Engineering immunomodulatory biomaterials for type 1 diabetes

A cure for type 1 diabetes (T1D) would help millions of people worldwide but remains elusive to date. Tolerogenic vaccines and β-cell replacement therapy are complementary therapies that seek to address aberrant T1D autoimmune attack and subsequent β-cell loss. However, both approaches require some form of systemic immunosuppression, imparting risks to the patient. Biomaterials-based tools enable localized and targeted immunomodulation, and biomaterial properties can be designed and combined with immunomodulatory agents to locally instruct specific immune responses. In this Review, we discuss immunomodulatory biomaterial platforms for the development of T1D tolerogenic vaccines and β-cell replacement devices. We investigate nanoparticles and microparticles for the delivery of tolerogenic agents and autoantigens and as artificial antigen-presenting cells, and we highlight how bulk biomaterials can be used to provide immune tolerance. We examine biomaterials for drug delivery and as immuno-isolation devices for cell therapy and islet transplantation and explore synergies with other fields for the development of new T1D treatment strategies