The use of stem cells and 3D bioprinting of pancreatic islets in the treatment of type 1 diabetes mellitus: history and perspectives

Abstract

Type 1 diabetes mellitus (DM) is a disease characterized by hyperglycemia due to an absolute insulin deficiency caused by autoimmune destruction of insulin-producing β-cells. The disease occurs at a young age, is characterized by a labile course, a tendency to ketoacidosis and leads to the development of vascular complications that contribute to disability and early death of patients. To date, insulin therapy is the only treatment for type 1 diabetes. However, this method of treatment is not perfect. Patients need to adjust their diet, conduct frequent glycemic control and multiple injections of insulin. In this regard, the search for more effective methods of treating type 1 diabetes continues. The transformation of stem cells as a potential source of αand β-cells and their transplantation to the patient seems promising. However, it is not enough to simply obtain α- and β-cells from any stem cell. An important role is played by the interaction between the cells of the pancreatic islets. Currently, attempts are being made to develop functional in vitro models of pancreatic islets in which the cellular microenvironment would be completely preserved. The possibility of culturing and monitoring cells in a permeable three-dimensional microenvironment has been demonstrated. Combining different types of cells with each other in biologically suitable protein hydrogels allows the formation of spatial tissue systems. Cell microvascularization is also important, which is critical for adequate glucose homeostasis. 3D bioprinting can help ensure proper cell distribution in the scaffold and help reduce hypoxia through vascularization. 3D bioprinting technology will solve the problems of creating a natural environment for pancreatic islets with extracellular matrix and vasculature, since this technology will help to create organs in fully controlled conditions in vitro. However, this technology is still developing and further research is required in this direction.