgery, UMCU), and an oviduct model with dr. Bart Gadella (Farm Animal Health, UU, and Biochemistry & Cell Biology, UU).

The 3D printing technology is also increasingly being used for other purposes, such as personalized surgical guides and pre-operative models. Together with the future tissue substitutes, it is contributing to personalized medicine. Malda stated that it is disappointing that healthcare insurers are still reluctant in reimbursements for these techniques. For this reason, he is part of the initiative Fieldlab 3D Medical that connects academic and commercial entities, aiming to stimulate translation of these technologies to the clinic.

Nevertheless, an important question remains: how far can we, and should we, go? Malda displayed a picture of the famous sculpture Tête otohinologique de Vénus of Salvador Dalí, in which the artist swapped the nose with the left ear to create a surrealistic representation of the impossible. With biofabrication, however, this could actually become biologically possible. Another image was of the famous Vacanti mouse, with a structure in the shape of the external ear on its back. Malda posed the questions: “What can science achieve? And are we promising more than we can live up to?” The general public may get a wrong interpretation of the visions we’re seeding, and hence the guidance of an ethical perspective is essential.

Malda also stressed that such perspectives are essential in the education of our future researchers. With support of the European Union, an international double degree Master program on Biofabrication was set up between Utrecht, Germany and Australia. Although education may not be the most popular subject amongst researchers, as research takes a lot of time and energy already, it is incredibly important to stimulate scientists to be involved in education.

It is evident that professor Malda is a big proponent of erasing the dividing lines, and of making connections. When multiple fields, and thus multiple perspectives, are working together, the whole network can grow.
By Iris Otto