Toward 4D printed functional soft tissues.

Amal Shabazz, Julia Fitlin, Henry Orozco-Contreras, Shengbo Guo, Lijie Grace Zhang, John P Fisher

Abstract readReview

In one paragraph

Review in Acta biomaterialia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amal ShabazzFischell Department of Bioengineering, University of Maryland, College Park, MD, USA; Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA.

Julia FitlinFischell Department of Bioengineering, University of Maryland, College Park, MD, USA; Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA.

Henry Orozco-ContrerasFischell Department of Bioengineering, University of Maryland, College Park, MD, USA; Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA.

Shengbo GuoDepartment of Mechanical and Aerospace Engineering, The George Washington University, WA, DC, USA.

Lijie Grace ZhangDepartment of Mechanical and Aerospace Engineering, The George Washington University, WA, DC, USA.

John P FisherFischell Department of Bioengineering, University of Maryland, College Park, MD, USA; Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA. Electronic address: jpfisher@umd.edu.

Funding

3D Bioprinted Nipple-Areolar Complex ImplantsR01HD112031 · NICHD · UNIV OF MARYLAND, COLLEGE PARK · PI John P Fisher · 2023 to 2026

$2.2M

NICHD NIH HHS R01 HD112031

6 · The paper itself

Abstract

The repair of soft tissue defects remains a leading clinical challenge for patients with active lifestyles, unintentional falls and injuries, cancer, and age-related diseases. Tissue engineering and 3D printing have been developed over the last decades as strategies to create personalized tissue mimics by precisely depositing biomaterials and cells to fabricate static constructs. However, long-term clinical solutions call for increasing the complexity of engineered models to incorporate bioactive processes that mimic the dynamic nature of human tissues. 4D printing has therefore become a growing strategy for building soft tissue constructs that exert function with time. The critical challenge lies in balancing biologically relevant tissue-specific function with programmable material capabilities in response to environmental stimuli. This review highlights the technological advancements that have improved progress in soft tissue engineering to build complex skin, cardiovascular, nerve, skeletal muscle, and connective tissue constructs. We first discuss mechanisms for 4D material actuation through external stimuli, which, when combined with advanced additive manufacturing tools, can assemble and program responsive tissue mimics. We next address progress in engineering functional soft tissues, which are characterized by tissue type, and discuss their limitations. Finally, the challenges associated with the fabrication of next generation 4D printed soft tissues are defined, and emerging frontiers are highlighted. STATEMENT OF SIGNIFICANCE: Soft tissue regeneration remains a clinical reconstructive challenge due to the hierarchical nature and intricate mechanics of native tissue. While 3D printing is an effective strategy for short-term healing outcomes, most tissues in the human body rely on dynamic properties to support normal physiological function. 4D printing strategies offer improvements in complexity to embed tissue-specific function into bioprinted constructs. Many existing reviews thoroughly cover 4D printing technologies and stimuli; however, their applications in soft tissue engineering toward prototyping functional tissue mimics remain underexplored. This review explores programmable stimuli for 4D printed soft tissues, advancements and limitations in function classified by soft tissue type, and insights and strategies for future challenges to work toward 4D printed functional, engineered soft tissues.

Indexed as

BioprintingConnective TissuePrinting, Three-DimensionalTissue EngineeringTissue ScaffoldsAnimalsHumans3D printing4D printingBiofabricationRegenerative medicineTissue engineering

Identifiers

PMID41722747

DOI10.1016/j.actbio.2026.02.035

PMCPMC13003350

What Socratic holds

Textmetadata

LicenceTDM

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.