The submucosa (or tela submucosa) is a thin layer of
tissue in various
organs of the
gastrointestinal
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. ...
,
respiratory, and
genitourinary tracts. It is the layer of
dense irregular connective tissue that supports the mucosa (
mucous membrane
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It ...
) and joins it to the
muscular layer
The muscular layer (muscular coat, muscular fibers, muscularis propria, muscularis externa) is a region of muscle in many organs in the vertebrate body, adjacent to the submucosa. It is responsible for gut movement such as peristalsis. The Latin ...
, the bulk of overlying
smooth muscle
Smooth muscle is one of the three major types of vertebrate muscle tissue, the others being skeletal and cardiac muscle. It can also be found in invertebrates and is controlled by the autonomic nervous system. It is non- striated, so-called bec ...
(fibers running circularly within layer of longitudinal muscle).
The submucosa (''
sub-'' + ''mucosa'') is to a mucous membrane what the
subserosa (''
sub-'' + ''serosa'') is to a
serous membrane
The serous membrane (or serosa) is a smooth epithelial membrane of mesothelium lining the contents and inner walls of body cavity, body cavities, which secrete serous fluid to allow lubricated sliding (motion), sliding movements between opposing ...
.
Structure
Blood vessels
Blood vessels are the tubular structures of a circulatory system that transport blood throughout many animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the tissues of a body. They also take waste an ...
,
lymphatic vessels, and
nerves (all supplying the
mucosa) will run through here. In the intestinal wall, tiny
parasympathetic
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system.
The autonomic nervous system is responsible for regulat ...
ganglia are scattered around forming the
submucous plexus (or "Meissner's plexus") where
preganglionic parasympathetic neurons synapse with
postganglionic nerve fibers that supply the
muscularis mucosae. Histologically, the wall of the alimentary canal shows four distinct layers (from the lumen moving out): mucosa, submucosa, muscularis externa, and either a
serous membrane
The serous membrane (or serosa) is a smooth epithelial membrane of mesothelium lining the contents and inner walls of body cavity, body cavities, which secrete serous fluid to allow lubricated sliding (motion), sliding movements between opposing ...
or an
adventitia.
In the
gastrointestinal tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...
and the
respiratory tract
The respiratory tract is the subdivision of the respiratory system involved with the process of conducting air to the alveoli for the purposes of gas exchange in mammals. The respiratory tract is lined with respiratory epithelium as respirato ...
the submucosa contains the
submucosal gland
Submucosal glands can refer to various Racemic mixture, racemose exocrine glands of the mucus, mucous type. These glands secrete mucus to facilitate the movement of particles along the body's various tubes, such as the throat and intestines. The mu ...
s that secrete
mucus
Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both Serous fluid, serous and muc ...
.
Clinical significance
Identification of the submucosa plays an important role in diagnostic and therapeutic
endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
, where special
fibre-optic cameras are used to perform procedures on the
gastrointestinal tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...
. Abnormalities of the submucosa, such as
gastrointestinal stromal tumors, usually show integrity of the mucosal surface.
The submucosa is also identified in
endoscopic ultrasound to identify the depth of tumours and to identify other abnormalities. An injection of
dye,
saline, or
epinephrine
Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands a ...
into the submucosa is imperative in the safe removal of certain
polyps.
Endoscopic mucosal
resection involves removal of the mucosal layer, and in order to be done safely, a submucosal injection of dye is performed to ensure integrity at the beginning of the procedure.
Female uterine submucosal layers are liable to develop fibroids during pregnancy and are often excised upon discovery.
Small intestinal submucosa
''Small intestinal'' submucosa (SIS) is submucosal
tissue in the
small intestine
The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...
s of
vertebrates
Vertebrates () are animals with a vertebral column (backbone or spine), and a cranium, or skull. The vertebral column surrounds and protects the spinal cord, while the cranium protects the brain.
The vertebrates make up the subphylum Vertebra ...
. SIS is harvested (typically from pigs) for
transplanted structural material in several
clinical applications, typically
biologic meshes. They have low
immunogenicity. Some uses under investigation include a
scaffold for
intervertebral disc
An intervertebral disc (British English), also spelled intervertebral disk (American English), lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the ver ...
regeneration.
Unlike other scaffold materials, the
resorbable SIS
extracellular matrix (SIS-ECM) scaffold is replaced by well-organized host tissues, including differentiated
skeletal muscle
Skeletal muscle (commonly referred to as muscle) is one of the three types of vertebrate muscle tissue, the others being cardiac muscle and smooth muscle. They are part of the somatic nervous system, voluntary muscular system and typically are a ...
.
History
A scientific article published in March 2018
[Benias, P., Wells, R., Sackey-Aboagye, B., Klavan, H., Reidy, J., Buonocore, D., Miranda, M., Kornacki, S., Wayne, M., Carr-Locke, D. and Theise, N. (2018). Structure and Distribution of an Unrecognized Interstitium in Human Tissues. Scientific Reports, 8(1).] proposed a revision of the anatomical definition of the submucosa. They first saw a non compact tissue which should be submucosa using a technology called
endomicroscopy. They hypothesised that the submucosa was not compact as it was previously seen on histological analysis but form a reticular pattern. To confirm their findings, they performed fixed samples of bile duct into a freezing media in order to conserve the shape of the submucosa. They then performed a histological analysis and with several staining techniques, they described the submucosa as a network of collagenous bands separating open, formerly fluid-filled spaces. Theses spaces are bordered by fibroblast-like cells
CD34
CD34 is a transmembrane phosphoglycoprotein protein encoded by the CD34 gene in humans, mice, rats and other species.
CD34 derives its name from the cluster of differentiation protocol that identifies cell surface antigens. CD34 was first desc ...
positive. However, these cells are devoid of ultrastructural features indicative of endothelial differentiation, including pinocytotic vesicles and Weibel-Palade bodies.
Additional images
File:Gastrointestinal wall of human stomach hariadhi.svg, Stomach.
File:Gray1033.png, Section of the human esophagus
The esophagus (American English), oesophagus (British English), or œsophagus (Œ, archaic spelling) (American and British English spelling differences#ae and oe, see spelling difference) all ; : ((o)e)(œ)sophagi or ((o)e)(œ)sophaguses), c ...
. Moderately magnified.
File:Gray1141.png, Vertical section of bladder wall.
File:Gut wall.svg, General structure of the gut wall showing the submucosa.
References
{{Authority control
Membrane biology
Digestive system