Limited Efficacy of Autologous Mesenchymal Stromal Cell Injections in Immunomodulatory-Dependent Dogs With Aqueous Deficient Dry Eye Disease.

Autologous MSC injections were safe but showed inconsistent, limited efficacy in dogs with immunomodulatory-dependent dry eye.

This prospective pilot study evaluated the safety and efficacy of autologous mesenchymal stromal cell (MSC) injections targeting the lacrimal gland and gland of the third eyelid in dogs with immunomodulatory-dependent aqueous deficient dry eye disease (ADDE). Stringent inclusion criteria—requiring Schirmer tear test I (STT-I) values below 15 mm/min, documented responsiveness to topical immunomodulatory therapy, and confirmed STT-I reduction after therapy cessation—resulted in a high screening failure rate, with only four dogs ultimately enrolled. Autologous MSCs were harvested, expanded ex vivo, and unilaterally injected following immunomodulatory therapy withdrawal. Serial ophthalmic examinations, diagnostic testing, clinical scoring, and owner-reported outcomes were collected at defined intervals. No adverse ocular events were observed, confirming acceptable short-term safety of the injection technique. Clinical responses were heterogeneous: one dog demonstrated a sustained 5.5-fold increase in STT-I; two dogs showed modest, transient improvements (0.6–0.7-fold increases); and one dog showed no measurable improvement over six months. Repeat MSC injections failed to enhance or sustain clinical benefits in any dog. The authors conclude that while autologous MSC therapy appears safe, efficacy is inconsistent and limited in this small cohort. The variable response may reflect differences in disease chronicity, lacrimal gland fibrosis, or MSC potency. The authors recommend future investigation into conditioned MSCs and exosome-based therapies as potentially more effective alternatives for managing refractory canine ADDE.

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