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Jeong-Yeol Yoon
Tissue
Engineering
A Primer with Laboratory
Demonstrations
Tissue Engineering
Jeong-Yeol Yoon
Tissue Engineering
A Primer with Laboratory Demonstrations
Jeong-Yeol Yoon
Department of Biomedical Engineering
The University of Arizona
Tucson, AZ, USA
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
v
vi Preface
–– Photographs of all equipment and results of all laboratories are provided to visu-
alize tissue engineering concepts. These can be used as guides for practical labo-
ratory exercises towards better understanding the concepts or starting points
towards further research and development.
I sincerely thank my graduate teaching assistants at the University of Arizona.
They have helped me create and implement the laboratory exercises in my Cell and
Tissue Engineering class in the spring semesters from 2015 to 2021. I specifically
appreciate the following graduate teaching assistants: Dr. Katherine Klug (currently
at Davids Engineering), Dr. Soohee Cho (currently at Abbott), Dr. Tiffany-Heather
Ulep (currently at Roche), and Dr. Kattika Kaarj (presently a faculty member at
Mahidol University in Thailand), who had laid foundations in these laboratory exer-
cises. The following graduate teaching assistants have also helped establish the
laboratory exercises: Dr. Soo Chung (presently at United States Department of
Agriculture – Agricultural Research Service), Mr. Kenneth Schackart (currently at
the University of Arizona), and Mr. Ryan Zenhausern (currently at Georgia Institute
of Technology). Other graduate teaching assistants, Mr. Christopher Camp and Ms.
Carissa Grijalva, both at the University of Arizona, have also contributed substan-
tially to the laboratory exercises. I also thank all students who took my cell and
tissue engineering class for providing critical feedback and corrections.
I also thank my former and current department heads, Dr. Urs Utzinger and Dr.
Arthur Gmitro in the Biomedical Engineering Department. They have supported my
class by providing personnel, equipment, and laboratory space at the University of
Arizona. Support and suggestions from the editorial office at Springer, especially
Michael McCabe, are greatly appreciated. Finally, I want to sincerely thank my
wife, Dr. Sunhi Choi (Mathematics Department at the University of Arizona), for
her continuous inspiration and support during the preparation of this textbook.
1 Introduction���������������������������������������������������������������������������������������������� 1
1.1 Narrow Definition of Tissue Engineering ���������������������������������������� 1
1.2 Early Attempt in Scaffold Development: Decellularized Matrix������ 2
1.3 Simple TE Transplant Example: Skin���������������������������������������������� 4
1.4 Simple TE Transplant Example: Pancreas���������������������������������������� 6
1.5 Expanded Definition of Tissue Engineering: Organ-on-a-Chip
(OOC) ���������������������������������������������������������������������������������������������� 8
1.6 Overview of This Book�������������������������������������������������������������������� 10
References�������������������������������������������������������������������������������������������������� 12
2 Cell Culture���������������������������������������������������������������������������������������������� 13
2.1 What Is Cell Culture?������������������������������������������������������������������������ 13
2.2 Cell Physiology: Cell Membrane and Cytoskeleton������������������������ 15
2.3 Focal Adhesion���������������������������������������������������������������������������������� 18
2.4 Cell Classification: Anchorage-Dependent Versus Anchorage-
Independent Cells������������������������������������������������������������������������������ 19
2.5 Cell Classification: Normal Versus Immortalized Cells������������������� 19
2.6 Cell Classification: Normal Versus Stem Cells�������������������������������� 22
2.7 Maintaining Sterile Environment: Biosafety Cabinet���������������������� 22
2.8 Maintaining Sterile Environment: Autoclave������������������������������������ 23
2.9 Cell Culture: CO2 Incubator�������������������������������������������������������������� 24
2.10 Cell Imaging: Fluorescence Microscope������������������������������������������ 25
2.11 Laboratory Task 1: Bacterial Cell Culture���������������������������������������� 26
2.12 Laboratory Task 2: Fluorescence Microscopic Imaging
of Mammalian Cells�������������������������������������������������������������������������� 30
Reference �������������������������������������������������������������������������������������������������� 32
3 Cell Metabolism �������������������������������������������������������������������������������������� 33
3.1 What Is Cell Metabolism?���������������������������������������������������������������� 33
3.2 Energy Currency: ATP���������������������������������������������������������������������� 34
3.3 Cell Metabolism: Glycolysis and TCA Cycle���������������������������������� 35
3.4 Glucose Transport and Uptake���������������������������������������������������������� 37
vii
viii Contents
Index������������������������������������������������������������������������������������������������������������������ 261
About the Author
Jeong-Yeol Yoon received his B.S., M.S., and Ph.D. degrees in chemical engineer-
ing from Yonsei University, Seoul (South Korea), in 1992, 1994, and 1999, respec-
tively. His dissertation advisor was Dr. Woo-Sik Kim, and his co-advisor was Dr.
Jung-Hyun Kim, while he worked primarily on polymer colloids. Dr. Yoon received
his second Ph.D. degree in biomedical engineering from the University of California,
Los Angeles, in 2004, working on lab-on-a-chip and biomaterials under the guid-
ance of Dr. Robin L. Garrell. He joined faculty at the University of Arizona in
August 2004 and currently holds split home appointments in the Department of
Biomedical Engineering (primary) and Department of Biosystems Engineering
(secondary). Dr. Yoon also holds joint appointments in Chemistry & Biochemistry
and BIO5 Institute. He is also associate head for graduate affairs in the Department
of Biomedical Engineering, starting from July 2018. He is currently directing
Biosensors Lab. Dr. Yoon is a member of IBE, ASABE, SPIE, BMES, and ACS and
was councillor-at-large for IBE for the 2010 and 2011 calendar years. He was the
president of the Institute of Biological Engineering (IBE) in 2015. Dr. Yoon cur-
rently serves as editor-in-chief for the Journal of Biological Engineering (the offi-
cial journal of IBE), associate editor for Biosensors and Bioelectronics (Elsevier),
and editorial board member for Scientific Reports (Springer Nature) and
Micromachines (MDPI). Dr. Yoon is the sole author of another Springer book,
Introduction to Biosensors – From Electric Circuits to Immunosensors, second edi-
tion, published in 2016, written similarly to this book.
xiii
Chapter 1
Introduction
When a tissue or an organ starts malfunctioning and drugs cannot resolve such
problems, you may wish to “substitute” the damaged tissue or organ with a new one.
Tissue or organ can be harvested from a human donor, either deceased or alive, and
transplanted to the patient. This procedure is called organ transplantation. While it
has successfully been practiced in the past, you have probably heard about the
extremely long waiting list of organ transplantation, and many patients would die
before receiving it. Because of this difficulty, synthetic materials have been used to
replace the damaged tissue or organ, made from metals, polymers, or ceramics.
They are called implants, which have shown limited successes in organs, such as
bones. However, such implants cannot metabolize nutrients, cannot produce pro-
teins, etc., and subsequently cannot truly replace the functions of tissues or organs.
Therefore, a new cell-based approach is needed to replicate a living tissue’s or
organ's structure and function. Tissue or organ can be damaged from traumatic
injury, degradation from exercise, cancer, aging, and adult-onset deficiency such as
diabetes. As tissue is made from cells and extracellular matrix (ECM), it is impor-
tant to replicate both the cells and ECM. (Implants may replace the ECM but not the
cells.) Both the cells and ECM must be “engineered” to provide structural integrity
and metabolic behavior found in normal tissue. With the narrow definition of tissue
engineering, engineered mimic of the ECM is constructed, made from either a natu-
ral material (e.g., collagen fibers) or a synthetic material (e.g., polymers). This ECM
mimic is called tissue-engineered scaffold (TE scaffold) or just scaffold. Cells are
then harvested from a patient or a donor. We can also use stem cells. They are cul-
tured and seeded on the scaffold in a laboratory, that is, in vitro (meaning “in a
representation,” typically representing a dish, flask, beaker, tube, etc.). The antonym
to in vitro is in vivo, meaning “in life,” typically representing a (human) body.
Sometimes the term ex vivo is used as an antonym to in vivo. While in vitro and ex
vivo do not necessarily represent the same, these two terms are sometimes used
interchangeably. Once the cells proliferate and exhibit normal metabolism in a scaf-
fold, it is then transplanted back to the body to replace the tissue or organ. This final
product is called tissue-engineered transplant (TE transplant). This procedure
describes the narrow definition of tissue engineering.
Early successes in tissue-engineered constructs date back to the late 1990s. The
most famous example would be the work by Cao et al., published in 1997, where a
tissue-engineered human ear was constructed on a nude mouse [Cao et al., 1997;
Bear in mind that there were many limitations and issues with this early pioneering
work]. Since then, tissue engineering has become widely known and practiced. In
the early 2000s, it has been established as a discipline. Tissue engineering is still a
new discipline at the time of writing.
Figure 1.1 shows one example of creating a tissue-engineered transplant (TE
transplant), that is, narrow definition of tissue engineering. Cells are removed from
a healthy host (or a healthy tissue from the same patient). They are cultured in a
laboratory, and the best-performing cell line is isolated. If stem cells are used, they
should also be differentiated using proper differentiation factors, physical stimuli,
and other environmental factors. A scaffold is constructed and the chosen cells are
seeded. Once the transplant is complete, it is transplanted to the patient.
Tissue-engineered transplants have numerous benefits over implants. Many
implants can be rejected from a body via inflammatory and immune responses,
where such issue is minimal with TE transplants. Since the best-performing cell line
can be selected and the scaffold design can be optimized, the resulting TE trans-
plants can perform far better than implants, while there is no availability issue com-
mon in organ transplants.
Since its conception in the early 2000s, scaffold design has been considered quite
challenging toward fully mimicking the natural ECM. One early attempt was the
use of natural ECM rather than designing and fabricating a whole new scaffold. An
organ from a dead body (cadaver) was harvested and the cells were removed with
surfactant (decellularization). This decellularized matrix was then used as a scaf-
fold. Ott et al. demonstrated this method using the heart from cadaver (published in
2008). After harvesting, they decellularized with surfactant (Fig. 1.2) and added
1.2 Early Attempt in Scaffold Development: Decellularized Matrix 3
Fig. 1.1 Narrow definition of tissue engineering. (Ude et al., 2018. (C) Open access article distrib-
uted under the terms of the Creative Commons Attribution 4.0 International License)
cardiac cells onto it. Cells were proliferated and maintained for up to 28 days in a
bioreactor (in vitro) (Fig. 1.3). The resulting construct generated the pump function
equivalent to about 2% of adult heart function. While 2% seemed very low, it was
the first demonstration of a thriving TE heart with pump function. It showed the
early promise of tissue engineering and has received a lot of media attention.
This method was groundbreaking in many aspects, eliminating many organ
transplantation issues, especially tissue healthiness or organ availability. However,
it still suffered numerous problems, such as (1) availability of cadavers and (2) lack
of engineering control over the scaffold design and structure. Therefore, follow-up
works have been focused on the design and construction of “engineered” scaffolds
that would meet the requirements of:
–– Size (volume) that can “process” the required amounts of nutrient metabolism,
protein production, waste removal, etc.
–– Mechanical properties that can fit within the available space, resist external
bending and shear force, etc.
–– Longevity that can last for a necessary duration of time
4 1 Introduction
Fig. 1.2 Decellularization of cadaveric heart. (Ott et al., 2008. Reprinted with permission, (C)
2008 Springer Nature)
One of the early examples of TE transplants is skin transplant as skin is highly pro-
lific and self-renewable, thus relatively easy to replicate with tissue engineering
technology. The skin has two layers: the outermost and top layer of the epidermis
and the immediate inner layer of the dermis (just underneath the epidermis)
(Fig. 1.4). Keratinocytes and fibroblasts make up most of the epidermis and dermis,
and they proliferate quite well both in vivo and in vitro. Damages of the epidermis
can be healed relatively quickly and do not generally require transplants. However,
severe burns damage the dermis layer and do not heal very well and usually leave
scars, where TE skin transplant can be the right solution. Diabetic patients also have
skin ulcer problems that do not heal, called diabetic ulcers (a famous example is a
diabetic foot), where TE skin transplant can also be utilized. TE skin transplant can
also be used for cosmetic purposes (plastic surgery) to replace the aged skin with a
fresh one.
As skin structure is relatively simple, a simple hydrogel of collagen fibers can be
used as a TE skin scaffold. A gel is a network of natural or synthetic polymers that
are cross-linked, filled with liquid. If the liquid is water, it is specifically called
1.3 Simple TE Transplant Example: Skin 5
Fig. 1.3 Perfusion bioreactor for constructing a tissue-engineered transplant from the decellular-
ized cadaveric heart. (Ott et al., 2008. Reprinted with permission, (C) 2008 Springer Nature)
Fig. 1.4 Human skin. The outermost layer is the epidermis (consisting of squames and keratino-
cytes), followed by the dermis (consisting of fibroblasts and ECM)
6 1 Introduction
Another example is the TE pancreas transplant. The pancreas is located just under-
neath the liver, and one of its primary functions is the release of protein insulin,
which regulates the glucose level in a body. When there is a problem with insulin,
such a disease is called diabetes. While drugs and adequate exercise may control the
diabetes symptoms, it is often necessary to self-inject insulin daily, sometimes more
than once a day. While continuous glucose monitoring (CGM) system and subse-
quent automatic insulin injection have become a reality, the ultimate solution would
be the use of TE pancreas transplant. Pancreatic cancer is another severe problem
whose mortality rate remained very high among all cancer types. Again, a TE pan-
creas transplant may be able to resolve this disease.
Decellularized cadaveric pancreas can be used as a TE scaffold, and the β-islet
cells (the primary cells in the pancreas) can be seeded and proliferated in vitro. The
β-islet cells can be harvested from a healthy donor. Unlike organ transplants, the
donor does not need to provide the whole pancreas; a small number of β-islet cells
can be extracted and proliferated in a laboratory (in vitro). The resulting TE
1.4 Simple TE Transplant Example: Pancreas 7
transplant may be rejected in the long run via immune reaction, and therefore, the
immunosuppressant drug should be taken throughout the patient’s lifespan. If the
donor is very well matched with the patient, such immune rejection could be
minimal.
A better alternative is the use of a semipermeable membrane as a TE scaffold. As
shown in Fig. 1.6, many different forms of such semipermeable membranes can be
used: (A) a cylindrical tube (macrocapsule), (B) a push-pull device with refillable
oxygen in it, and (C) a sphere (microcapsule). β-islet cells are loaded inside these
devices, where the semipermeable membrane allows the movements of oxygen,
nutrients, wastes, and protein products (e.g., insulin), moving freely inside and out.
However, these membranes’ pores are small enough to keep the β-islet cells inside
and not allow the immune cells (white blood cells) to attack the β-islet cells. This
procedure is called immunoisolation, which has been a popular method in designing
a TE scaffold.
Fig. 1.6 Immunoisolation methods can be used toward TE pancreas transplant. (Hu & de Vos,
2019 (C). Open access article distributed under the terms of the Creative Commons Attribution 4.0
International License)
8 1 Introduction
Fig. 1.8 Lung-on-a-chip example. (Shrestha et al., 2019. (C) Open access article distributed under
the terms of the Creative Commons Attribution 4.0 International License)
OOCs are typically not for in vivo use. Instead, OOCs provide a laboratory in
vitro platform for the following applications:
–– Cancer study: carcinogenesis (formation of cancer); metastasis (spread of can-
cer), etc.
–– Stem cell differentiation study: identification and optimization of physical and
biological cues to induce successful differentiation to stem cells
–– Biocompatibility test of synthetic materials (e.g., implants)
–– Drug efficacy and toxicity tests
–– Cosmetics toxicity tests
–– Studying the long-term exposure of environmental toxicants to human tissues
and organs
The above studies have conventionally been conducted by (1) in vitro cell assays,
(2) animal tests, and (3) human clinical trials, in this order. There are huge gaps
between (1) and (2) – different responses from individual cells versus tissue or
organ – and between (2) and (3) – species difference between animal and human. As
human cells are used to create a tissue or organ mimic in OOCs, such gaps would be
minimized and eventually eliminated. Besides, as the final device does not need to
be transplanted back to humans while there is a huge commercial potential, OOCs
have gained substantial popularity in tissue engineering research.
10 1 Introduction
This book is intended for the audience with limited understanding and experience in
wet laboratory-based biology. Brief and easy-to-practice laboratory modules are
introduced in each chapter. They can certainly be used for an undergraduate-level
class (or a graduate-level introductory class) with lecture and laboratory compo-
nents. However, it will equally be useful for the course with no laboratory compo-
nents. The laboratory procedures are well-documented, with ample figures,
photographs, experimental data, and subsequent analyses, which provides the vir-
tual laboratory experience. It will equally be great for the people self-studying tis-
sue engineering.
Chapter 2 will learn the fundamental basics of cell culture and the basic labora-
tory skills necessary to conduct it. Bacterial cell culture (the easiest cell culture)
laboratory will be introduced, and the use of a microscope will be demonstrated.
Chapter 3 will then advance to cell metabolism – how cells consume nutrients
and oxygen and generate wastes. Feeding and passaging – the two most essential
skills for mammalian (including human) cell culture – will be demonstrated as labo-
ratory exercises.
In Chapter 4, once cells are successfully cultured, it is crucial to “stain” the dif-
ferent areas of cells and image them. This staining and imaging process is mostly
done by fluorescence microscopy. Basic principles of fluorescence, staining, and
fluorescence microscopy will be covered, along with the laboratory exercise on
fluorescence cell imaging.
Chapter 5 will learn stem cells, which are quite crucial for many tissue engineer-
ing applications (although not always necessary). Stem cell culture and confirma-
tion of differentiation will be demonstrated as laboratory exercises.
Chapter 6 will learn various biomaterial surfaces – basically what material is
preferred for tissue engineering applications and whether a surface modification is
necessary or not. As tissue engineering requires the use of “engineered” scaffold
(including organ-on-a-chip), choice and modification of biomaterial surface must
be preceded before constructing the scaffold. Several different biomaterial surfaces
will be fabricated or prepared in the laboratory exercise. Their surface properties,
especially the two most popularly used ones – contact angle and surface rough-
ness – will be evaluated through the laboratory exercise.
Chapter 7 will learn the focal adhesion. It is a primary mechanism for most mam-
malian (including human) cells to be anchored on the extracellular matrix (ECM) to
form a functional tissue, which must be duplicated in tissue-engineered devices.
Fluorescence imaging to confirm focal adhesion will be exercised through a labora-
tory exercise.
Chapter 8 will learn contact guidance. Through focal adhesion, cells can be
aligned with the shape and pattern of ECM, which is the definition of contact guid-
ance. Again, contact guidance must be demonstrated in tissue-engineered devices to
1.6 Overview of This Book 11
References
Cao, Y., Vacanti, J. P., Paige, K. T., Upton, J., & Vacanti, C. A. (1997). Transplantation of chon-
drocytes utilizing a polymer-cell construct to produce tissue-engineered cartilage in the
shape of a human ear. Plastic and Reconstructive Surgery, 100(2), 297–302. https://doi.
org/10.1097/00006534-199708000-00001
Hu, S., & de Vos, P. (2019). Polymeric approaches to reduce tissue responses against devices
applied for islet-cell encapsulation. Frontiers in Bioengineering and Biotechnology., 7, 134.
https://doi.org/10.3389/fbioe.2019.00134
Ott, H. C., Matthiesen, T. S., Goh, S. K., Black, L. D., Kren, S. M., Netoff, T. I., & Taylor,
D. A. (2008). Perfusion-decellularized matrix: Using nature’s platform to engineer a bioartifi-
cial heart. Nature Medicine, 14, 213–221. https://doi.org/10.1038/nm1684
Shrestha, J., Ghadiri, M., Shanmugavel, M., Bazaz, S. R., Vasilescu, S., Ding, L., & Warkiani,
M. E. (2019). A rapidly prototyped lung-on-a-chip model using 3D-printed molds. Organs-on-
a-Chip, 1, 100001. https://doi.org/10.1016/j.ooc.2020.100001
Ude, C. C., Miskon, A., Idrus, R. B. H., & Bakar, M. B. A. (2018). Application of stem cells in tis-
sue engineering for defense medicine. Military Medical Research, 5, 7. https://doi.org/10.1186/
s40779-018-0154-9
Chapter 2
Cell Culture
In the previous chapter, we have learned the overview of tissue engineering princi-
ples and their applications. All tissue engineering applications start from growing
cells in an appropriate culture, which is the first topic that we should learn. Here are
two inquires for you:
Inquiry 1. What is cell culture?
More importantly, how do we “feed” cells and maintain their health? How can
we assess their health (typically by monitoring their shape, metabolism, and protein
production)?
Inquiry 2. How can we classify cell types?
Different cell types require varied methods of cell culture. Have you heard
anchorage-dependent versus anchorage-independent cells? Have you heard primary
versus stem cells? How about transformed or immortalized cells?
While there are many different definitions of cell culture, we can always find the
following three components in its definition:
(1) In vitro, meaning “in a representation,” that is, in a tube or a culture dish, and
outside a living organism (antonym is in vivo)
(2) Maintain cells in a viable state, indicating that cells should be alive and actively
proliferating (dividing or reproducing)
(3) Maintain cells in a metabolically active state
To accomplish all three, we need to feed oxygen, nutrients, and growth factors
appropriately. Maintenance of metabolically active state is quite crucial for tissue
engineering applications. Cells should produce necessary proteins and respond to
environmental factors (e.g., physical and biological cues) to perform essential func-
tions toward tissue engineering applications.
Cells are typically harvested from humans for most tissue engineering applica-
tions. For specific tissue engineering applications, we can also use the cells from
animals, plants, and bacteria. In many tissue engineering applications, it may be
preferable to use a cell population descended from a single cell, referred to as a cell
line, as they would contain identical genetic information. However, most mammal
and human cells would divide only up to a certain number of doublings (known as
Hayflick limit, discussed later in Sect. 10.2), and there are limitations in using cell
lines. On the other hand, certain cells can divide into an indefinite number of dou-
blings, appropriate as cell lines. These cells are referred to as immortalized cells.
Cancer cells are probably the most well-known example of immortalized cells (they
are spontaneously immortalized cells). One of the earliest human cell lines is HeLa
cells, descended from the cancer cell from Henrietta Lacks in the 1960s, who died
of cancer. Figure 2.1 shows the microscopic image of cultured HeLa cells with
Hoechst staining, which stains the cell nuclei in blue. (These days, cell nuclei are
stained with better dye, DAPI, which will be discussed later in Sect. 4.3.)
Cell cultures are commonly used for various applications. From the definition of
cell culture, cells must maintain a metabolically active state in cell culture, produc-
ing adequate amounts of proteins and responding to various environmental factors.
The protein production feature can be utilized in many different industrial applica-
tions. Such proteins are typically used as drugs, including vaccines. A large-scale
bioreactor can also be used instead of a simple culture dish to produce many such
drugs. Such specific application is often referred to as cellular engineering, which
shares many standard features with tissue engineering.
Protein products from cell culture include (1) enzymes, (2) hormones, (3) viral
vaccines, (4) antibodies, and (5) cytokines. Enzymes are proteins that function as
biological catalysts, that is, facilitating and speeding up chemical reactions. Many
of them can be utilized as drugs to facilitate or speed up specific chemical reactions.
Hormones are not necessarily proteins but are produced by the cells in certain
glands, regulating physiology and behavior. Viral vaccines are typically attenuated
or modified viruses that can trigger human immune responses, providing acquired
immunity but not making people sick. Recombinant protein and messenger RNA
(mRNA) are also used as viral vaccines, as seen from the recent vaccine develop-
ment for COVID-19. While vaccines to nonviral pathogens also exist, viral vaccines
are by far the most important ones. Antibodies are the proteins secreted by B lym-
phocytes (or B cells in short) in the blood that make up the critical part of humans’
and mammals’ immune systems. They bind to specific antigens (proteins, viruses,
bacteria, etc.) and neutralize their action. While antibodies have previously been
used for diagnostics and biosensing applications in the past, they are now more
frequently used in treating diseases, including many different autoimmune diseases
and various types of cancer. Cytokine (cyto = cell and kine = movement) is a collec-
tive term for the small proteins secreted from cells used for cell signaling purposes.
Specific cytokines can signal the onset or suppression of certain diseases and are
subsequently used as drugs. Famous examples include interferons (used to treat
cancer) and interleukins (secreted by inflammatory and immune cells).
Cell culture is also being popularly used for evaluating the efficacy and toxicity
of drugs. Once a new drug is identified or developed, it is assessed for its efficacy
and toxicity in three different steps, namely, (1) in vitro test, (2) animal test, and (3)
human clinical trial. Cell culture has frequently been used for the first step – in vitro
test. In such a test, varying amounts (doses) of the drugs are added to the cell cul-
ture, for example, human liver cells, human kidney cells, etc., and the cells’ viability
and metabolic status are assessed. The number of live versus dead cells is the most
frequently evaluated after a certain drug exposure time (ranging from a couple of
hours to a few weeks). The shape of cells (cell morphology) can also be assessed.
Production of specific proteins (e.g., albumin from liver cells) is also frequently
evaluated. While a simple 2D cell culture has widely been investigated for drug
efficacy and drug toxicity tests, a more sophisticated 3D cell culture has emerged as
an improved alternative. While 3D culture provides an environment that resembles
the in vivo human environment, it still lacks a network of vessels in most organs in
the human body. Organ-on-a-chip (OOC) is essentially a 3D culture with vessel
structures (thus with the active fluid flow) that can better mimic the human organ.
Most tissue engineering technologies are used in developing and using OOCs. OOC
has already been explained in Chap. 1 briefly, will be frequently mentioned through-
out this book, and discussed in detail in Chap. 11.
Before we tackle cell culture, it is essential to learn the basics of cell physiology.
Two components of cells are critical in learning cell culture and tissue engineering:
(1) membrane and (2) cytoskeleton. Here is why: most cells used in tissue engineer-
ing applications are anchorage-dependent, that is, they should be anchored on a
16 2 Cell Culture
surface to behave normally. (Do not worry – we will cover the difference between
anchorage-dependent and anchorage-independent cells later in this chapter.) And
cells’ anchorage to a surface is governed by their membrane and cytoskeleton.
The cell membrane is made from a phospholipid bilayer. Each layer is made
from phospholipid, where the head is made from a phosphate group (PO3−) that is
negatively charged. The tail of this phospholipid is simply lipid (= a long hydrocar-
bon chain). Such hydrocarbon chain is neither charged nor polar, thus insoluble to
water (water is strongly polar and thus a strong solvent). Therefore, this lipid tail is
hydrophobic (hydro = water and phobic = hating; sometimes referred to as lipo-
philic although less frequently used), while the phosphate head is hydrophilic (philic
= loving) as it is negatively charged. As the majority mass of a cell and its environ-
ment is water, the lipid tails should associate with each other to avoid the water
molecules’ entropy penalty. Such association is referred to as hydrophobic interac-
tion. This self-assembly will form a bilayer of phospholipid molecules, which is the
cell membrane’s very nature, as shown in Fig. 2.2.
As you can see from Fig. 2.2, the inner layer of a cell membrane is hydrophobic,
while the outer surfaces (one at the outside of a cell and the other facing the inside)
are negatively charged (and thus hydrophilic). In the cell membrane, there are mem-
brane proteins. Proteins are polymers of amino acids, where some amino acids are
hydrophobic and other amino acids are hydrophilic. Depending on the amino acid
sequence, some parts of a protein are hydrophobic, while the others are hydrophilic.
The hydrophobic portion of a membrane protein is associated with a phospholipid
bilayer’s lipid portion and forcing the membrane protein to stay within a phospho-
lipid bilayer. The hydrophilic part of a membrane protein is exposed to a cell mem-
brane’s outer or inner side, as shown in Fig. 2.2. They communicate with the
Fig. 2.2 Cell membrane. Phospholipids are colored in blue, showing their hydrophilic and nega-
tively charged heads and hydrophobic tails. They are associated in a bilayer form, making up a cell
membrane. Membrane proteins, colored in orange, are “floating” on this cell membrane, extruding
their structure to both inside and outside the cell (left) or only outside the cell (right)
2.2 Cell Physiology: Cell Membrane and Cytoskeleton 17
molecules outside the cells (extracellular matrix) or inside the cells (mostly cyto-
skeletons, which will be discussed in the following section). Specific membrane
proteins play critical roles in cell–cell or cell–surface adhesion, which will be dis-
cussed later in this chapter.
Cytoskeleton means the bone (= skeleton) in a cell (= cyto). It consists of three
components: (1) actin filaments, (2) microtubules, and (3) intermediate filaments.
Actin filaments are two-stranded helical polymers made from the protein actin.
They have flexible structures of diameter 5–9 nm. As shown in Fig. 2.3, they are
most highly organized on the periphery of a cell, while the actin fibers that cross a
cell (stress fibers) can also be found. Actins are initially formed as G-actin, where
“G” stands for “globular,” that is, rounded shape. Polymerization of G-actins leads
to F-actin, where “F” stands for “filament.” This polymerization (growth) proceeds
primarily in one direction, with a fast-growing “+” end. This polymerization rate
varies by the cell activity, that is, whether the cells are actively proliferating (divid-
ing), moving, or quiescent (neither proliferating nor moving). For the cells actively
proliferating and/or moving, the mean filament lifetime is relatively short (8 min),
with a small fraction (40%) of actins polymerized. For the quiescent cells, that is,
anchorage-dependent cells occupying most of the surface (= confluent monolayer,
discussed in the next section), the mean filament lifetime is quite long (40 min) with
a large fraction (70%) of actins polymerized. Actin filaments play a crucial role in
cell adhesion to a surface for anchorage-dependent cells.
Microtubules are hollow cylinders comprising the protein tubulin. Their outer
diameter is 25 nm, much larger than that of actin filaments. They are also much
more rigid and straight than actin filaments due to their cylindrical, tubular struc-
ture. Microtubules are usually attached to a single microtubule-organizing center, as
shown in Fig. 2.3. Like actin filaments, microtubules are polymerized from tubulins,
and this polymerization proceeds in one direction, with a fast-growing “+” end.
Microtubules play vital roles in the structure of cilia and flagella of cells, which
provides rigidity and assists in generating cellular motion and cell division through
forming mitotic spindle.
Fig. 2.3 Actin filaments (left), microtubules (middle), and intermediate filaments (right)
18 2 Cell Culture
As mentioned, actin filaments are the most critical cytoskeleton in cell culture,
involved in cell adhesion to a surface. For the cells in mammals and humans, that is,
cells in vivo, such surface is extracellular matrix (ECM). ECM provides a surface
where anchorage-dependent cells can be anchored to and give a specific structure
built into tissue and ultimately an organ. In cell culture, it is essential to provide an
artificial surface that mimics such ECM. The most desirable cell adhesion to a sur-
face is focal adhesion (for anchorage-dependent cells), and its schematic is shown
in Fig. 2.4. In focal adhesion, certain proteins in ECM or a specific structure and
character of an artificial surface can be recognized by a membrane protein integrin.
Such binding to integrin triggers adaptor proteins’ binding within the cell, including
actinin, talin, tensin, paxillin, and vinculin. Vinculin is the essential protein that can
connect integrin and actin filaments. While other adaptor proteins may or may not
be found at the focal adhesion site, you can always find vinculin. Identification of
vinculin has been used as a preferred method of confirming focal adhesion of
anchorage-dependent cells. In this manner, a continuous link is formed from a sur-
face, cell membrane (integrin), to the cytoskeleton (actin filaments), providing quite
At this point, you will probably have a good idea of the difference between
anchorage-dependent and anchorage-independent cells. Anchorage-dependent cells
require a surface they can anchor. The surface is typically extracellular matrix
(ECM) in vivo, while an artificial surface can also be used for the cell culture in
vitro. Anchorage-dependent cells cannot be stacked in multilayers on a surface, that
is, they can only form a monolayer. When a surface is saturated with anchorage-
dependent cells in a monolayer (caused by contact inhibition), such condition is
referred to as confluency, for example, 80% confluency represents 80% of the sur-
face is covered by anchorage-dependent cells.
On the other hand, anchorage-independent cells do not require a surface for their
proliferation and metabolism and can be cultured in a suspension. The best exam-
ples are blood cells, including red blood cells (RBCs) and white blood cells (WBCs).
As you can imagine, it will be quite problematic if blood cells are anchored to a
surface (in this case, the wall of blood vessels) – they should be able to move along
the blood flow to circulate throughout the body.
Anchorage-dependent cells can lose their anchorage-dependency and become
anchorage-independent. A famous example is cancer cells – where the normal cells
become “crazy,” dividing indefinitely (no Hayflick limit), not fulfilling their assigned
duties, consuming a large number of nutrients and oxygen, and converting the
nearby cells into cancer cells. Sounds familiar? Yes, zombies! All those zombie
movies are inspired by these crazy cancer cells, although such mutations do not
occur that quickly. As cancer cells are not doing their original duties and forgetting
who they were, they gradually forget their anchorage-dependency (Fig. 2.5).
Cells can also be classified based on their growth behavior, that is, normal versus
immortalized. Normal cells can proliferate (divide) for a limited number of times
(typically limited by Hayflick limit; discussed later in Sec. 10.2) and are highly dif-
ferentiated, that is, they perform specific functions. They usually require a variety of
growth factors and other components in the growth media, that is, a serum is pre-
ferred as growth media, which will be discussed in the later section of this chapter.
On the other hand, immortalized cells can proliferate (divide) for an indefinite
number of times, thus immortal. They are sometimes referred to as a more generic
20 2 Cell Culture
term of transformed cells, although these two terms’ specific meanings may slightly
differ. Cancer cells are considered as spontaneously immortalized cells. If the
immortalized cells were originally anchorage-dependent cells, they lose their
anchorage-dependency in full or in part and become (partly) anchorage-independent.
Once they lose their anchorage-dependency, they can grow in suspension or multi-
layers without contact inhibition. As they tend to lose their differentiation, it is
essential to retain some differentiation if you plan to use immortalized cells for tis-
sue engineering applications. As they are “crazy” cells, they are not picky eaters and
may not need sophisticated serum as their growth media.
As discussed earlier in this chapter, a healthy cell culture requires (1) a viable
state and (2) a metabolically active state. As immortalized cells focus on the first
condition of a viable state, they comprise the second condition of the metabolically
active state. Therefore, their metabolism, protein production (including cell signal-
ing), and response to environmental factors (including anchorage-dependency) can
be compromised in part or in full. Besides, the rate of DNA mutation increases, and
it becomes harder to fix it.
2.5 Cell Classification: Normal Versus Immortalized Cells 21
Various methods can be used to immortalize normal cells. One of the standard
techniques is infecting normal mammalian cells (= human and mammal cells) with
a virus that can cause cancer. SV-40 (simian vacuolating virus 40 or simian virus 40
in short) is a good example, which is a small DNA virus found in monkeys and
humans (thus “simian”) and can cause cancer to them. Various mammalian cells
have been infected with SV-40, causing them to partially or fully lose their serum
requirement, anchorage-dependency, and thus gaining immortality.
Primary cells and cell lines are often used in place of normal versus immortal-
ized cells. Primary cells are harvested from mammals or humans, and they are most
likely normal cells, that is, differentiated cells. On the other hand, cell lines are the
ones that descended from a single cell and thus have been passaged for a long time
(refer to the next section of cell passaging). While both normal and immortalized
cells can be used for cell lines, cell lines are most likely immortalized cells as they
can proliferate (divide) for an indefinite number of times. In this sense, normal ver-
sus immortalized cells and primary cells versus cell lines are sometimes used inter-
changeably, although their exact meanings differ.
Both primary cells and cell lines should be stored frozen for long-term storage.
Most refrigerators have a dedicated section for freezing, and exclusive freezers are
also available. However, these freezers can only provide a temperature around
−20°C and are inappropriate for storing mammalian cells for the long term. Because
of this, deep freezers are available, which can provide −40 °C or −80 °C, respec-
tively (Fig. 2.6, left). Of course, the −80 °C deep freezer is substantially more
expensive than the −40 °C one. However, the ultimate solution is to store these cells
in liquid nitrogen storage, which will provide −196 °C (the boiling temperature of
liquid nitrogen) (Fig. 2.6, right).
Fig. 2.6 −40 °C deep freezer (left) and liquid nitrogen tank (right) for storing mammalian cells
22 2 Cell Culture
Fig. 2.7 A class II biosafety cabinet: (left) overall view and (right) inside view
and tips can be placed inside an autoclave, and high temperature (over 120 °C) and
high pressure (above 15 PSI = 0.1 MPa) are applied to disinfect (= kill) any bacteria,
yeast, etc.
Fig. 2.9 Left: double-stacked CO2 incubator with a CO2 gas tank attached to it; right: multiple cell
culture flasks within a CO2 incubator
(when dissolved into water, CO2 turns into bicarbonate and becomes acidic).
Traditional incubators, for example, without CO2, can be used to culture bacteria.
Figure 2.9 shows a typical CO2 incubator. In this case, two incubators are stacked.
You can see a CO2 gas tank next to it. Within the CO2 incubator, multiple cell culture
flasks are stacked, each being cultured with different cells and varying media
conditions.
Once cells are properly cultured, you may wish to image them to count their num-
ber, check their shape (morphology), and identify subcellular components. As cells
are too small to be imaged by a conventional camera, a microscope becomes neces-
sary. A typical microscope is shown in Fig. 2.10, where an objective lens is located
underneath the sample stage. This setup is known as an inverted microscope, which
is popular in cell imaging as it provides more room to a user. When the objective
lens is located on top of the sample stage, it is known as an upright microscope,
which is more traditional but less popular in cell imaging as it does not provide suf-
ficient room to a user.
In cell imaging, it is quite common to stain different subcellular components
with varying fluorescent dyes. It is quite challenging to figure out subcellular parts
purely based on their shapes. For example, nuclei can be stained with a
26 2 Cell Culture
4. Close the lid of a tube and shake it gently using your hand (Fig. 2.11, left).
Objective 2. Culturing in an Incubator
5. Place the tube in an incubator (Fig. 2.11, right). A regular incubator is preferred.
It may be possible to use a CO2 incubator without a CO2 supply. However, it may
contaminate the CO2 incubator and should be used with caution, and the inside
cabinet should thoroughly be disinfected after the culture.
6. Maintain 37 °C and culture for 6 h or overnight (~12 h) (Fig. 2.12).
Fig. 2.11 After gentle mixing of LB and E. coli K12 powder (left), tubes are placed in an incuba-
tor at 37 °C (right)
Fig. 2.12 E. coli suspension culture over time, from 2 h (left), 4 h (middle left), 6 h (middle right),
and overnight (~12 h; right). You can observe more gas formation in the early phase (= active
metabolism) and more turbid solution in the later phase (= a great number of E. coli cells)
28 2 Cell Culture
Fig. 2.13 Left: LB (as a blank) or E. coli culture suspension is loaded into a cuvette; right: the
cuvette with the sample is placed within a spectrophotometer (a miniature spectrometer with a
light source and a cuvette holder from Ocean Optics)
Fig. 2.14 Intensity spectrum of E. coli suspension. Note that high-intensity (I) value is correlated
to smaller absorbance (A), as A = −log I / I0
2.11 Laboratory Task 1: Bacterial Cell Culture 29
Fig. 2.15 Absorbance values at 600 nm for E. coli K12 culture are plotted against time
30 2 Cell Culture
Fig. 2.19 Images acquired by a fluorescence microscope. The blue fluorescence image shows
nuclei (top left), the green fluorescence image shows actin filaments (top right), the red fluores-
cence image shows mitochondria (bottom left), and the stacked image is finally shown (bottom
right). (Reprinted with permission from Yoon, 2016. (C) 2016 Springer)
Review Questions
1. Describe three main objectives of cell culture.
2. What is a cell line, and how is it different from a primary cell?
3. What are membrane proteins, and how can they be stable within the cell
membrane?
4. Describe the differences in actin filaments, microtubules, and intermediate filaments.
5. Describe the differences between anchorage-dependent and anchorage-
independent cells.
6. What is focal adhesion? Why is it important for anchorage-dependent cells?
7. What is cell immortalization? How can it be done?
8. What are the negative impacts of cell immortalization?
9. How is a biosafety cabinet different from a chemical hood?
10. Why is CO2 needed for mammalian cell culture?
11. Compare two different incubators for bacterial and mammalian cell culture.
12. Draw a typical cell growth curve. Identify each phase.
Reference
In the previous chapter, we have learned the basics of cell culture. In this chapter,
we will learn the details of cell culture – how we can feed and grow them. Here are
three inquires for you:
Inquiry 1. What is cell metabolism?
How do cells “eat” nutrients and metabolize them with oxygen? And how do
cells generate energy (ATPs) and produce proteins?
Inquiry 2. How do we feed cells?
More specifically, how do we prepare the media for cells? Should we replace or
replenish media periodically? Why do we need to “passage” cells?
Inquiry 3. How can we determine the initial cell number (or density) for tissue engi-
neering applications?
It can be calculated using the first-order growth model under varying cell culture
restrictions.
Cells require nutrients (and oxygen) to generate energy, produce proteins, and pro-
liferate (divide) themselves. Nutrients include sugars, amino acids, small molecules,
etc. Energy is generated in the form of ATP (adenosine triphosphate), which is the
primary energy currency in cell metabolism (other forms of energy currency are
also available). Cells can also produce small molecules, such as lactic acid, ammo-
nia, water, etc., as waste or by-products. These processes, taken together, form cell
metabolism. It can be divided into two parts: (1) catabolic reaction, that is, break-
down of complex molecules to generate energy (e.g., ATP) while generating small
molecules as waste or by-product, and (2) anabolic reaction, that is, biosynthesis of