General information
Transplantation of islets to individuals with type 1 diabetes is a treatment option for this disease. Recipients must receive long-term immunosuppressive therapies that cause severe side effects. Encapsulating islets with gels can form a barrier through which immune cells cannot diffuse and thus has the potential to circumvent immunosuppressive therapy. Currently, such islet encapsulating approaches only focus on maintaining clear grafts after transplantation by eliminating fibrotic insulation. However, gels trigger immune activation leading to the release of large numbers and types of immune components such as IgG, IgM, or IgA that can diffuse through the barrier and impair islet function. As well as this, the engraftment of islets (revascularization to the host vasculature), which is critical for their optimal function, was also not even considered with this approach. Thus, passive diffusion results in a delay of glucose-stimulated insulin secretion by at least 30 minutes, as shown in recent clinical trials.
A novel approach with novel immunosuppressive gels may solve the above challenges.