Islet Encapsulation and Engraftment Strategies in Type 1 Diabetes

Type 1 diabetes mellitus continues to pose global health challenges as the incidence increases among children and young adults worldwide.As a treatment regimen for this, islet transplantation offers the potential to restore glycemic control without lifelong insulin administration to diabetic patients.Currently, islet encapsulation technologies and vascularization-enhancing strategies are gaining significant attention to overcome immune rejection and poor transplant survival rates during islet transplantation.At the same time, recent breakthroughs in islet encapsulation and engraftment have accelerated clinical translation efforts.Encapsulation platforms, including nano-coatings, microcapsules, and macro-encapsulation devices, now incorporate advanced biomaterials to prolong graft survival and reduce host responses.Simultaneously, strategies enhancing islet engraftment, including pre-vascularized implantation niches, co-transplantation with mesenchymal stem cells, and integration of pro-angiogenic molecules address the critical issue of hypoxia and delayed revascularization.Clinical trials utilizing stem cell-derived islets and gene-edited immune-evasive cells represent the forefront of innovation.This review synthesizes recent research and translational progress, highlighting how interdisciplinary integration of biomaterials, synthetic biology, and vascular engineering could unlock durable and functional islet replacement therapies.