ABSTRACT
Diabetes is a devastating disease that has been around for centuries. The discovery of insulin revolutionized the treatment of diabetes. After the initial discovery of insulin, its usage definitely saved numerous lives, however, the inability to replicate the exquisite glucose balance that pancreatic islets help to regulate, led to hyperglycemia-driven microvascular and macrovascular complications as well as “potentially fatal “episodes of hypoglycemia. The concept of an “artificial pancreas” was envisioned at least by the 1950s. Overall, these systems have conceptually evolved from external devices to implantable devices. Despite advances, however, there continue to be several limitations with clinical application of the “artificial pancreas.” Several cell-based insulin delivery systems have been evaluated. These include: pancreas transplantation, human pancreatic islet transplantation, and pancreatic islet xenotransplantation. Limitations with these various modalities have helped to fuel the ongoing quest for the development of a bioartificial pancreas. Main structural approaches, that have been utilized to this end, include: (i) microdevices that encapsulate individual islets or small groups of islets within spherically shaped capsules that provide the permselective function, (ii) nanoencapsulation and “layer-by-layer” coatings, which place a thin film of protection on each islet, and (iii) macrodevices that hold the islets within a major structure with selective permeability component on the perimeter of the device.
Successful development of a reproducible and reliable bioartificial pancreas would provide a treatment that should more closely mimic the physiologic responses of endogenous insulin and be able to avoid the need for immunosuppressive medications and their associated potential comorbidities.
