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Staff member

Juanma Fernandez Costa

Staff member publications

De Chiara, F, Ferret-Miñana, A, Fernández-Costa, JM, Ramón-Azcón, J, (2024). The Tissue Engineering Revolution: From Bench Research to Clinical Reality Biomedicines 12, 453

Tejedera-Villafranca, A, Montolio, M, Ramón-Azcón, J, Fernández-Costa, JM, (2023). Mimicking sarcolemmal damage in vitro: a contractile 3D model of skeletal muscle for drug testing in Duchenne muscular dystrophy Biofabrication 15, 45024

Duchenne muscular dystrophy (DMD) is the most prevalent neuromuscular disease diagnosed in childhood. It is a progressive and wasting disease, characterized by a degeneration of skeletal and cardiac muscles caused by the lack of dystrophin protein. The absence of this crucial structural protein leads to sarcolemmal fragility, resulting in muscle fiber damage during contraction. Despite ongoing efforts, there is no cure available for DMD patients. One of the primary challenges is the limited efficacy of current preclinical tools, which fail in modeling the biological complexity of the disease. Human-based three-dimensional (3D) cell culture methods appear as a novel approach to accelerate preclinical research by enhancing the reproduction of pathophysiological processes in skeletal muscle. In this work, we developed a patient-derived functional 3D skeletal muscle model of DMD that reproduces the sarcolemmal damage found in the native DMD muscle. These bioengineered skeletal muscle tissues exhibit contractile functionality, as they responded to electrical pulse stimulation. Sustained contractile regimes induced the loss of myotube integrity, mirroring the pathological myotube breakdown inherent in DMD due to sarcolemmal instability. Moreover, damaged DMD tissues showed disease functional phenotypes, such as tetanic fatigue. We also evaluated the therapeutic effect of utrophin upregulator drug candidates on the functionality of the skeletal muscle tissues, thus providing deeper insight into the real impact of these treatments. Overall, our findings underscore the potential of bioengineered 3D skeletal muscle technology to advance DMD research and facilitate the development of novel therapies for DMD and related neuromuscular disorders.

JTD Keywords: 3d cell culture, disease modeling, drug testing, duchenne muscular dystrophy, sarcolemmal damage, skeletal muscle, 3d cell culture, Animal-models, Disease modeling, Dmso, Drug testing, Duchenne muscular dystrophy, Gene, Image, Mechanisms, Sarcolemmal damage, Skeletal muscle, Tissue engineering


Mughal, S, Xia, QR, Costa, JMF, Azcón, JR, (2023). Taurine Supplementation against Steroid Myopathy in 3-D in vitro Skeletal Muscle Tissues Tissue Engineering Part a 29, PP-391

Fernández-Garibay, X, Gómez-Florit, M, Dominguez, RMA, Gomes, ME, Fernández-Costa, JM, Ramón-Azcón, J, (2023). Xeno-free bioengineered human skeletal muscle tissues Tissue Engineering Part a 29, PP-435

Fernández-Costa, JM, Tejedera-Vilafranca, A, Fernández-Garibay, X, Ramón-Azcón, J, (2023). Muscle-on-a-chip devices: a new era for in vitro modelling of muscular dystrophies Disease Models & Mechanisms 16, dmm050107

Muscular dystrophies are a heterogeneous group of highly debilitating diseases that result in muscle atrophy and weakness. The lack of suitable cellular and animal models that reproduce specific aspects of their pathophysiology is one of the reasons why there are no curative treatments for these disorders. This highlights a considerable gap between current laboratory models and clinical practice. We strongly believe that organs-on-chip could help to fill this gap. Organs-on-chip, and in particular muscles-on-chip, are microfluidic devices that integrate functional skeletal muscle tissues. Biosensors in these systems allow monitoring of muscle homeostasis or drug responses in situ. This Perspective outlines the potential of organs-on-chip as advanced models for muscular dystrophies, as well as the current challenges and future opportunities for this technology.© 2023. Published by The Company of Biologists Ltd.

JTD Keywords: cell, tissue, Skeletal-muscle


Fernández-Costa, JM, Ortega, MA, Rodríguez-Comas, J, Lopez-Muñoz, G, Yeste, J, Mangas-Florencio, L, Fernández-González, M, Martin-Lasierra, E, Tejedera-Villafranca, A, Ramon-Azcon, J, (2023). Training-on-a-Chip: A MultiOrgan Device to Study the Effect of Muscle Exercise on Insulin Secretion in Vitro Advanced Materials Technologies 8, 2200873

Overby, SJ, Cerro-Herreros, E, Espinosa-Espinosa, J, González-Martínez, I, Moreno, N, Fernández-Costa, JM, Balaguer-Trias, J, Ramón-Azcón, J, Pérez-Alonso, M, Moller, T, Llamusí, B, Artero, R, (2023). BlockmiR AONs as Site-Specific Therapeutic MBNL Modulation in Myotonic Dystrophy 2D and 3D Muscle Cells and HSALR Mice Pharmaceutics 15, 1118

The symptoms of Myotonic Dystrophy Type 1 (DM1) are multi-systemic and life-threatening. The neuromuscular disorder is rooted in a non-coding CTG microsatellite expansion in the DM1 protein kinase (DMPK) gene that, upon transcription, physically sequesters the Muscleblind-like (MBNL) family of splicing regulator proteins. The high-affinity binding occurring between the proteins and the repetitions disallow MBNL proteins from performing their post-transcriptional splicing regulation leading to downstream molecular effects directly related to disease symptoms such as myotonia and muscle weakness. In this study, we build on previously demonstrated evidence showing that the silencing of miRNA-23b and miRNA-218 can increase MBNL1 protein in DM1 cells and mice. Here, we use blockmiR antisense technology in DM1 muscle cells, 3D mouse-derived muscle tissue, and in vivo mice to block the binding sites of these microRNAs in order to increase MBNL translation into protein without binding to microRNAs. The blockmiRs show therapeutic effects with the rescue of mis-splicing, MBNL subcellular localization, and highly specific transcriptomic expression. The blockmiRs are well tolerated in 3D mouse skeletal tissue inducing no immune response. In vivo, a candidate blockmiR also increases Mbnl1/2 protein and rescues grip strength, splicing, and histological phenotypes.

JTD Keywords: antisense oligonucleotides, aon, blockmir, brain, expression, genes, mbnl, mir-218, mir-23b, mirna, muscleblind, myotonic dystrophy 1, phenotypes, proteins, type-1, Messenger-rna, Muscleblind, Myotonic dystrophy 1


Mughal, S, Lopez-Munoz, GA, Fernandez-Costa, JM, Cortes-Resendiz, A, De Chiara, F, Ramon-Azcon, J, (2022). Organs-on-Chips: Trends and Challenges in Advanced Systems Integration Advanced Materials Interfaces 9,

Organ-on-chip platforms combined with high-throughput sensing technology allow bridging gaps in information presented by 2D cultures modeled on static microphysiological systems. While these platforms do not aim to replicate whole organ systems with all physiological nuances, they try to mimic relevant structural, physiological, and functional features of organoids and tissues to best model disease and/or healthy states. The advent of this platform has not only challenged animal testing but has also presented the opportunity to acquire real-time, high-throughput data about the pathophysiology of disease progression by employing biosensors. Biosensors allow monitoring of the release of relevant biomarkers and metabolites as a result of physicochemical stress. It, therefore, helps conduct quick lead validation to achieve personalized medicine objectives. The organ-on-chip industry is currently embarking on an exponential growth trajectory. Multiple pharmaceutical and biotechnology companies are adopting this technology to enable quick patient-specific data acquisition at substantially low costs.

JTD Keywords: A-chip, Biosensor, Biosensors, Cancer, Cells, Culture, Disease models, Epithelial electrical-resistance, Hydrogel, Microfabrication, Microphysiological systems, Models, Niches, Organ-on-a-chips, Platform


Fernández-Garibay, X, Gómez-Florit, M, Domingues, RMA, Gomes, ME, Fernández-Costa, JM, Ramón-Azcón, J, (2022). Xeno-free bioengineered human skeletal muscle tissue using human platelet lysate-based hydrogels Biofabrication 14, 45015

Abstract Bioengineered human skeletal muscle tissues have emerged in the last years as new in vitro systems for disease modeling. These bioartificial muscles are classically fabricated by encapsulating human myogenic precursor cells in a hydrogel scaffold that resembles the extracellular matrix. However, most of these hydrogels are derived from xenogenic sources, and the culture media is supplemented with animal serum, which could interfere in drug testing assays. On the contrary, xeno-free biomaterials and culture conditions in tissue engineering offer increased relevance for developing human disease models. In this work, we used human platelet lysate-based nanocomposite hydrogels (HUgel) as scaffolds for human skeletal muscle tissue engineering. These hydrogels consist of human platelet lysate reinforced with cellulose nanocrystals (a-CNC) that allow tunable mechanical, structural, and biochemical properties for the 3D culture of stem cells. Here, we developed hydrogel casting platforms to encapsulate human muscle satellite stem cells in HUgel. The a-CNC content was modulated to enhance matrix remodeling, uniaxial tension, and self-organization of the cells, resulting in the formation of highly aligned, long myotubes expressing sarcomeric proteins. Moreover, the bioengineered human muscles were subjected to electrical stimulation, and the exerted contractile forces were measured in a non-invasive manner. Overall, our results demonstrated that the bioengineered human skeletal muscles could be built in xeno-free cell culture platforms to assess tissue functionality, which is promising for drug development applications.

JTD Keywords: 3d culture, generation, identification, image, manipulate, matrigel, mechanics, model, platelet lysate, scaffolds, skeletal muscle, tissue engineering, xeno-free, Platform, Skeletal muscle, Xeno-free


De Chiara, F, Ferret-Miñana, A, Fernández-Costa, JM, Senni, A, Jalan, R, Ramón-Azcón, J, (2022). Fatty Hepatocytes Induce Skeletal Muscle Atrophy In Vitro: A New 3D Platform to Study the Protective Effect of Albumin in Non-Alcoholic Fatty Liver Biomedicines 10, 958

The liver neutralizes endogenous and exogenous toxins and metabolites, being metabolically interconnected with many organs. Numerous clinical and experimental studies show a strong association between Non-alcoholic fatty liver disease (NAFLD) and loss of skeletal muscle mass known as sarcopenia. Liver transplantation solves the hepatic-related insufficiencies, but it is unable to revert sarcopenia. Knowing the mechanism(s) by which different organs communicate with each other is crucial to improve the drug development that still relies on the two-dimensional models. However, those models fail to mimic the pathological features of the disease. Here, both liver and skeletal muscle cells were encapsulated in gelatin methacryloyl and carboxymethylcellulose to recreate the disease’s phenotype in vitro. The 3D hepatocytes were challenged with non-esterified fatty acids (NEFAs) inducing features of Non-alcoholic fatty liver (NAFL) such as lipid accumulation, metabolic activity impairment and apoptosis. The 3D skeletal muscle tissues incubated with supernatant from fatty hepatocytes displayed loss of maturation and atrophy. This study demonstrates the connection between the liver and the skeletal muscle in NAFL, narrowing down the players for potential treatments. The tool herein presented was employed as a customizable 3D in vitro platform to assess the protective effect of albumin on both hepatocytes and myotubes.

JTD Keywords: 3r, ammonia, cirrhosis, crosstalk, disease, expression, myostatin, nefas, sarcopenia, tissue engineering, Crosstalk, Nuclear factor 4-alpha, Tissue engineering


Fernandez-Garibay, X, Ortega, MA, Cerro-Herreros, E, Comelles, J, Martinez, E, Artero, R, Fernandez-Costa, JM, Ramon-Azcon, J, (2022). BIOENGINEERED IN VITRO 3D MODEL OF MYOTONIC DYSTROPHY TYPE 1 HUMAN SKELETAL MUSCLE (Abstract 2087) Tissue Engineering Part a 28, S591-S591

Myotonic dystrophy type 1 (DM1) is the most common hereditarymyopathy in adults. The disease is characterized by progressiveskeletal muscle degeneration that produces severe disability. There isstill no effective treatment for DM1 patients, but new therapeuticstrategies are being tested. Animal models and in vitro 2D cell cul-tures have been essential for these advances. However, these modelscannot reproduce the biological complexity of the disease. Biofab-rication tools can be applied to engineer human 3D culture systemsthat complement current preclinical research models.Here, we describe the development of the first in vitro 3D model ofDM1 human skeletal muscle. Patient-derived cells were encapsulatedin micromolded gelatin methacryloyl-carboxymethyl cellulose meth-acrylate (GelMA-CMCMA) hydrogels through photomold patterning.These hydrogels present a microstructured topography that promotesmyoblast alignment and differentiation, resulting in highly alignedmyotubes from healthy and DM1 cells. The DM1 3D microtissuespresent the molecular alterations detected in patient biopsies. Im-portantly, fusion index analyses demonstrate that 3D micropatterningsignificantly improved DM1 cell differentiation into multinucleatedmyotubes compared to standard cell cultures. Moreover, character-ization of the 3D cultures of DM1 myotubes detects a reduced thick-ness of myotubes that can be used for drug screening. Therefore, weevaluated the therapeutic effect of antagomiR-23b administration onbioengineered DM1 skeletal muscle microtissues. AntagomiR-23btreatment rescues both molecular DM1 hallmarks and structural phe-notype, restoring myotube diameter to healthy control sizes. Overall,these new microtissues represent an improvement over conventionalmodels and can be used as biomimetic platforms to establish preclin-ical studies for myotonic dystrophy.

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Tejedera-Villafranca, A, Mangas-Florencio, L, Yeste, J, Ramon-Azcon, J, Fernandez-Costa, JM, (2022). A FUNCTIONAL 3D SKELETAL MUSCLE MODEL FOR DUCHENNE MUSCULAR DYSTROPHY FOR THE EVALUATION OF POTENTIAL THERAPIES (Abstract 2157) Tissue Engineering Part a 28, S612-S612

Research into the development of therapeutic strategies is basedmainly on animal models and cell cultures. The ability to extrapolatedata from them is limited, and research on new drugs cannot beperformed efficiently. This is especially dramatic in rare diseases,which are intrinsically very heterogeneous. The generation of ad-vanced models using tissue engineering and patient-derived cellsallows fabricating new platforms for studying pathological processesand discovering new potential drugs. Here, we developed a patient-derived 3D functional skeletal muscle for Duchenne muscular dys-trophy (DMD). DMD is the most prevalent neuromuscular diseasediagnosed during childhood. The disease is characterized by pro-gressive degeneration of skeletal and cardiac muscle caused by thelack of dystrophin protein. Although there are several molecules indrug development for DMD, there is no treatment available for pa-tients to date. By using a 3D-printed casting mold, we encapsulatedpatient-derived myogenic precursor cells in a fibrin-composite ma-trix. This platform incorporated two flexible T-shaped pillars thatprovided continuous tension to the tissue, thus allowing the orien-tation of the muscle fibers. Our 3D muscle model expressed maturemuscle markers and responded to electric pulse stimulation (EPS).Besides, contraction dynamics between DMD and control tissueswere shown to be different. Moreover, an increase of damagemarkers after EPS was observed in DMD but not in healthy tissues.Finally, the tissues will be integrated into a microfluidic device tomonitor drug administration. Eventually, the microfluidic systemwill be connected to a biosensors system for the real-time detectionof biomarkers.

JTD Keywords: Casting, Contraction dynamics, Muscular dystrophy


Lopez-Muñoz, GA, Fernández-Costa, JM, Ortega, MA, Balaguer-Trias, J, Martin-Lasierra, E, Ramón-Azcón, J, (2021). Plasmonic nanocrystals on polycarbonate substrates for direct and label-free biodetection of Interleukin-6 in bioengineered 3D skeletal muscles Nanophotonics 10, 4477-4488

Abstract The development of nanostructured plasmonic biosensors has been widely widespread in the last years, motivated by the potential benefits they can offer in integration, miniaturization, multiplexing opportunities, and enhanced performance label-free biodetection in a wide field of applications. Between them, engineering tissues represent a novel, challenging, and prolific application field for nanostructured plasmonic biosensors considering the previously described benefits and the low levels of secreted biomarkers (?pM–nM) to detect. Here, we present an integrated plasmonic nanocrystals-based biosensor using high throughput nanostructured polycarbonate substrates. Metallic film thickness and incident angle of light for reflectance measurements were optimized to enhance the detection of antibody–antigen biorecognition events using numerical simulations. We achieved an enhancement in biodetection up to 3× as the incident angle of light decreases, which can be related to shorter evanescent decay lengths. We achieved a high reproducibility between channels with a coefficient of variation below 2% in bulk refractive index measurements, demonstrating a high potential for multiplexed sensing. Finally, biosensing potential was demonstrated by the direct and label-free detection of interleukin-6 biomarker in undiluted cell culture media supernatants from bioengineered 3D skeletal muscle tissues stimulated with different concentrations of endotoxins achieving a limit of detection (LOD) of ? 0.03 ng/mL (1.4 pM).

JTD Keywords: assay, crystals, drug, label-free biosensing, molecules, plasmonic nanostructures, sensors, skeletal muscle, tissue engineering, Biodetection, Biomarkers, Biosensors, Cell culture, Cells, Chemical detection, Histology, Interleukin-6, Interleukin6 (il6), Label free, Label-free biosensing, Muscle, Nano-structured, Nanocrystals, Plasmonic nanocrystals, Plasmonic nanostructures, Plasmonics, Polycarbonate substrates, Polycarbonates, Refractive index, Sensitivity, Skeletal muscle, Tissue engineering, Tissues engineerings


Fernández-Garibay, X, Ortega, MA, Cerro-Herreros, E, Comelles, J, Martínez, E, Artero, R, Fernández-Costa, JM, Ramón-Azcón, J, (2021). Bioengineered in vitro 3D model of myotonic dystrophy type 1 human skeletal muscle Biofabrication 13, 35035

Myotonic dystrophy type 1 (DM1) is the most common hereditary myopathy in the adult population. The disease is characterized by progressive skeletal muscle degeneration that produces severe disability. At present, there is still no effective treatment for DM1 patients, but the breakthroughs in understanding the molecular pathogenic mechanisms in DM1 have allowed the testing of new therapeutic strategies. Animal models and in vitro two-dimensional cell cultures have been essential for these advances. However, serious concerns exist regarding how faithfully these models reproduce the biological complexity of the disease. Biofabrication tools can be applied to engineer human three-dimensional (3D) culture systems that complement current preclinical research models. Here, we describe the development of the first in vitro 3D model of DM1 human skeletal muscle. Transdifferentiated myoblasts from patient-derived fibroblasts were encapsulated in micromolded gelatin methacryloyl-carboxymethyl cellulose methacrylate hydrogels through photomold patterning on functionalized glass coverslips. These hydrogels present a microstructured topography that promotes myoblasts alignment and differentiation resulting in highly aligned myotubes from both healthy and DM1 cells in a long-lasting cell culture. The DM1 3D microtissues recapitulate the molecular alterations detected in patient biopsies. Importantly, fusion index analyses demonstrate that 3D micropatterning significantly improved DM1 cell differentiation into multinucleated myotubes compared to standard cell cultures. Moreover, the characterization of the 3D cultures of DM1 myotubes detects phenotypes as the reduced thickness of myotubes that can be used for drug testing. Finally, we evaluated the therapeutic effect of antagomiR-23b administration on bioengineered DM1 skeletal muscle microtissues. AntagomiR-23b treatment rescues both molecular DM1 hallmarks and structural phenotype, restoring myotube diameter to healthy control sizes. Overall, these new microtissues represent an improvement over conventional cell culture models and can be used as biomimetic platforms to establish preclinical studies for myotonic dystrophy.

JTD Keywords: 3d cell culture, hydrogel micropatterning, myotonic dystrophy, skeletal muscle, tissue engineering, 3d cell culture, Hydrogel micropatterning, Myotonic dystrophy, Skeletal muscle, Tissue engineering


Fernández-Costa, JM, Fernández-Garibay, X, Velasco-Mallorquí, F, Ramón-Azcón, J, (2021). Bioengineered in vitro skeletal muscles as new tools for muscular dystrophies preclinical studies Journal Of Tissue Engineering 12, 2041731420981339

© The Author(s) 2021. Muscular dystrophies are a group of highly disabling disorders that share degenerative muscle weakness and wasting as common symptoms. To date, there is not an effective cure for these diseases. In the last years, bioengineered tissues have emerged as powerful tools for preclinical studies. In this review, we summarize the recent technological advances in skeletal muscle tissue engineering. We identify several ground-breaking techniques to fabricate in vitro bioartificial muscles. Accumulating evidence shows that scaffold-based tissue engineering provides topographical cues that enhance the viability and maturation of skeletal muscle. Functional bioartificial muscles have been developed using human myoblasts. These tissues accurately responded to electrical and biological stimulation. Moreover, advanced drug screening tools can be fabricated integrating these tissues in electrical stimulation platforms. However, more work introducing patient-derived cells and integrating these tissues in microdevices is needed to promote the clinical translation of bioengineered skeletal muscle as preclinical tools for muscular dystrophies.

JTD Keywords: biomaterials, drug screening platforms, muscular dystrophy, skeletal muscle, tissue engineering, Biomaterials, Drug screening platforms, Muscular dystrophy, Skeletal muscle, Tissue engineering


Velasco, Ferran, Fernandez-Costa, Juan M., Neves, Luisa, Ramon-Azcon, Javier, (2020). New volumetric CNT-doped Gelatin-Cellulose scaffold for skeletal muscle tissue engineering Nanoscale Advances 2, (7), 2885-2896

Currently, the fabrication of scaffolds for engineered skeletal muscle tissue is unable to reach the millimeter size. The main drawbacks are the poor nutrients diffusion, lack of internal structure to align precursor cells as well as poor mechanical and electric properties. Herein, we present a combination of gelatin-carboxymethyl cellulose materials polymerised by a cryogelation process that allowed us to reach scaffold fabrication up to millimeters size and solve the main problems related with large size muscle tissue constructs. 1) By incorporating carbon nanotubes (CNT) we can improve the electrical properties of the scaffold, thereby enhancing tissue maturation when applying an electric pulse stimulus (EPS). 2) We have fabricated an anisotropic internal three-dimensional microarchitecture pore distribution with high aligned morphology to enhance cells alignment, cell fusion and myotubes formation. With this set up, we were able to generate a fully functional skeletal muscle tissue using a combination of EPS and our doped-biocomposite scaffold and obtain a mature tissue in a millimeter scale. We also characterized pore distribution, swelling, stiffness and conductivity of the scaffold. Moreover, we proved that the cells are viable and able to fuse in a three-dimensional (3D) functional myotubes throughout the scaffold. In conclusion, we fabricate a biocompatible and customizable scaffold for 3D cell culture suitable for a wide range of application such as organ-on-a-chip, drug screening, transplantation and disease modelling.

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