medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-155medsovet-7607Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSИспользование стволовых клеток и 3D-биопечати островков поджелудочной железы в лечении сахарного диабета 1-го типа: история проблемы и перспективыThe use of stem cells and 3D bioprinting of pancreatic islets in the treatment of type 1 diabetes mellitus: history and perspectiveshttps://orcid.org/0000-0003-0027-1786БулгаковаС. В.BulgakovaS. V.

Булгакова Светлана Викторовна, д.м.н., доцент, заведующая кафедрой эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Svetlana V. Bulgakova, Dr. Sci. (Med.), Associate Professor, Head of Department of Endocrinology

89, Chapaevskaya St., Samara, 443099

osteoporosis63@gmail.comhttps://orcid.org/0000-0001-6678-6411ДолгихЮ. А.DolgikhY. A.

Долгих Юлия Александровна, к.м.н., ассистент кафедры эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Yulia A. Dolgikh, Cand. Sci. (Med.), Assistant of Department of Endocrinology and Geriatrics

89, Chapaevskaya St., Samara, 443099

yu.a.dolgikh@samsmu.ruhttps://orcid.org/0000-0003-0097-7252ТреневаЕ. В.TrenevaE. V.

Тренева Екатерина Вячеславовна, к.м.н., доцент кафедры эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Ekaterina V. Treneva, Cand. Sci. (Med.), Assistant Professor of Department of Endocrinology

89, Chapaevskaya St., Samara, 443099

eka1006@yandex.ruhttps://orcid.org/0000-0001-8827-4919ШароноваЛ. А.SharonovaL. A.

Шаронова Людмила Александровна, к.м.н., доцент кафедры эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Lyudmila A. Sharonova, Cand. Sci. (Med.), Assistant Professor of Department of Endocrinology and Geriatrics

89, Chapaevskaya St., Samara, 443099

l.a.sharonova@samsmu.ruhttps://orcid.org/0000-0002-5754-1057КосареваО. В.KosarevaO. V.

Косарева Ольга Владиславовна, к.м.н., доцент кафедры эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Olga V. Kosareva, Cand. Sci. (Med.), Assistant Professor of Department of Endocrinology and Geriatrics

89, Chapaevskaya St., Samara, 443099

o.v.kosareva@samsmu.ruhttps://orcid.org/0000-0003-4114-5233КурмаевД. П.KurmaevD. P.

Курмаев Дмитрий Петрович, ассистент кафедры эндокринологии и гериатрии

443099, Самара, ул. Чапаевская, д. 89

Dmitriy P. Kurmaev, Assistant of Department of Endocrinology and Geriatrics

89, Chapaevskaya St., Samara, 443099

geriatry@mail.ruСамарский государственный медицинский университетРоссияSamara State Medical UniversityRussian Federation2023240620231796773Copyright © Булгакова С.В., Долгих Ю.А., Тренева Е.В., Шаронова Л.А., Косарева О.В., Курмаев Д.П., 20232023Булгакова С.В., Долгих Ю.А., Тренева Е.В., Шаронова Л.А., Косарева О.В., Курмаев Д.П.Bulgakova S.V., Dolgikh Y.A., Treneva E.V., Sharonova L.A., Kosareva O.V., Kurmaev D.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7607

Сахарный диабет (СД) 1-го типа является заболеванием, которое проявляется гипергликемией вследствие абсолютного дефицита инсулина, причиной которого является аутоиммунная деструкция β-клеток, продуцирующих инсулин. Заболевание возникает в молодом возрасте, характеризуется лабильным течением, склонностью к кетоацидозу и приводит к развитию сосудистых осложнений, которые способствуют инвалидизации и  ранней смертности больных. На  сегодняшний день инсулинотерапия является единственным методом лечения СД1. Однако данный метод лечения несовершенен. Пациентам необходимо корректировать питание, проводить частый контроль гликемии и многократные инъекции инсулина. В связи с этим продолжается поиск более эффективных методов лечения СД1. Перспективным представляется трансформация стволовых клеток как потенциального источника α- и  β-клеток и  их пересадка пациенту. Однако недостаточно просто получить α- и  β-клетки из  любых стволовых клеток  – важную роль играет взаимодействие между клетками островков поджелудочной железы. В настоящее время предпринимаются попытки разработать функциональные in vitro модели панкреатических островков, в  которых клеточное микроокружение было  бы полностью сохранено. Продемонстрирована возможность культивирования и мониторинга клеток в проницаемой трехмерной микросреде. Объединение разных типов клеток друг с другом в биологически подходящих белковых гидрогелях позволяет формировать пространственные тканевые системы. Также важна микроваскуляризация клеток, что имеет решающее значение для адекватного гомеостаза глюкозы. 3D-биопечать может помочь обеспечить правильное распределение клеток в каркасе и способствовать уменьшению гипоксии за счет васкуляризации. Технология 3D-биопечати позволит решить проблемы создания естественной среды для островков поджелудочной железы с внеклеточным матриксом и сосудистой сетью, поскольку такая технология поможет создавать органы в полностью контролируемых условиях in vitro. Однако данная технология еще только развивается и требуются дальнейшие исследования в этом направлении.

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.

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The authors declare that there are no conflicts of interest present.