Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA 94143, USA.
University of California Berkeley - University of California San Francisco Graduate Program in Bioengineering, San Francisco, CA 94143, USA.
Adv Drug Deliv Rev. 2021 Jul;174:87-113. doi: 10.1016/j.addr.2021.01.011. Epub 2021 Jan 21.
Diabetes Mellitus is a group of diseases characterized by high blood glucose levels due to patients' inability to produce sufficient insulin. Current interventions often require implants that can detect and correct high blood glucose levels with minimal patient intervention. However, these implantable technologies have not reached their full potential in vivo due to the foreign body response and subsequent development of fibrosis. Therefore, for long-term function of implants, modulating the initial immune response is crucial in preventing the activation and progression of the immune cascade. This review discusses the different molecular mechanisms and cellular interactions involved in the activation and progression of foreign body response (FBR) and fibrosis, specifically for implants used in diabetes. We also highlight the various strategies and techniques that have been used for immunomodulation and prevention of fibrosis. We investigate how these general strategies have been applied to implants used for the treatment of diabetes, offering insights on how these devices can be further modified to circumvent FBR and fibrosis.
糖尿病是一组因患者无法产生足够的胰岛素而导致血糖水平升高的疾病。目前的干预措施通常需要植入物，可以在最小的患者干预下检测和纠正高血糖水平。然而，由于异物反应和随后的纤维化发展，这些可植入技术在体内尚未充分发挥其潜力。因此，为了实现植入物的长期功能，调节初始免疫反应对于防止免疫级联的激活和进展至关重要。本综述讨论了参与异物反应（FBR）和纤维化激活和进展的不同分子机制和细胞相互作用，特别是针对用于糖尿病的植入物。我们还强调了用于免疫调节和预防纤维化的各种策略和技术。我们研究了这些一般策略如何应用于治疗糖尿病的植入物，提供了关于如何进一步修改这些设备以避免 FBR 和纤维化的见解。
