There is a critical unmet need for the application of new therapies to treat dry eye disease. A true aqueous- deficient dry eye due to inefficient lacrimal gland (LG) function is among the most common and debilitating clinical outcomes. Unfortunately, dry eye has no cure, and current treatment options target symptoms rather than resolving disease. A potential regenerative approach for restoring lacrimal function is stem cell therapy, where autologous stem/progenitor cells are transplanted into the injured organ or stem cells within the tissue are reactivated. However, to achieve this goal, we must identify LG stem/progenitor cells and understand how they are regulated. Our first objective is to resolve how nerves regulate LG homeostasis and regeneration by characterizing potential progenitor cells and determining how nerves control their differentiation into functional glandular tissue. Parasympathetic nerves regulate epithelial progenitor cells in other glandular systems, and are essential to the maintenance of lacrimal tissue. Yet, despite reduced innervation being a component of dry eye, the impact of nerve alterations on lacrimal gland homeostasis and repair (or on progenitor cells) is not known. Based on our preliminary data strongly suggesting the parasympathetic-nerve derived neuropeptide Y (NPY) is altered in patients with aqueous deficient dry eye disease (GWAS) and controls LG morphogenesis and tissue maintenance, we will test the hypothesis that NPY signaling regulates LG formation, homeostasis and regeneration by controlling stem/progenitor cell behavior. Our prediction will be addressed through 2 specific aims that seek to: 1) Define how NPY signaling regulates LG progenitor cells during development; and to 2) Determine the contribution of acinar progenitors and NPY signaling to adult LG homeostasis and regeneration.
These aims will be achieved using a combination of human lacrimal glands and mouse genetics in conjunction with genetic, biochemical, immunochemical, and transcriptomic techniques. Our rationale for investigating this hypothesis is that understanding how progenitor cells are regulated during organ formation and after injury is critical if we are to repair, regenerate or replace the LG, and improve patient quality of life.

Public Health Relevance

Aqueous-deficient dry eye syndrome is among the most common and debilitating clinical conditions for which there is no cure. Stem cell therapy is a promising strategy to replace/regenerate tear producing lacrimal glands damaged due to disease or trauma but the identity of stem cells and the mechanisms that regulate their behavior are not known. This project aims to identify lacrimal gland stem/progenitor cells that contribute to regeneration after damage as well as the signals that control these events in order to develop targeted regenerative approaches to reverse lacrimal gland dysfunction.

National Institute of Health (NIH)
National Eye Institute (NEI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Mckie, George Ann
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
Anatomy/Cell Biology
Schools of Dentistry/Oral Hygn
San Francisco
United States
Zip Code
May, Alison J; Cruz-Pacheco, Noel; Emmerson, Elaine et al. (2018) Diverse progenitor cells preserve salivary gland ductal architecture after radiation-induced damage. Development 145: