Do Meibomian Glands Regenerate?

Yes, Meibomian glands can regenerate. It has been published by Dr. Maskin that they can regrow just with probing. We have seen a more dramatic effect with probing combined with PRP insertion, autologous stem cell insertion or Cord Blood Serum insertion. I have also seen them regrow with Lipiflow or IPL:

Meibomian Glands renew daily in the sense that more and more meibum continues to be produced with stimulation (such as blinking or eyelid massaging or Lipiflow or meibum expression). How that exactly happens is still not fully understood: see below.

It appears that if the wall of the meibomian gland and its progenitor cells or stem cells are damaged, the whole gland can atrophy. Re-inserting stem cells into the meibomian gland with the right growth medium can potentially regrow even very damaged glands. Likely combining a patient’s PRP with their autologous stem cell insertion and Cord Blood Serum together for meibomian gland insertion is better than each alone, but this has yet to be done. This is still experimental and not FDA approved. We have an IRB (Investigational Research Board) protocol approved for this treatment, but long-term, randomized, studies are years away from proving we can re-grow glands completely. 

If the orifice is scarred over, I have not been able to regrow these glands yet: we would likely have to bore into the orifice area to create a new passage and insert cells there. Whether the cells would set up a new column of meibomian gland cells is unknown.

The goal is thus to get to patients before the orifice gets scarred over completely.

Thus I hope you are blinking as you read this or better yet, having Siri read it to you.

. 2016 Sep 13; 7(3): 399–410.
Published online 2016 Aug 11. doi: 10.1016/j.stemcr.2016.07.010
PMCID: PMC5031954
PMID: 27523617

Renewal of the Holocrine Meibomian Glands by Label-Retaining, Unipotent Epithelial Progenitors

The meibomian and sebaceous glands secrete lipids to prevent desiccation of the ocular surface and skin, respectively. Precisely how these holocrine tissues regenerate is not well understood. To address this, we characterized keratin 5+ (K5) label-retaining cells (LRCs) and the lineage tracing of keratin 14 (K14) progenitors in mouse meibomian glands. Using the tet-off H2B-GFP/K5tTA mouse, H2B-GFP fluorescence dilutes 2-fold with every division in K5+ cell nuclei after doxycycline administration. In 3D reconstructions generated over a >28-day doxycycline chase, we observed LRCs at the acinus entrance where K6+ ductal epithelium terminates. For lineage tracing, K14CreERT2-Confetti mice were injected intraperitoneally with tamoxifen and euthanized at 23 and 59 weeks later. Meibomian gland acini in these mice were either monochromatic or dual-colored, whereas the duct exhibited multiple colors. In conclusion, LRCs are likely to direct meibomian gland turnover and may exist as two distinct unipotent progenitors that renew ductal and acinar tissue separately.
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