How 3D printing could revolutionise medicine

The air has the acrid tang of chem­i­cals. Flasks with colour­ful liq­uids sit in fume hoods, while pur­ple-gloved researchers in white lab coats study chem­i­cal struc­tures on their com­put­er screens. Phar­ma­ceu­ti­cal sci­ences lec­tur­er Dr Stephen Hilton hands over a pair of safe­ty gog­gles and the tour of the lab at Uni­ver­si­ty Col­lege Lon­don begins.

It’s not the chem­i­cals that are of inter­est per se, but rather the row of box-like machines which line the back wall. This lab is home to the Stephen Hilton Group; 14 researchers with a par­tic­u­lar inter­est in 3D print­ing and chem­i­cals. There are 11 3D print­ers here; one makes a buzzy whirr as it spits out a mould.

3D print­ing, also known as addi­tive man­u­fac­tur­ing, takes a com­put­er-gen­er­at­ed design and turns it into a three-dimen­sion­al object via a spe­cial print­ing machine that deposits suc­ces­sive lay­ers of a mate­r­i­al, such as plas­tic or met­al, on top of each oth­er. The tech­nol­o­gy is well known for mak­ing quirky pieces of jew­ellery and plas­tic repli­cas of the Eif­fel Tow­er. But as costs have decreased, inter­est has surged and the tech­nol­o­gy is now com­mon in main­stream man­u­fac­tur­ing from car parts to toys.

$6 billion market by 2025

Health­care is set to be a big win­ner from 3D print­ing, with hear­ing aids, pros­thet­ics and implants already trans­form­ing the space. Accord­ing to con­sul­tants Frost & Sul­li­van, the health­care indus­try will dri­ve 3D-print­ing growth, which will bal­loon into a $6‑billion mar­ket by 2025.

But it’s what 3D print­ing might mean for the pills we pop that is real­ly spark­ing inter­est and a flur­ry of research activ­i­ty. Last year, the US Food and Drug Admin­is­tra­tion approved epilep­sy drug Spri­tam (lev­e­tirac­etam), the world’s first 3D-print­ed pill. The tablet, man­u­fac­tured by Apre­cia Phar­ma­ceu­ti­cals, is print­ed with alter­nate lay­ers of pow­der and droplets of liq­uid, cre­at­ing a very high-dose drug with the abil­i­ty to dis­solve quick­ly. These fea­tures togeth­er are unachiev­able by con­ven­tion­al man­u­fac­tur­ing.

Spritam’s approval is a mile­stone moment and now paves the way for a future of 3D-print­ed med­i­cines. But these med­i­cines won’t be any­thing like today’s. As Dr Hilton notes, 3D print­ing allows con­cepts to move “beyond imag­i­na­tion”. “It’s amaz­ing­ly excit­ing,” he says. “There’s a lot of hype about 3D print­ing, but a lot of poten­tial as well. In the­o­ry we can make any­thing we want.”

Health­care is set to be a big win­ner from 3D print­ing, with hear­ing aids, pros­thet­ics and implants already trans­form­ing the space

With this in mind, we may be pop­ping pyra­mid-shaped pills in the future or 4D-print­ed med­i­cines that change shape in the stom­ach. This is based on research by Dr Hilton’s group, which found that dif­fer­ent shaped drugs, which can only be made through 3D print­ing, had dif­fer­ent rates of drug release. Com­plex “polyp­ills” could also become a real­i­ty, as seen with research at Not­ting­ham

Epilep­sy treat­ment Spri­tam, pro­duced by Apre­cia Phar­ma­ceu­ti­cals, became the world’s first approved 3D-print­ed drug in August 2015

Uni­ver­si­ty, where one pill con­tain­ing five drugs was suc­cess­ful­ly 3D print­ed.

A one pill solution

These inno­va­tions would change how patients take their med­ica­tions in the future, with dos­es tai­lored to indi­vid­u­als and one pill a day or week replac­ing the mul­ti­tudes of tablets that might nor­mal­ly have to be tak­en. Drugs would be eas­i­er to take, work bet­ter and have few­er side effects.

Even more futur­is­tic is research at the Uni­ver­si­ty of Glas­gow, where regius pro­fes­sor of chem­istry Lee Cronin is cre­at­ing 3D-print­ed chem­i­cal reac­tors that car­ry out reac­tions to make new mol­e­cules. Using a dig­i­tal code, chang­ing the shape of 3D-print­ed ves­sels and alter­ing a mix of 3D-print­ed base ingre­di­ents, Pro­fes­sor Cronin can cre­ate chem­i­cal reac­tions and pro­duce dif­fer­ent drugs. He is val­i­dat­ing this approach to devel­op a 3D-print­er-like chem­i­cal robot to accel­er­ate the dis­cov­ery and man­u­fac­ture of new nov­el drugs in the future.

Yet 3D print­ing won’t just change the types of med­i­cines we take in the future, but also how we access them or rather where they will be print­ed. 3D print­ing pills at home is a pos­si­bil­i­ty, but still a long way off, with numer­ous issues to address.

More like­ly, and what many experts spec­u­late, is that phar­ma­cies will become 3D-print­ing med­i­cine hubs. Here phar­ma­cists would be hand­ed a pre­scrip­tion, down­load a recipe from a phar­ma­ceu­ti­cal com­pa­ny, then 3D print the drug from basic ingre­di­ents while the patient waits.

“This is some­thing phar­ma­cists are wak­ing up to,” says Pro­fes­sor Jayne Lawrence, chief sci­en­tist at the Roy­al Phar­ma­ceu­ti­cal Soci­ety. “They’re start­ing to realise this is a pos­si­bil­i­ty.” And the time-frame? About ten years.

There are, of course, a num­ber of chal­lenges with this future sce­nario, includ­ing qual­i­ty con­trol, cyber attacks and ille­gal or coun­ter­feit use. Mean­while, reg­u­la­to­ry hur­dles, safe­ty lia­bil­i­ty issues and out­dat­ed health­care infra­struc­ture could poten­tial­ly delay adop­tion.

Monumental improvement for developing countries

Regard­less, this future is very real. Print­ing drugs on demand would cut stor­age and ship­ping costs, and improve access to med­i­cines. For devel­op­ing coun­tries, this alone would be mon­u­men­tal. “The beau­ty of 3D print­ing is it reduces health inequal­i­ties world­wide because med­i­cine becomes acces­si­ble for every­one,” says Dr Hilton.

Sim­ple tablets will be print­ed ini­tial­ly, but the ulti­mate out­come is for per­son­alised 3D-print­ed drugs. “Peo­ple would be able to have med­i­cine tai­lored to their age, size, gen­der and med­ical require­ments, rather than hav­ing to con­form to cur­rent mass-pro­duc­tion stan­dards,” says Lucy Ack­land, senior devel­op­ment engi­neer at the Insti­tu­tion of Engi­neer­ing and Tech­nol­o­gy.

She believes per­son­al infor­ma­tion will be entered into the pharmacist’s com­put­er where an algo­rithm will adjust the recipe, pro­duc­ing a drug tai­lored to the patient. In this way, peo­ple with swal­low­ing dif­fi­cul­ties could get quick dis­solve tablets, pills in fun shapes could be print­ed for chil­dren, ten drugs could be com­bined into one pill or brail bumps added for those with poor eye­sight.

Back in his lab, Dr Hilton denies 3D print­ing med­i­cines is rev­o­lu­tion­ary. The tech­nol­o­gy already exists, he says. It’s just the mat­ter of link­ing it togeth­er. The break­through is in explor­ing con­cepts you couldn’t think about before. “Now you can take the con­cept of ‘what if’ and use the tech­nol­o­gy to explore its lim­its,” he says. “This is beyond imag­i­na­tion. That’s excit­ing stuff.”

FIVE 3D-PRINTING MEDICAL BREAKTHROUGHS

01 Pros­thet­ics

3D print­ing allows the cus­tomised pro­duc­tion of pros­thet­ics at a frac­tion of the cost of tra­di­tion­al pros­thet­ics. Arm pros­thet­ics are the most notable cur­rent use, with the tech­nol­o­gy par­tic­u­lar­ly pop­u­lar in war-torn coun­tries. But research into oth­er 3D-print­ed pros­thet­ics such as ears is under­way.

02 Equip­ment and devices

A vari­ety of med­ical equip­ment can be 3D print­ed, such as for­ceps and clamps, which can dras­ti­cal­ly cut costs and could be par­tic­u­lar­ly use­ful in devel­op­ing coun­tries where access and san­i­ta­tion can be a prob­lem. Already cus­tomised 3D-print­ed hear­ing aids are wide­ly avail­able.

03 Mod­els

While mod­els of any part of the human anato­my can be 3D print­ed, it’s the fact these could be patient-spe­cif­ic based on CT and MRI scans that is excit­ing. Such mod­els can be used in prepa­ra­tion for surgery or as tai­lor-made implants, such as in facial, den­tal or cra­nial recon­struc­tion.

04 Scaf­folds

Researchers have been able to 3D print porous biodegrad­able scaf­folds. These could be implant­ed in the body where cells migrate into the scaf­fold, form­ing new tis­sue and effec­tive­ly regen­er­at­ing a new organ. New bone has been grown in this way, while cus­tomised nose and ear scaf­folds are also being explored.

05 3D-print­ed tis­sue

Researchers have suc­cess­ful­ly 3D print­ed live cells to pro­duce dif­fer­ent tis­sue types includ­ing, skin, liv­er, car­ti­lage and blood ves­sels. This 3D bio­print­ing can be used to test new med­i­cines, but the future poten­tial is to 3D print new organs using the patient’s own cells, which would reduce organ rejec­tion.