随着全球糖尿病患者人数逐年增长，临床上亟需一种行之有效的糖尿病治疗方案。胰岛移植可通过植入具有正常功能的胰岛以替代患者体内功能受损的胰岛，从而维持正常血糖水平，有望发展为理想的糖尿病治疗方法。然而，胰岛供体资源短缺，且移植后长期服用免疫抑制剂不仅产生诸多不良反应甚至会有致癌风险。以上瓶颈极大限制了胰岛移植的临床应用。采用天然高分子、合成高分子、无机化合物等生物材料对胰岛进行封装，营造免疫隔离微环境，避免宿主免疫细胞与植入胰岛直接接触，可有效抑制免疫排斥反应。免疫隔离的同时，胰岛的封装不影响胰岛素、葡萄糖、氧气等胰岛必需或输出关键分子的交换，同时确保移植胰岛的正常生理活性及精准控制血糖水平的能力。本文综述了胰岛封装的研究现状，常用材料及设计策略，并初步展望其应用前景。
With the rapid increase in number of diabetes patients in the world, there has been an urgent need for a clinically effective diabetes treatment. Islet transplantation is able to replace the impaired islets by implanting normal islets so as to maintain normal blood glucose level, which is recognized as an ideal treatment for diabetes. However, there is a shortage of islet donor resources, and the clinical outcome suffers from a variety of adverse reactions and even cancer risks for long-term use of immunosuppressive agents after transplantation. These challenges have greatly impeded the clinical application of islet transplantation. The applications of bio-derived or synthesized polymers(natural polymers, synthetic polymers, inorganic compounds and other biomaterials) to encapsulate islets enable to create an immune isolation microenvironment. These artificial constructs effectively inhibit immune rejection by avoiding the direct contact between host immune cells and implanted islets. In the application, the islet encapsulation is mandatory to keep the exchange capacity of essential key molecules, such as insulin, glucose and oxygen. This is necessary to ensure the normal physiological activity of transplanted islets and the ability to accurately control blood glucose level. This review summarizes the state-of-the-art of the field of islet encapsulation, including the introduction of the most employed materials, strategies of islet encapsulation, as well as the perspective.
Contents
1 Introduction
2 Advantages of islet encapsulation in islet transplantation
3 Encapsulation materials for islets and islet cells
3.1 Natural polymers
3.2 Synthetic macromolecules
3.3 Inorganic nanomaterials
4 Design strategy of encapsulation of islets and islet cells
4.1 Long-term immune isolation effect
4.2 Transportation of nutrients and oxygen
4.3 Biocompatibility of materials
4.4 Choice of the appropriate transplantation site
4.5 Suppression of the immune response around the graft
5 Conclusion and outlook
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