Get Rid Of Scar Tissue Under Skin – A new tool, which doesn’t rely on immunosuppressive drugs, may help pancreas-enhancing efforts to treat diabetes.

Caption: In a new approach, the scar tissue (pictured) that often forms around medical implants has a more aligned structure that allows drugs to pass through more easily.

Get Rid Of Scar Tissue Under Skin

Caption: The drug delivery system consists of an actuator that repeatedly inflates and deflates the device for five minutes every 12 hours. This mechanical deflection prevents immune cells from accumulating around the device.

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In a new approach, the scar tissue (pictured) that often forms around medical implants has a more aligned structure that allows drugs to pass through more easily.

The drug delivery system includes an actuator that repeatedly inflates and deflates the device for five minutes every 12 hours. This mechanical deflection prevents immune cells from accumulating around the device.

Implantable devices that release insulin into the body are promising as an alternative to diabetes treatment without insulin injections or cannula insertion. However, one obstacle that has prevented their use until now is that the immune system attacks them after implantation, forming a thick layer of scar tissue that blocks the release of insulin.

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This condition, known as a foreign body reaction, can interfere with many other types of implantable medical devices. However, a team of MIT engineers and collaborators has now devised a way to overcome this response. In a study on mice, they showed that when they integrated mechanical functionality into a soft robotic device, the device lasted longer than standard drug delivery implants.

The device is repeatedly ventilated and rinsed for five minutes every 12 hours, and this mechanical deviation prevents immune cells from accumulating around the device, the researchers found.

“We’re using this type of movement to extend the life and effectiveness of these reservoirs that can deliver drugs like insulin, and we think this platform can be expanded beyond this application,” said Ellen Roche, Latham Family Career Development Associate. Professor of Mechanical Engineering and member of MIT’s Institute for Medical Engineering and Science.

Among other possible applications, the researchers now plan to see if they can use the device to deliver pancreatic islet cells that could act as a “bioartificial pancreas” to help treat diabetes.

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Roche is the lead author of the study, along with Eimear Dolan, a former postdoc in his lab who is now a faculty member at the National University of Ireland in Galway. Garry Duffy, who is also a professor at NUI Galway, is a key contributor to this project, from

. MIT postdocs William Whyte and Debkalpa Goswami, along with visiting scholar Sophie Wang, are lead authors of the paper.

Most patients with type 1 diabetes, and some with type 2 diabetes, must inject themselves with insulin every day. Some patients use wearable insulin pumps that are attached to the skin and deliver insulin through a tube inserted under the skin, or patches that can deliver insulin without a tube.

For years, scientists have been working on devices that deliver insulin that can be injected under the skin. However, fibrous capsules that form around such devices can lead to device failure within weeks or months.

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Researchers have tried many ways to prevent this type of scar tissue from forming, including local delivery of immunosuppressants. The MIT team took a different approach that doesn’t require any medication – instead, their implant includes a mechanical robotic device that can inflate and deflate. In a 2019 study, Roche and colleagues (with Dolan as first author) showed that this type of oscillation can measure how nearby immune cells respond to an implanted device.

In a new study, researchers wanted to see if that immunomodulatory effect could help improve drug delivery. They created a two-chamber device made of polyurethane, a plastic with the same elasticity as the extracellular matrix that surrounds tissue. One of the chambers serves as a drug storage area, while the other serves as a soft, inflatable actuator. Using an external controller, researchers can stimulate the actuator to inflate and deflate on a specific schedule. In this study, they performed an action every 12 hours, for five minutes at a time.

This mechanical action drives away immune cells called neutrophils, the cells that start the process that leads to the formation of scar tissue. When researchers implanted these devices in mice, they found that it took longer for scar tissue to develop around the devices. Scar tissue eventually formed, but its structure was unusual: Instead of tangled collagen fibers built around stationary devices, the collagen fibers around the activated devices were more aligned, which researchers believe could help drug molecules pass through the tissue.

“In the short term, we see that there are fewer neutrophils surrounding the device in the tissue, and then in the long term, we see that there is a difference in collagen formation, which may be related to why we have better drug delivery throughout the eight-week period,” said Wang.

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To show how useful this device can be, researchers have shown that it can be used to deliver insulin through mice. The device is designed in such a way that the insulin can be released slowly through the pores in the drug reservoir or released in a large burst controlled by an actuator.

The researchers tested the effectiveness of the insulin release by measuring the subsequent changes in the blood sugar levels of the mice. They found that in mice with the activated device, effective insulin delivery was maintained throughout the eight weeks of the study. However, in mice that did not work, the efficiency of delivery began to decrease after only two weeks, and after eight weeks, almost no insulin was able to pass through the fibrous capsule.

The authors also created a human version of the device, 120 millimeters by 80 millimeters, and showed that it can be successfully implanted in the human stomach.

“This was a proof of concept to show that there is a minimally invasive surgical technique that could be used for a large, human-scale machine,” Goswami said.

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In collaboration with Jeffrey Millman of Washington University School of Medicine in St. Louis, researchers now plan to modify the device to be used to deliver stem-cell-derived pancreatic cells that sense glucose levels and release insulin when glucose is too high. Such an implant would eliminate the need for patients to constantly measure glucose levels and inject insulin.

“The idea would be that the cells would stay in the reservoir, and act as an insulin factory,” Roche said. “They could see the glucose levels in the blood and release insulin as needed.”

Other applications that researchers may explore for this type of device include delivering immunotherapy to treat ovarian cancer, and delivering drugs to the heart to prevent heart failure in patients who have had a heart attack.

“You can imagine that we could apply this technology to anything that is inhibited by a foreign body reaction or a fibrous capsule, and have a long-term effect,” Roche said. “I think any type of implantable drug delivery device can benefit.”

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The research was funded, in part, by Science Foundation Ireland, the Juvenile Diabetes Research Foundation, and the National Institutes of Health.

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When someone is seriously injured or has surgery, their body responds to the trauma by forming tissue that protects it. Scar tissue is actually a layer of cells and collagen fibers that form over the site of an injury. It can be formed as a response to it

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