_Kim_Engineering immune-evasive islet replacement- cell-intrinsic and peri-graft strategies.pdf - Google Drive
Islet transplantation offers a physiological approach for restoring endogenous insulin secretion in type 1 diabetes, yet its broad clinical application remains constrained by donor scarcity, immune-mediated rejection, and limited graft durability. Stem cell-derived islets have emerged as a scalable alternative, sup- ported by recent clinical progress, but long-term therapeutic efficacy remains challenged by incomplete maturation, immune incompatibility, and persistent immune-mediated injury after transplantation. Early efforts to mitigate immune rejection relied on physical immunoisolation strategies, including micro- and macroencapsulation, to limit immune cell access to transplanted grafts. However, incomplete protection from soluble inflammatory mediators and diffusion-related constraints highlighted the need for more direct immune modulation. In response, substantial efforts have focused on engineering immune-evasive islets through a spectrum of cell-intrinsic strategies, ranging f