Stem cell research

[fundryeyes]

Although I feel better now that I'm on Restasis and doxycycline, I can't imagine waking up one day with a normal functioning tear system. I've been told my tear rate looks fine but what they consist of they don't know. My oil looks milky which is not normal. I've also been told my eyes are allergy reactive, so I have small bumps or papules under the lids randomly that come and go.
The worst part of my symptoms is eyelid twitching which can drive you absolutely bonkers. The Drs. I've seen regarding this say "its because your tired" or "too much caffeine" Rubbish ! I sleep well and don't consume caffeine. How can my eyes be tired the moment I wake up ? LOL
So, my question is if our immune system attacks our oil or tear goblet cells, are they permanently damaged ? Like a Type 1 diabetic whose pancreatic cells are destroyed, do we not suffer the same fate with our tear system ? I've never seem a thread on stem cells for our condition. Anyone hear about this ?

[regina]

I would like to know too

I have sjorgrens, dry mouth and dry eye. I asked my dentist, will the damage continue to wreck havack?...and get worse till I lose my teeth? Do the ducts ever repair themselves? Are my symptoms gonna get worse with time and age? And he said...hmmm good question, he doesnt know. I have tried to research it...and really didnt find the answer

[y-gwair]

This is probably too complex a question to answer in short, but I'll have a go.

Assuming that dryness problems are autoimmune in origin, the nature of damage to glands and changes in the composition of secretions is very complex; very little research had been done in this area until recently but there have been some studies recently that suggest some tissues can stabilise/recover if the autoimmune/inflammatory process is controlled. With regard to the eye surface, there seems to be some recent evidence that treatment with cyclosporine emulsion encourages goblet cells to regenerate.


Two more recent studies also suggest cyclosporine/restasis may improve or repair tissues on the surface of the eye:
Efficacy of topical cyclosporine A in the treatment of severe trachomatous dry eye. 2009

The effect of topical cyclosporine a on clinical findings and cytological grade of the disease in patients with dry eye. 2010.

More generally, the amount of damage (and potential reversibility) depends on the whether your glands are being actively infiltrated by lymphocytes (as in Sjogrens), or affected by changes in chemistry which interfere with the body's ability to communicate with glands (probably the case in sicca syndrome). Some medications can work quite well to interfere with the latter process, and may also slow the progess of glandular infiltration. However, this is more likely to be the case if treatment starts at a relatively early stage in the disease process. I take plaquenil/hydroxychloroquine for connective tissue disease, and so far it does seem to have helped stabilise my own condition (though the process by which it works isn't really understood yet). My current eye flare corresponds exactly with stepping down the dosage.

Use of monoclonal antibodies (Rituximab) to treat Sjogren's has shown that glandular lymphocyte infiltration can be reversed temporarily, and this would appear to allow salivary tissue to regenerate if the patient is in an early stages of disease (I don't think the treatment improved lacrimal function very much however). I wouldn't get too excited though; the remission only lasts a few months, these treatments were originally developed for the treatment of lymphoma and thus have some very serious side effects. Currently they are only available to a few people on trials or refractory cases off-label, but their use has provided some interesting evidence that glandular tissue can regenerate when the autoimmune process is stopped temporarily.

Renewing diseased glandular tissue via stem cells might be a possibility in the future, but would be pretty pointless if the underlying autoimmunity cannot be controlled, as any new, healthy tissue would simply be destroyed again by the immune system.

[y-gwair]

Sorry, just updated my post so it makes a bit more sense!