Fig. 5

Proposed clinical paradigm for use of autologous BM-MSCs for SG regeneration. MSCs harvested from the bone marrow of patients with SG hypofunction or dysfunction, would be cultured in an environment (i.e., ECM produced by BM cells from young donors [i.e., young BM-ECM]) which promotes the expansion of regenerative subpopulations of autologous MSCs. Once sufficient numbers of MSCs are obtained, they will be combined with a homogenate of decellularized SG-ECM (or, in the future, a mimetic of SG-ECM), which recapitulates components of the healthy SG microenvironment, and induces the trans-differentiation of the MSCs to the SG epithelial cell lineage (i.e., SG progenitors) during culture. After an initial period of culture with the decellularized SG-ECM, followed by the addition of differentiation media and additional time in culture, the cells begin to form SG salispheres, which are transplanted, along with the accompanying ECM, back into the damaged SG of the patient