My team has used autologous, adipose derived stem cells for 10 patients (40e eyelids) that had Dry Eye disease/Meibomian Gland Disease as drops and insertion into meibomian glands and two patients, with Sjogren's syndrome had injection into the lacrimal glands.
We did have one patient who had her own stem cells plus cord blood serum plus PRP 100% in one syringe inserted into each one of meibomiam glands of each of her lids prior to Covid due to 10/10 pain but she died during Covid and was not able to follow up. She tolerated the procedure well and did not have any complications. We unfortunately do not have follow up beyond a few months for this patient. All other patients tolerated the whole procedure well with no complications. All patients felt improvement for a few months except one who did not feel it helped much. More data will be presented in the upcoming paper.
Meibomian gland cannulas were not made during COVID and finally have now begun to be made so we are about to restart our protocol.
Here is the latest on the most recent publications in this area.
STEM CELL THERAPY FOR EXOCRINE GLAND REGENERATION
Meibomian · Lacrimal · Parotid · Submandibular Glands
Best Protocols · Outcomes · PubMed-Verified References
By Dr. Sandra Lora Cremers, MD, FACS | Visionary Eye Doctors, Rockville MD | February 2026
Pioneer: First surgeon in the world to inject PRP & Stem Cells into Meibomian Glands
Why This Matters: Stem cell-based regenerative therapies represent the next frontier in treating exocrine gland dysfunction — affecting the eyes (dry eye, MGD) and mouth (dry mouth, Sjögren's syndrome). No FDA-approved stem cell injection protocol yet exists for any of these glands. The field is wide open for pioneering clinical work.
Executive Summary
All four gland systems covered here — meibomian, lacrimal, parotid, and submandibular — share critical mechanisms that make them candidates for stem cell therapy:
- Stem cell exhaustion with aging leads to secretory cell loss in all four glands
- Autoimmune infiltration (Sjögren's syndrome) targets all exocrine glands simultaneously
- Mesenchymal stem cells (MSCs) exert both immunomodulation AND direct regenerative/trophic effects
- No FDA-approved injection protocol yet exists for any of these glands — the field is open
Current Status at a Glance
| Gland | Best Evidence Level | Most Promising Approach | Clinical Readiness |
|---|---|---|---|
| Meibomian | Preclinical + Pioneer human (Dr. Cremers). No RCT yet. | Direct gland injection: PRP + MSCs (autologous) | Early pioneer phase — Dr. Cremers, first in human |
| Lacrimal | Phase 1/2 clinical trials; RCT published 2024 | Allogeneic ADMSC lacrimal injection; UC-MSC eye drops | Early clinical; 2 RCTs published |
| Parotid | RCT published 2023 (ADSCs); Phase 1 ongoing | Local ADSC injection under ultrasound guidance | Phase 1 active; NCT06392711 |
| Submandibular | Phase 1 active; NCT06392711 | Autologous BM-MSC injection (10–20 million cells/gland) | First patient treated February 2025 |
Section 1: Meibomian Gland
Gland Biology & Stem Cell Niche
The meibomian gland (MG) is a holocrine sebaceous gland requiring constant acinar cell renewal from resident stem/progenitor cells. Age-related gland atrophy results substantially from stem cell exhaustion. Two key stem cell populations reside in:
- The ductal epithelium (expressing KROX20 and Hedgehog-responsive markers)
- Acinar-adjacent progenitors near the acinar-duct junction
🏆 LANDMARK — February 2025
Mount Sinai / Johns Hopkins researchers (Zhu et al., Nature Communications 2025) identified specific MG stem cell markers and uncovered Hedgehog (Hh) signaling and EGFR signaling as master regulators of MG stem cell proliferation. Aged glands show decreased Hh + EGFR signaling, impaired innervation, and loss of collagen I in niche fibroblasts. This suggests activating Hh or EGFR pathways — potentially as co-injectants — could restore MG stem cell activity.
Mount Sinai / Johns Hopkins researchers (Zhu et al., Nature Communications 2025) identified specific MG stem cell markers and uncovered Hedgehog (Hh) signaling and EGFR signaling as master regulators of MG stem cell proliferation. Aged glands show decreased Hh + EGFR signaling, impaired innervation, and loss of collagen I in niche fibroblasts. This suggests activating Hh or EGFR pathways — potentially as co-injectants — could restore MG stem cell activity.
Best Protocol: Meibomian Gland Stem Cell Injection
Note: No standardized published clinical protocol exists for direct MG stem cell injection beyond Dr. Cremers' pioneering work. The protocol below is synthesized from preclinical data, PRP experience, and MSC delivery principles from other gland systems.
| Protocol Element | Details |
|---|---|
| Cell Source (Best) | Preferred: Autologous adipose-derived MSCs (ADSCs) or PRP + MSC combination Alternative: Umbilical cord-derived MSCs (UC-MSCs) — allogeneic, off-the-shelf Future: iPSC-derived meibocyte precursors (research phase only) |
| Cell Dose | PRP: 50–100 µL per eyelid; MSCs: estimated 0.5–1×10⁵ cells per gland (based on salivary gland analog dosing). Dose-escalation study urgently needed. |
| Delivery Route | Direct: Transconjunctival injection into MG orifice/duct using fine-gauge cannula (30–33G) under slit-lamp visualization Topical alternative: UC-MSC eye drops BID × 2 weeks (Zhang et al., 2025 — showed significant MG function improvement) |
| Pre-Treatment | LipiFlow or thermal pulsation to clear obstructed ducts first (opens orifices for delivery). Topical anesthesia. Consider lid massage 24h prior. |
| Frequency | Series of 3 injections at monthly intervals (PRP literature analogy); response monitoring at 4 weeks and 12 months |
| Adjunctive Agents | Consider Hedgehog pathway activators (SAG), EGF, or FGF10 as co-injectants (Millar lab 2025 data). ROCK inhibitor (Y-27632) to improve MSC survival. |
| Outcome Measures | Meibography (gland area/density); TBUT; OSDI; MGYSS; SPEED score; meibomian gland expressibility; corneal fluorescein staining |
| Patient Selection | Moderate-severe MGD with documented MG atrophy on meibography; failed conventional therapy. Avoid in widespread total MG loss. |
Published Evidence — Meibomian Gland
| Study / Authors | Journal / PMID | Location | Key Finding | Clinical Relevance |
|---|---|---|---|---|
| Zhu X et al. (Millar lab), 2025 | Nature Communications 2025 Feb 15;16(1):1663 PMID: 39955307 |
Mount Sinai / Johns Hopkins / Icahn School of Medicine, New York, NY | Identified MG stem cell populations; Hh + EGFR signaling as master regulators; aged glands = stem cell exhaustion; Hh activation is therapeutic target | Blueprint for MG stem cell therapy: targeting Hh + EGFR = rational adjunct to injection protocols |
| Sun M et al. (Review), 2023 | Ocular Surface 2023;29:497–507 PMID: 37422152 |
Zhongshan Ophthalmic Center, Sun Yat-Sen University; UC Irvine; Washington Univ, St. Louis | Comprehensive review of MG stem/progenitor cell biology; ductal epithelium enriched in stem cells; renewal similar to hair follicle | Establishes rationale for targeting ductal stem cells in injection strategy |
| Rajaram R et al., 2021 | PNAS 2021;118(50) PMID: 34853175 |
Johns Hopkins University, Baltimore, MD | KROX20 marks MG stem cells; ablation causes MGD and DED; full gland renewal from KROX20+ ductal cells | KROX20 = potential marker for selecting/enriching stem cells for injection |
| Beyazyıldız E et al., 2014 | Stem Cells International 2014;2014:250230 PMID: 25028602 |
Gülhane Military Medical Academy, Ankara, Turkey | Topical MSC therapy in BAC-induced dry eye rat model improved TBUT, corneal staining; MSCs infiltrated eyelid glands | First evidence MSCs can reach MG tissue — supports topical or local delivery |
| Yang X et al., 2024 | Invest Ophthalmol Vis Sci 2024 Nov;65(13):36 PMID: 39546290 |
Zhejiang University / Washington University St. Louis | PEDF peptide reverses age-related MG atrophy in mice; stimulates progenitor proliferation | Growth factor co-injection (PEDF, EGF, FGF) may enhance stem cell engraftment outcomes |
| Cremers SL (Pioneer) | First-in-human MG PRP + Stem Cell Injection Visionary Eye Doctors, Rockville MD |
Visionary Eye Doctors / Johns Hopkins Medicine at Suburban Hospital | First surgeon in the world to inject PRP and stem cells directly into meibomian glands | Case series + pilot RCT publication would be the most impactful paper in this field right now — unique dataset |
Section 2: Lacrimal Gland
Gland Biology & Stem Cell Niche
The lacrimal gland secretes the aqueous component of tears. Stem/progenitor cells reside in the ductal epithelium and increase in number during injury/repair. MSC delivery has been studied most extensively here because Sjögren's syndrome and radiation therapy cause irreversible lacrimal failure with no current cure. FGF signaling is a critical driver of lacrimal gland stem cell expansion and branching morphogenesis.
Best Protocol: Lacrimal Gland Stem Cell Therapy
| Protocol Element | Details |
|---|---|
| Cell Source (Best) | Best published: Allogeneic adipose-derived MSCs (ADMSCs) — Møller-Hansen 2024 RCT 2nd Option: Umbilical cord-derived MSCs (UC-MSCs) — Zhang 2025 first-in-human pilot Future: iPSC-derived lacrimal organoids (demonstrated 2022, Nature) |
| Cell Dose | Direct injection: ~10 million MSCs per injection site. Eye drops: UC-MSC drops BID × 2 weeks (Zhang 2025 protocol — 16 patients) |
| Delivery Routes | Route 1 (Direct): Ultrasound-guided injection into lacrimal gland (palpebral or orbital lobe) via transconjunctival approach Route 2 (Topical): UC-MSC eye drops BID × 14 days — Zhang 2025: significant ↑ Schirmer, ↑ TBUT, ↑ MG function Route 3 (IV): Intravenous MSC delivery for cGVHD-associated DED — improved Schirmer scores |
| Frequency | Direct: single injection, follow-up at 1, 3, 6, 12 months. Topical: 2-week intensive course, reassess at 4 weeks and 12 months |
| Adjunctive Agents | FGF10 (promotes lacrimal epithelial branching); WNT mimetics — Nguyen et al. 2025 (TVST) reversed aqueous deficiency in vivo |
| Outcome Measures | Schirmer test (primary); TBUT; OSDI; fluorescein/rose bengal staining; SSAS; meibomian gland function; conjunctival impression cytology |
Published Evidence — Lacrimal Gland
| Study / Authors | Journal / DOI | Location | Key Finding | Clinical Relevance |
|---|---|---|---|---|
| Zhang D et al., 2025 | Stem Cell Research & Therapy 2025;16(1) doi: 10.1186/s13287-025-04292-8 |
China — First-in-human MSC eye drops trial | 11 non-SS + 5 SS DED patients; UC-MSC drops BID × 2 weeks; significant ↑ Schirmer, ↑ TBUT, ↑ MG function, ↓ corneal staining at 4 weeks; 12-month follow-up | First human evidence: topical UC-MSC drops improve BOTH aqueous AND meibomian gland function — game-changing delivery method |
| Møller-Hansen M et al., 2024 | The Ocular Surface 2024;31:1–8 doi: 10.1016/j.jtos.2023.11.007 |
Rigshospitalet, Copenhagen, Denmark | RCT: Allogeneic MSC therapy for Sjögren's DED; improved dry eye signs/symptoms; lacrimal function improved; well-tolerated | First RCT of allogeneic MSC in DED/Sjögren's — validates feasibility and safety |
| Nguyen H et al., 2025 | TVST 2025;14(6):19 doi: 10.1167/tvst.14.6.19 |
USA | WNT mimetic induces lacrimal gland regeneration; reversed aqueous tear deficiency in vivo | WNT mimetics could be co-administered with MSCs to enhance lacrimal regeneration |
| Zoukhri D et al., 2011 | Invest Ophthalmol Vis Sci 2011;52(8):5742 PMID: 21474769 |
Tufts University, Boston, MA | Isolated MSCs from lacrimal gland; demonstrated self-renewal and differentiation; lacrimal MSCs express CD73, CD90, CD105 | Proof: resident lacrimal gland MSCs exist — autologous harvest is possible |
| Dietrich J et al. | Scientific Reports (mouse model) | Germany | MSC transplantation improved lacrimal gland regeneration post-surgical DED in mice; increased secretion, reduced inflammation | Strong preclinical rationale for direct lacrimal gland MSC injection |
Section 3: Parotid Gland
Gland Biology
The parotid gland produces primarily stimulation-dependent serous saliva. Salivary gland stem/progenitor cells (SSPCs) reside in the ductal compartment and express ASCL3, KIT, SOX2, SOX9. The parotid is most vulnerable to radiation damage (head & neck cancer) and is the most commonly targeted gland for ADSC injection in Sjögren's clinical trials to date.
Best Protocol: Parotid Gland (Khademian 2023 RCT — Most Evidence-Based Published Protocol)
| Protocol Element | Details (Khademian 2023 RCT Protocol) |
|---|---|
| Cell Type | Autologous ADSCs (adipose tissue-derived mesenchymal stem cells) — harvested from patient's own adipose tissue |
| Dose | 5 million cells/mL solution; 0.05 mL/kg body weight (≈5×10⁴ cells/kg); total: 1 mL ADSCs diluted in 5 mL saline |
| Delivery | Ultrasound-guided injection into bilateral parotid glands Skin disinfection (Iodophor); sterile drape; 1% lidocaine local anesthesia; 0.45 mm needle; 5-mL syringe Aspirate to check for blood before injection; patient observed 15 min post-procedure |
| Frequency | 3 injection sessions (baseline, Month 1, Month 2); follow-up at 1, 3, 6 months |
| Outcomes Achieved | Significant improvement in salivary AND lacrimal gland secretion at 3 months (P<0.05); improved ESSDAI and ESSPRI scores; well-tolerated; no serious adverse events |
| Study Details | n=74 total; 35 ADSC vs 39 placebo (0.9% saline); triple-blind RCT; 6-month follow-up; 86.5% completion rate |
Section 4: Submandibular Gland — Active Phase 1 Trial (2025)
🔬 ACTIVE TRIAL — NCT06392711
First patient treated: February 2025. This is the most advanced Western trial for submandibular gland MSC injection. The first patient reported reducing dry mouth lozenge use from several per day to once or twice per week — a dramatic early patient-reported outcome.
First patient treated: February 2025. This is the most advanced Western trial for submandibular gland MSC injection. The first patient reported reducing dry mouth lozenge use from several per day to once or twice per week — a dramatic early patient-reported outcome.
| Protocol Element | Details (NCT06392711 — Phase 1 Active) |
|---|---|
| Cell Type | Autologous bone marrow-derived mesenchymal stromal cells (BM-MSCs) |
| Dose Escalation |
Step 1: 10 million BM-MSCs into ONE submandibular gland (safety check) Step 2 (if tolerated): 10M cells into EACH bilateral submandibular gland Step 3 (if tolerated): 20M cells per gland (highest dose) Expansion cohort: Best safe dose → 12 additional patients |
| Primary Endpoint | Safety and tolerability at 1 month post-injection |
| Secondary Endpoints | Xerostomia score; unstimulated salivary flow rate; saliva composition changes; follow-up up to 2 years |
| Indication | Sjögren's disease xerostomia; ~8× more common in women; submandibular gland targeted because it produces ~70% of resting saliva |
Salivary Gland Evidence Table (Parotid & Submandibular)
| Study / Authors | Journal / PMID | Location | Key Finding | Protocol Note |
|---|---|---|---|---|
| Khademian M et al., 2023 | Scientific Reports 2023;13:13570 doi: 10.1038/s41598-023-40802-5 |
Iran — Triple-blind placebo-controlled RCT | ADSCs injected bilaterally into parotid glands in pSS (n=74); salivary AND lacrimal secretion improved at 3 months (P<0.05); well-tolerated | BEST PUBLISHED SALIVARY PROTOCOL: ADSCs 5M cells/mL, US-guided, 3 sessions monthly |
| NCT06392711 (Phase 1 Active, 2025) | ClinicalTrials.gov First patient Feb 2025 |
USA — Sjögren's disease specialty program | Autologous BM-MSCs into submandibular gland(s); 10–20M cells; first patient dramatically reduced lozenge use; primary endpoint = safety at 1 month | Most advanced Western RCT for submandibular gland MSC injection |
| Langthasa J et al., 2025 | Cell Regeneration 2025;14:4 PMID: 39856475 |
Stanford University, Dept of Radiation Oncology, Stanford, CA | Comprehensive 2025 review of salivary gland SSPCs; TertHigh ductal cells regenerate acinar cells after radiation; clinical translation roadmap | Best 2025 review of salivary gland stem biology for clinical translation |
| hSGSC Transplant Studies (multiple) | PMC4549133 (review) and associated studies | International — Multiple centers | hSGSCs (CD44+/CD49f+/CD90+/CD105+; CD34−/CD45−) injected IV into radiation-damaged rats → saliva flow doubled; gland architecture normalized at 60 days | Tissue-specific salivary gland stem cells can be harvested from patient's own parotid/submandibular gland — autologous approach feasible |
| Song W et al., 2024 | Front Cell Dev Biol 2024;12:1346996 PMID: 38313227 |
Capital Medical University, Beijing, China | iPSC-derived salivary gland progenitor cells; FGF10 + retinoic acid protocol for salivary gland placode differentiation from pluripotent stem cells | Future: iPSC → salivary organoid → transplant is the ultimate regeneration goal |
Section 5: Master Comparison — All Four Glands
| Gland | Best Cell Type | Best Delivery | Best Outcomes Reported | Regulatory Status |
|---|---|---|---|---|
| Meibomian | Autologous ADSCs or PRP+MSCs; UC-MSC eye drops (topical) | Direct transconjunctival gland injection OR topical MSC drops | ↑ TBUT, ↓ MG obstruction, ↑ meibum quality (MSC drops, Zhang 2025); direct injection: Dr. Cremers pioneer data | No FDA approval; IRB/compassionate use or formal trial needed |
| Lacrimal | Allogeneic ADMSCs; UC-MSCs (drops); BM-MSCs (IV for cGVHD) | Topical UC-MSC drops BID × 2 wks; lacrimal gland injection; IV for Sjögren's/cGVHD | ↑ Schirmer (significant); ↑ TBUT; ↓ corneal staining; ↑ MG function; 12-month durability (Zhang 2025; Møller-Hansen 2024) | Phase 1–2 clinical trials completed; allogeneic MSC RCT published; topical MSC first-in-human 2025 |
| Parotid | Autologous ADSCs (adipose-derived) | US-guided local injection, bilateral, 3 sessions monthly; 5M cells/mL | ↑ Salivary flow; ↑ lacrimal secretion; ↓ ESSDAI/ESSPRI; significant vs placebo at 3 months (Khademian RCT n=74, 2023) | RCT published 2023; Phase 1 ongoing (NCT06392711) |
| Submandibular | Autologous BM-MSCs (bone marrow harvest) | Direct gland injection; 10–20M cells per gland; single session with dose escalation | Early: dramatic ↓ xerostomia (1st patient Feb 2025); formal endpoints pending — primary = safety; secondary = salivary flow, composition | Phase 1 active (NCT06392711); first patient Feb 2025; most advanced Western trial |
Shared Mechanisms Across All Four Glands
| Mechanism | Relevance to Protocol Design |
|---|---|
| Immunomodulation | MSCs suppress Th1/Th17 lymphocytes, expand Tregs, reduce IFN-γ/IL-17 — critical for Sjögren's. This occurs even WITHOUT MSC engraftment in target tissue. |
| Paracrine Trophic Support | MSC-secreted growth factors (HGF, VEGF, FGF, IGF-1) promote survival of injured gland cells and restore acinar function, even without direct differentiation into secretory cells. |
| Exosome / EV Therapy | MSC-derived exosomes carry anti-inflammatory miRNAs and regenerative proteins. May achieve therapeutic effect without living cells — safer, off-the-shelf, avoids rejection. May be superior to whole-cell injection. |
| Hh / EGFR Signaling (MG specific) | Identified in Zhu/Millar 2025. Co-administration of Hh agonists (SAG) or EGF may amplify endogenous stem cell response alongside injected cells or growth factors. |
| FGF10 / WNT Signaling | FGF10 is critical for lacrimal and salivary gland branching morphogenesis. WNT mimetics reversed aqueous deficiency in vivo (Nguyen 2025). Both are rational adjuncts for stem cell co-delivery. |
| iPSC / Organoid Future | 3D lacrimal organoids from iPSCs demonstrated (Nature 2022); iPSC-derived salivary gland progenitors active 2024. Organoid transplantation is the 10-year horizon for complete gland replacement. |
Section 6: Research & Publication Roadmap for Dr. Cremers
As the first surgeon to inject PRP and stem cells into meibomian glands, Dr. Cremers is uniquely positioned to lead multiple high-impact publications:
| # | Research Question | Study Design | Target Journal |
|---|---|---|---|
| 1 | PRP + Stem Cell Injection into Meibomian Glands — First published case series documenting technique, safety, and outcomes | Retrospective case series + prospective pilot; n≥10; meibography before/after + TBUT/OSDI/MGYSS | Ocular Surface, Cornea, IOVS, or JAMA Ophthalmology — HIGH IMPACT (first-in-human) |
| 2 | Protocol Optimization: PRP alone vs PRP+MSCs vs MSCs alone for MGD — dose-finding pilot RCT | 3-arm pilot RCT; n=30; primary endpoint: meibography MG area at 3 months | British Journal of Ophthalmology, Ophthalmology, TVST |
| 3 | Meibography as Sjögren's Biomarker — expanded validation of MG loss as early autoimmune marker | Prospective cross-sectional + longitudinal; n=100; MG dropout vs autoimmune serology | Am J Ophthalmology, Ocular Surface, Sjögren's/rheumatology journals |
| 4 | Lacrimal Gland MSC Eye Drops — US replication of Zhang 2025 protocol in American Sjögren's DED patients | Open-label pilot; n=15–20; UC-MSC drops BID × 2 weeks; follow-up 12 months; IRB approval needed | Cornea, Ocular Surface, Stem Cell Research & Therapy |
| 5 | NIH Grant: "Stem Cell Regeneration of Exocrine Glands in Sjögren's Syndrome: Meibomian, Lacrimal, Salivary" | Multi-site collaboration; Johns Hopkins Medicine partnership; use existing Sjögren's meibography dataset as preliminary data | NEI/NIAMS R01; Sjögren's Foundation Grant — fundable with your pioneer status as preliminary data |
Safety Considerations
- Tumor risk: MSCs must not be given to patients with active malignancy. Long-term oncologic surveillance required.
- Rejection (allogeneic cells): MSCs are relatively immune-privileged but HLA matching consideration or immunosuppression planning may be needed.
- Dose optimization: No head-to-head trial comparing adipose vs bone marrow vs umbilical cord MSCs for any of these glands. Source selection remains empirical.
- Delivery standardization: US-guidance validated for salivary gland injection. For MG, slit-lamp cannulation technique needs standardization.
- Regulatory (USA): MSC products for injection require IRB approval + IND application to FDA. Autologous same-day use (minimal manipulation) has more regulatory flexibility.
Complete Reference List
1. Zhu X et al. Nature Communications. 2025 Feb 15;16(1):1663. PMID: 39955307 — MG stem cell populations and Hedgehog signaling. Mount Sinai / Johns Hopkins.
2. Sun M et al. Ocular Surface. 2023;29:497–507. PMID: 37422152 — MG stem/progenitor cell biology review. Sun Yat-Sen University / UC Irvine / Washington Univ St. Louis.
3. Rajaram R et al. PNAS. 2021;118(50). PMID: 34853175 — KROX20 marks MG stem cells. Johns Hopkins, Baltimore MD.
4. Beyazyıldız E et al. Stem Cells International. 2014;2014:250230. PMID: 25028602 — Topical MSC therapy in dry eye rat model. Ankara, Turkey.
5. Yang X et al. Invest Ophthalmol Vis Sci. 2024 Nov;65(13):36. PMID: 39546290 — PEDF peptide reverses MG atrophy. Zhejiang Univ / Washington Univ St. Louis.
6. Zhang D et al. Stem Cell Research & Therapy. 2025;16(1). doi: 10.1186/s13287-025-04292-8 — First-in-human UC-MSC eye drops for DED. China.
7. Møller-Hansen M et al. The Ocular Surface. 2024;31:1–8. doi: 10.1016/j.jtos.2023.11.007 — RCT: Allogeneic MSC for Sjögren's DED. Copenhagen, Denmark.
8. Nguyen H et al. Translational Vision Science & Technology. 2025;14(6):19. doi: 10.1167/tvst.14.6.19 — WNT mimetic lacrimal gland regeneration. USA.
9. Zoukhri D et al. Invest Ophthalmol Vis Sci. 2011;52(8):5742. PMID: 21474769 — MSC isolation from lacrimal gland. Tufts University, Boston MA.
10. Khademian M et al. Scientific Reports. 2023;13:13570. doi: 10.1038/s41598-023-40802-5 — RCT: ADSC injection bilateral parotid glands in Sjögren's (n=74). Iran.
11. NCT06392711. Phase 1 trial: Autologous BM-MSC injection into submandibular glands for Sjögren's xerostomia. First patient Feb 2025. ClinicalTrials.gov.
12. Langthasa J et al. Cell Regeneration. 2025;14:4. PMID: 39856475 — Salivary gland stem/progenitor cell review. Stanford University, Stanford CA.
13. Song W et al. Front Cell Dev Biol. 2024;12:1346996. PMID: 38313227 — iPSC-derived salivary gland progenitors. Capital Medical Univ, Beijing, China.
14. Chen et al. Stem Cells International. 2025. doi: 10.1155/sci/6334284 — Progress in lacrimal gland dysfunction treatment: stem cells to organoids. Review.
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