Harnessing cellular therapeutics for type 1 diabetes mellitus: progress, challenges, and the road ahead
Top Cited Papers
- 3 September 2024
- journal article
- review article
- Published by Springer Nature in Nature Reviews Endocrinology
- Vol. 21 (1) , 14-30
Abstract
Type 1 diabetes mellitus (T1DM) is a growing global health concern that affects approximately 8.5 million individuals worldwide. T1DM is characterized by an autoimmune destruction of pancreatic β cells, leading to a disruption in glucose homeostasis. Therapeutic intervention for T1DM requires a complex regimen of glycaemic monitoring and the administration of exogenous insulin to regulate blood glucose levels. Advances in continuous glucose monitoring and algorithm-driven insulin delivery devices have improved the quality of life of patients. Despite this, mimicking islet function and complex physiological feedback remains challenging. Pancreatic islet transplantation represents a potential functional cure for T1DM but is hindered by donor scarcity, variability in harvested cells, aggressive immunosuppressive regimens and suboptimal clinical outcomes. Current research is directed towards generating alternative cell sources, improving transplantation methods, and enhancing cell survival without chronic immunosuppression. This Review maps the progress in cell replacement therapies for T1DM and outlines the remaining challenges and future directions. We explore the state-of-the-art strategies for generating replenishable β cells, cell delivery technologies and local targeted immune modulation. Finally, we highlight relevant animal models and the regulatory aspects for advancing these technologies towards clinical deployment.Keywords
This publication has 226 references indexed in Scilit:
- Modeling of a Bioengineered Immunomodulating Microenvironment for Cell TherapyAdvanced Healthcare Materials, 2024
- Advanced strategies to thwart foreign body response to implantable devicesBioengineering & Translational Medicine, 2022
- Risks of Multiple Skin Cancers in Organ Transplant RecipientsJAMA Dermatology, 2021
- Design Considerations for Macroencapsulation Devices for Stem Cell Derived Islets for the Treatment of Type 1 DiabetesAdvanced Science, 2021
- Streptozotocin‐Induced Diabetic Models in Mice and RatsCurrent Protocols, 2021
- Particulate‐Based Single‐Dose Local Immunosuppressive Regimen for Inducing Tolerogenic Dendritic Cells in Xenogeneic Islet TransplantationAdvanced Healthcare Materials, 2020
- Enhanced In Vivo Vascularization of 3D‐Printed Cell Encapsulation Device Using Platelet‐Rich Plasma and Mesenchymal Stem CellsAdvanced Healthcare Materials, 2020
- Functionalization of Alginate with Extracellular Matrix Peptides Enhances Viability and Function of Encapsulated Porcine IsletsAdvanced Healthcare Materials, 2020
- Supporting Survival of Transplanted Stem‐Cell‐Derived Insulin‐Producing Cells in an Encapsulation Device Augmented with Controlled Release of Amino AcidsAdvanced Biosystems, 2019
- Generation of human embryonic stem cell‐derived mesoderm and cardiac cells using size‐specified aggregates in an oxygen‐controlled bioreactorBiotechnology and Bioengineering, 2008