Extracellulära Matrixen (ECM)
Vävnadsutrymmet mellan cellerna; den extracellulära matrisen (ECM), består av fiberproteiner, samt av en flytande gel som kallas grundsubstans.
Fiberproteinerna är mest kollagen, som ger styrka, elasticitet och struktur, och grundsubstansens huvudbeståndsdel är hyaluronsyra och vatten som bland annat ger viskositet och glidfunktion till bindvävens olika lager.
I grundsubstansen finns även flera andra föreningar av proteiner och kolhydrater, t ex något som kallas kondroitinsulfat, som också innehåller svavel vilket hyaluronsyra saknar.
ECM består framförallt av tre komponenter;
Fiberproteiner: främst olika typer av kollagen och elastiska fibrer
Grundsubstans: glukosaminoglykaner (GAG, hyaluronsyra är en typ av GAG) och proteoglykaner (PG)
Linkproteiner: icke kollagena proteiner
Utöver detta även
- Joner – t ex Na, K, Ca, Mg mm
- och vatten
Större delen av det vatten vi har i kroppen, förutom i blod, lymfa och tarmsystem finns i fascian.
99 % av de kemiska reaktioner som sker i vår kropp kräver vatten! Vatten ger också vår vävnad volym och därmed dess mekaniska funktion.
Fiberproteinerna står för struktur, hållfasthet och elasticitet.
Grundsubstansen svarar för den ”flytande” delen med stora molekyler som binder stora mängder vatten för att bland annat kunna ansvara för transport och diffusion av joner, näringsämnen, avfallsämnen med mera, mellan blodets kapillärer och cellerna. Även kommunikation mellan celler, fungerar med hjälp av grundsubstansen.
Linkproteinernas huvudsakliga uppgift är att binda kollagenfibrer till cellmembranen, vilket gör att alla celler har en mekanisk kontakt via den extracellulära matrixen. Linkproteiner hjälper också till att binda fast proteinkedjor på HA-molekyler så att det bildas proteoglykaner.
Beståndsdelarna i ECM bildas ifrån olika celler i bindväven. Sammansättningen av ECM och proportionerna mellan de olika komponenterna varierar beroende av den mekaniska belastning som vävnadens celler utsätts för. Allt för att anpassas efter de behov och krav som ställs på vävnaden. Den mekaniska belastningen på ECM och därmed cellerna gör att cellerna svarar med att producera olika komponenter och signalproteiner. Detta kallas mekanotransduktion, då mekanisk belastning på celler omvandlas till ett kemiskt svar. Fysik blir till kemi!
Sammansättningen och förändring i ECM och grundsubstans och bland annat den snabba förändringen hyaluronsyrans molekylsammansättning är nya insikter som givit ny kunskap om hur fascian påverkar uppkomst av olika typer av problem, som t ex ryggont, tennisarmbåge, frozen shoulder, nackont med mera. Problem som kan vara svåra att diagnostisera då förändringar i grundsubstansen inte syns på röntgen, MRI, ultraljud mm. Mer om det senare.
- Av Camilla Ranje Nordin, Lärare i Fasciakunskap & Fasciabehandling
Fascians anatomi & fysiologi
Guimberteau
Surgeon Jean Claude Guimberteau has spent 15 years conducting over 1,200 examinations of Fascia, which he filmed with an endoscope in vivo (in a living subject)
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