Engineering challenges in the development of an encapsulated cell system for treatment of type 1 diabetes

Implantation of glucose-responsive, insulin-secreting cells is promising in providing a treatment for type I diabetes, which is more effective, less invasive, and potentially less costly than conventional insulin injections. However, in spite of promising results with animal studies, a clinical product or therapeutic procedure based on encapsulated cells does not yet exist. This is because a number of barriers remain to be addressed, which include a source of functional cells, a stable, biocompatible membrane offering immune protection to the implant, a construct architecture ensuring cell viability and construct function, and the engineering of immune acceptance of the construct post-implantation. This article reviews these barriers and the current state-of-the-art, with special emphasis on the engineering challenges involved, and discusses possible ways to tackle the complex problems currently preventing this approach from reaching clinical practice.