title: Encapsulated islets for diabetes therapy: history, current progress, and critical issues requiring solution.
abstract: Insulin therapy became a reality in 1921 dramatically saving lives of people with diabetes, but not protecting them from long-term complications. Clinically successful free islet implants began in 1989 but require life long immunosuppression. Several encapsulated islet approaches have been ongoing for over 30 years without defining a clinically relevant product. Macro-devices encapsulating islet mass in a single device have shown long-term success in large animals but human trials have been limited by critical challenges. Micro-capsules using alginate or similar hydrogels encapsulate individual islets with many hundreds of promising rodent results published, but a low incidence of successful translation to large animal and human results. Reduction of encapsulated islet mass for clinical transplantation is in progress. This review covers the status of both early and current studies including the presentation of corporate efforts involved. It concludes by defining the critical items requiring solution to enable a successful clinical diabetes therapy.
authors.affiliation: Prodo Laboratories & Scharp-Lacy Research Institute, 32A Mauchly, Irvine, CA 92618, USA. Electronic address: dscharp@prodolabs.com.
authors.forename: David W
authors.initials: DW
authors.lastname: Scharp
authors.affiliation: Department of Endocrinology and Metabolism, Metabolic Unit, Cisanello Hospital, University of Pisa, Via Paradise 2, Pisa 56100, Italy. Electronic address: piero.marchetti@med.unipi.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Marchetti
mesh_terms: D000818:Animals; D003920:Diabetes Mellitus / Q000601:surgery*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D016381:Islets of Langerhans Transplantation / Q000295:instrumentation / Q000379:methods*; D016035:Pancreas Transplantation; D014183:Transplantation, Heterologous
chemical_list: D007328:Insulin
keywords: Diabetes; Encapsulation; Immuno-isolation; Implantation; Islets; Macro-device; Micro-device; Transplantation; “Conformal coating”; “Minimum Volume Capsule”