胰岛细胞包封技术治疗糖尿病的研究进展

doi:10.3877/cma.j.issn.2095-1221.2025.06.005

糖尿病是因胰岛素分泌不足或作用缺陷导致血糖持续高水平的代谢性疾病。在现有治疗手段中，胰岛素注射需频繁操作，严重影响患者生活质量；胰腺移植虽能根治，但供体稀缺且易引发强烈免疫排斥。为克服这些挑战，越来越多的研究集中于移植用水凝胶包封的胰岛细胞治疗糖尿病。因此，本综述总结水凝胶包封胰岛细胞用于糖尿病细胞治疗的有关策略，并从细胞来源、材料选择、包封方法及当前挑战4个方面展开详细介绍，探讨胰岛包封技术的发展前景。

关键词: 糖尿病, 包封, 胰岛移植, 干细胞, 类器官

Diabetes is a metabolic disease characterized by persistently high blood glucose levels due to insufficient insulin secretion or impaired insulin effects. Among the current treatment options, insulinrequires frequent injection, which seriously reduces the quality in life of patients; although pancreatic transplantation may cure the disease, the scarcity of donors and potential risk of strong immune rejection pose significant challenges. To overcome these obstacles, an increasing number of studies have focused on transplanting insulin-producing islet cells encapsulated in hydrogels for the treatment of diabetes. Therefore, this review summarizes the relevant strategies for using hydrogel-encapsulated islet cells in the cellular therapy of diabetes and elaborates in detail from four aspects: cell sources, material selection, encapsulation methods, and current challenges. Finally, the development prospects of islet encapsulation technology are also discussed.

Key words: Diabetes mellitus, Encapsulation, Islet transplantation, Stem cells, Organoids

图1 SC-islets分化的代表性示意^[24]

表1 用于包封细胞的常见生物材料分类及其特点

材料类型	具体例子	优势	局限性
天然生物材料	海藻酸盐^[34]	离子交联成胶，易于改性修饰	降解产物体内积累
	透明质酸^[36]	生物相容性好，调控细胞行为	稳定性差
	肝素^[37]	稳定生长因子，促血管生成	供应有限，有出血风险
	胶原蛋白^[40]	可制备温度响应性凝胶	机械强度有限
合成生物材料	PLA ^[43]	应用场景广，常用于3D打印	降解产物为酸性
	PLGA ^[44]	生物可降解，多孔结构支持细胞定植
	PLCL ^[45]	机械性能可调节
	PEG ^[46]	降低免疫反应，促进分子交换	部分降解性差，需手术移除
脱细胞外基质材料	胰腺脱细胞外基质^[33]	保留天然结构和多种蛋白，为胰岛提供良好生长环境	质量控制标准不统一

表1 用于包封细胞的常见生物材料分类及其特点

材料类型	具体例子	优势	局限性
天然生物材料	海藻酸盐^[34]	离子交联成胶，易于改性修饰	降解产物体内积累
	透明质酸^[36]	生物相容性好，调控细胞行为	稳定性差
	肝素^[37]	稳定生长因子，促血管生成	供应有限，有出血风险
	胶原蛋白^[40]	可制备温度响应性凝胶	机械强度有限
合成生物材料	PLA ^[43]	应用场景广，常用于3D打印	降解产物为酸性
	PLGA ^[44]	生物可降解，多孔结构支持细胞定植
	PLCL ^[45]	机械性能可调节
	PEG ^[46]	降低免疫反应，促进分子交换	部分降解性差，需手术移除
脱细胞外基质材料	胰腺脱细胞外基质^[33]	保留天然结构和多种蛋白，为胰岛提供良好生长环境	质量控制标准不统一

图2 胰岛细胞包封的示意^[47]注：a图为宏观包封装置示意图。装置内包含大量胰岛，通常皮下植入；b图为微观包封装置示意图。胰岛被包封在半透性的微胶囊中；c图为涂层包封装置示意图。在单个胰岛表面形成纳米级屏障层；d图为胰岛装置允许胰岛素、胰高血糖素和代谢废物从装置中扩散，同时允许气体交换、营养摄入，并阻止免疫分子进入

图3 常见的移植部位优缺点对比^[23]

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Advances in islet cell encapsulation technology in diabetes treatment

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Advances in islet cell encapsulation technology in diabetes treatment