Dermis is the major compartment of skin tissue, dictating the overall functionality of the tissue in large part through its extracellular matrix. Due to the clinical dissimilarities of the studied skin diseases, we first questioned whether those were related to alterations in the extracellular matrix of the dermis. We found that each type of disease has its own fingerprint; yet, despite the highly different clinical manifestation of the varied dystrophic epidermolysis bullosa variants, common unique traits may serve as therapeutic targets. The next step towards the generation of extracellular matrix-based bioinks, led to the establishment of a new method of extraction and fractioning of extracellular matrix without losing key components. Importantly, the obtained extracts featured specific biological functions providing important cues to the different bioink formulations. Key technological tools such as a printer that allow using different inks to fabricate a single 3D structure, and a dynamic culture platform that facilitates the generation and maintenance of mature and functional complex tissues/multi-tissues, were developed concurrently.
Ultimately, fully biological dystrophic epidermolysis bullosa and squamous cell carcinoma models were fabricated demonstrating that native extracellular matrix comprises key components that must be included in the recreation of bioengineering models, particularly for disease modelling.