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International Journal of Bioprinting Biofabrication for islet transplantation

and their profound implications in islet transplantation. including 3D bioprinting, have the potential to establish
Notably, remarkable strides toward islet transplantation have high-throughput manufacturing systems that allow rapid
been made in recent decades, predominantly because of the and efficient production. By incorporating biomaterials
remarkable progress achieved in biofabrication technology. with diverse mechanical and biochemical characteristics,
Many biofabrication techniques have been introduced by bioprinting technology can faithfully mimic the native
researchers who employed diverse biomaterials as carriers for pancreatic microenvironment and optimize the conditions
efficient islet delivery. The primary focus of these studies was for islet survival and functionality. Consequently, this
to enhance islet engraftment, fortify immune protection, and, high-throughput bioprinting technology holds promise
ultimately, prolong graft viability. To address the challenge for meeting the clinical demand for large-scale islet
of the immune response and optimize cell survival, it is encapsulation constructs and for advancing the field of
imperative for researchers to prioritize the development of islet transplantation. Combining the strengths of dECM
encapsulation technology as a viable means of islet delivery. and bioprinting technology offers an opportunity to
Although ongoing clinical trials are assessing the efficacy of enhance the efficacy and long-term outcomes of islet
microencapsulated islets, sustained blood glucose control transplantation, bringing us closer to curing diabetes.
over an extended period has not yet been achieved. The
fundamental objective of islet encapsulation is to mitigate Concurrently, there is an imminent need for more
the risk of immune rejection of transplanted islets while alternative cell sources. Multiple cell types have been used
effectively emulating the pancreatic microenvironment, in islet delivery systems to generate insulin-producing
thereby facilitating insulin secretion and enabling the uptake cells. Although cell lines present advantages in terms of
of vital nutrients for sustained survival. ease of handling and mass production, they present notable
challenges in clinical trials and are inherently constrained
The careful selection of appropriate biomaterials is in terms of their capabilities. The use of primary islets
of paramount importance for establishing an optimal obtained from suitable donors poses inherent challenges,
microenvironment for islets, which is crucial for including those associated with allograft transplantation
the transplantation process. The microenvironment and limited availability. Consequently, a promising avenue
encompassing the islet graft exerts a pivotal influence, in this domain is the utilization of insulin-producing cells
owing to a multitude of factors. A particularly promising differentiated from human or patient-derived iPSCs. This
approach for islet transplantation involves the utilization approach offers unrestricted access to organs and facilitates
of dECM, which offers distinct advantages and specialized donor-independent transplantation. This approach
characteristics. Through the removal of cellular components offers unrestricted access to organs and facilitates donor-
while retaining the native ECM structure, the dECM serves independent transplantation, while the improvement of
as a biocompatible scaffold that facilitates the survival and differentiation efficiency through established protocols is
functionality of islets. The integration of dECM in the context still ongoing. Although several differentiation protocols
of islet transplantation enhances the biocompatibility of islet have been established, the implementation of this approach
grafts, diminishes the risk of immune rejection, and fosters a is still in progress, with challenges such as difficulties
favorable microenvironment conducive to sustained survival in improving the efficiency of differentiation [100–103] .
and insulin production in islets. Extensive research focused The iPSC differentiation technique presents technical
on dECM derived from pancreatic tissue has successfully complexities and financial challenges that require further
validated its inherent characteristics, particularly regarding attention [104,105] . Nevertheless, differentiation techniques
the intricate interplay between islets and their surrounding to generate insulin-producing cells are expected to play a
environmental cues, including viability, insulin secretion, critical role in future research on islet transplantation.
and glucose responsiveness. Furthermore, dECM can be
further functionalized to enable the targeted delivery of Acknowledgments
bioactive molecules, such as immunomodulatory factors or
angiogenic agents, thereby offering additional enhancements None.
to the therapeutic outcomes of islet transplantation.
Funding
The choice of the fabrication method is of significant
importance in the development of a comprehensive islet This work was funded by the National Research Foundation
delivery system that encompasses both biomaterials of South Korea (NRF) grant from the Ministry of Science
and cells. The versatile nature of the 3D bioprinting and ICT (No. 2021R1A2C2004981) and supported by the
technology enables the use of multiple biomaterials Korean Fund for Regenerative Medicine funded by the
and facilitates the creation of constructs with tailored Ministry of Science and ICT and Ministry of Health and
properties. Furthermore, biofabrication technologies, Welfare (21A0104L1, Republic of Korea), as well as the

Volume 9 Issue 6 (2023) 408 https://doi.org/10.36922/ijb.1024