Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, USA.
Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201.
ACS Biomater Sci Eng. 2020 May 11;6(5):2543-2562. doi: 10.1021/acsbiomaterials.9b01406. Epub 2019 Dec 2.
Type 1 diabetes is an autoimmune disease in which the immune system attacks insulin-producing beta cells of pancreatic islets. Type 1 diabetes can be treated with islet transplantation; however, patients must be administered immunosuppressants to prevent immune rejection of the transplanted islets if they are not autologous or not engineered with immune protection/isolation. To overcome biological barriers of islet transplantation, encapsulation strategies have been developed and robustly investigated. While islet encapsulation can prevent the need for immunosuppressants, these approaches have not shown much success in clinical trials due to a lack of long-term insulin production. Multiple engineering strategies have been used to improve encapsulation and post-transplantation islet survival. In addition, more efficient islet cryopreservation methods have been designed to facilitate the scaling-up of islet transplantation. Other islet sources have been identified including porcine islets and stem cell-derived islet-like aggregates. Overall, islet-laden capsule transplantation has greatly improved over the past 30 years and is moving towards becoming a clinically feasible treatment for type 1 diabetes.
1 型糖尿病是一种自身免疫性疾病，其中免疫系统攻击胰岛的胰岛素产生β细胞。1 型糖尿病可以通过胰岛移植来治疗；然而，如果供体胰岛不是自体的，或者没有经过免疫保护/隔离工程改造，患者必须接受免疫抑制剂治疗，以防止移植的胰岛被免疫排斥。为了克服胰岛移植的生物学障碍，已经开发并深入研究了封装策略。虽然胰岛封装可以防止免疫抑制剂的需要，但由于缺乏长期的胰岛素产生，这些方法在临床试验中并没有取得太大的成功。已经使用了多种工程策略来改善封装和移植后胰岛的存活。此外，还设计了更有效的胰岛冷冻保存方法，以促进胰岛移植的规模化。已经确定了其他胰岛来源，包括猪胰岛和干细胞衍生的胰岛样聚集物。总的来说，胰岛负载胶囊移植在过去 30 年中得到了极大的改善，并正在朝着成为 1 型糖尿病的一种临床可行的治疗方法发展。
