Bioinspired interface between – old and new – in medicine

In medicine, engineered tissue substitutes (THE NEW) need to be truly “bioinspired” to have an evolutionary significance: as in the case of theevolutionary strategy, which has allowed successful vertebrate survival (THE OLD),function follows form. This involves a progressively positive role for the repetition of the cycles that make function follow form, the latter in turn following function. The methodological translation of all this is the fact that the first phase of the construction of an engineered tissue begins with the design and realisation of a metal scaffold, polymeric or mineral, serving as a substrate and interface for the growth of the cells that will give rise to the new tissue. These structures are open systems that encourage implanted cells to interact with the host tissue and form a new tissue, which after degradation of the artificial support will become structurally integrated. “INDIRECT” INTERFACE INTERACTION COMPUTER-AIDED DESIGN (CAD) – TISSUE-ENGINEERED INTERFACE The development of image processing technologies (CAD/CAM) has also contributed to tissue engineering, especially to what has come to be called Computer-Aided Tissue Engineering (CATE). Magnetic resonance imaging (MRI) and computed tomography (CT) now allow computer design of the internal structures of tissues and organs (CAD/CAM System), allowing to predefine the micro- and macroscopic scaffold structure to obtain the finished product . This is realised in the most appropriate material (polymers, metals, minerals), which after implantation in the body will promote tissue reconstitution in the desired shape . “DIRECT” INTERFACE INTERACTION NANOTECHNOLOGICAL INTERFACE Traditional manufacturing methods do not allow to make scaffolds with predefined 3D structures. However, in the manufacturing of devices with 2D structures surface topography, both chemical and geometrical, has a critical role in material biointegration with the tissue to be repaired. This can be achieved with recent techniques that allow to make the surface of these materials “nanostructured”, i.e. characterised by high affinity for the molecular organisation of the cells that interface with it. Information on cells (morphology, doubling time, adhesion, etc.), materials (surface morphology, mechanism of degradation, contact angle, chemical composition, etc), and their interactions will be collected in a database endowed with a relational structure. The highly structured organisation of the data will allow both a user-friendly presentation of the information to improve the reasoning process and also the implementation of an artificial intelligence-based tool to indicate, in an objective way and in semiquantitative form, different degrees of compatibility between possible new materials and the cells considered.