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Pirri C, Torre DE, Stecco C. Fascial plane blocks: from microanatomy to clinical applications. Curr Opin Anaesthesiol 2024; 37:526-532. [PMID: 39108103 PMCID: PMC11356744 DOI: 10.1097/aco.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
PURPOSE OF REVIEW In the last 20 years, advancements in the understanding of fasciae have significantly transformed anaesthesia and surgery. Fascial plane blocks (FPBs) have gained popularity due to their validated safety profile and relative ease. They are used in various clinical settings for surgical and nonsurgical indications. Growing evidence suggests a link between the microscopic anatomy of fasciae and their mechanism of action. As a result, knowledge of these aspects is urgently needed to better optimise pain management. The purpose of this review is to summarise the different microscopic aspects of deep/muscular fascia to expand our understanding in the performance of FPBs. RECENT FINDINGS There is ample evidence to support the role of FPBs in pain management. However, the exact mechanism of action remains unclear. Fasciae are composed of various structural elements and display complex anatomical characteristics at the microscopic level. They include various cell types embedded within an extracellular matrix abundant in collagens and hyaluronan. Increasingly, numerous studies demonstrated their innervation that contributes to their sensory functions and their role in proprioception, motor coordination and pain perception. Lastly, the diversity of the cellular and extracellular matrix, with their viscoelastic properties, is essential to understanding the FPBs' mechanism of action. SUMMARY Physicians must be aware of the role of fascial microscopic anatomy and better understand their properties to perform FPBs in a conscious manner and enhance pain management.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua
| | - Debora Emanuela Torre
- Department of Cardiac Anesthesia and Intensive Care Unit, Cardiac Surgery, Ospedale dell’Angelo, Venice Mestre, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua
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Duarte França ME, Botti MDSA, Ide FC, Sinhorim L, Santos GM, do Nascimento IB. Effect of myofascial release techniques on internal biomechanics and their resultant application to sports: A systematic review. J Bodyw Mov Ther 2024; 40:525-533. [PMID: 39593637 DOI: 10.1016/j.jbmt.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/22/2024] [Accepted: 05/01/2024] [Indexed: 11/28/2024]
Abstract
OBJECTIVE To investigate the influence of myofascial release (MFR) techniques on biomechanical parameters, including force, speed, Range of Motion (ROM), and flexibility in athletes. METHOD This is a systematic review conducted on the databases United States National Library of Medicine (PubMed), Scopus, Scientific Electronic Library Online (SciELO); LILACS, and Embase. The PRISMA guidelines - 2020 were followed, and bias risk analysis was performed using the Cochrane Handbook tool (RoB2). RESULTS Sixteen studies were included for qualitative analysis. Techniques using MFR applied or self-applied to improve strength, speed, ROM and flexibility, have no consensus regarding the period of their applicability, due to difficulties in identifying the ideal load of applied tension, temperature level, and viscoelastic properties during the release of the deep fascia. However, improvements in oxygenation, reorganization of piezoelectricity, and normalization of fascial tension became evident after MFR. CONCLUSION Regarding strength, speed, and range of motion (ROM), instrument-assisted soft tissue mobilization performed in isolation and self-applied techniques combined with other methods emerged as favorable predictors for lower limb outcomes. However, isolated self-myofascial release requires further investigation. Regarding flexibility, there is a contrast in results between the use of self-applied foam rolling in isolation, which seems to prevent densification but suggests improvements in muscle strength acquisition without compromising flexibility. Applied MRF provided a more flexible quality for scapular mobilization, both in isolation and in combination with other techniques, but its best indication and/or specific applicability is for pain reduction.
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Meng X, Ding B, Zhu Z, Ma Q, Wang Q, Feng Y, Liu Y, Wang J, Yang P. Evaluation of the Plasticity of Novel Regulatory Cells-Telocytes-in the Gonad of the Male Chinese Soft-Shelled Turtle ( Pelodiscus sinensis) Associated with Seasonal Reproductive Activity. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2022; 28:1-9. [PMID: 36204971 DOI: 10.1017/s1431927622012302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Telocyte (TC)—a new type of interstitial cell with long telopodes, can form cellular junctions with various tissues or cells to participate in the regulation of multitudes of physiological activities and diseases. This study aimed to characterize the morphology, molecular features, and potential functions of hormone regulation in Chinese soft-shelled turtle (Pelodiscus sinensis) testis TCs at different reproductive stages by histological evaluation, immunohistochemistry (IHC), immunofluorescence (IF), and transmission electron microscopy. During hibernation, TCs were widely distributed in the interstitial tissue. In contrast, during reproductive activity, TCs were noted to be in close proximity with peritubular myoid cells surrounding the seminiferous tubule. Moreover, formed cell–cell junctions were observed between TCs and PTMs. The results of IHC and IF showed that the immunophenotype of testicular TCs in hibernating Chinese soft-shelled turtles is CD34+Vimentin−, while the reproductive telopodes (Tps) show low expression of vimentin. The androgen receptor is expressed in Tps of TCs of testis during hibernation. Our results showed also that TCs in seasonal breeding animals regulate the activity of neighboring cells by releasing extracellular microvesicles (EXMVs), thus influencing the activity of spermatogenesis and steroidogenesis. Consideration of our novel and interesting results indicate that the whole area warrants further research.
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Affiliation(s)
- Xiangfei Meng
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Baitao Ding
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Zhaoxuan Zhu
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Qianhui Ma
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Qi Wang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Yongchao Feng
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Yue Liu
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Jia Wang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Ping Yang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
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Pirri C, Fede C, Pirri N, Petrelli L, Fan C, De Caro R, Stecco C. Diabetic Foot: The Role of Fasciae, a Narrative Review. BIOLOGY 2021; 10:biology10080759. [PMID: 34439991 PMCID: PMC8389550 DOI: 10.3390/biology10080759] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/15/2021] [Accepted: 08/04/2021] [Indexed: 12/19/2022]
Abstract
Simple Summary Diabetes mellitus and its complications are increasingly prevalent worldwide with severe impacts on patients and health care systems. Diabetic foot ulcers have an important impact on disability, morbidity, and mortality. The mechanism of diabetic wound chronicity has not yet been understood in a complete way. Regarding the involved soft tissues, little space has been given to the fasciae, even if nowadays there is more and more evidence of their role in proprioception, muscular force transmission, skin vascularization and tropism, and wound healing. Thus, we aimed to deepen the fascial involvement in diabetic wounds. Based on this review, we suggest that a clear scientific perception of fascial role can improve treatment strategies and create new perspectives of treatment. Abstract Wound healing is an intricate, dynamic process, in which various elements such as hyperglycemia, neuropathy, blood supply, matrix turnover, wound contraction, and the microbiome all have a role in this “out of tune” diabetic complex symphony, particularly noticeable in the complications of diabetic foot. Recently it was demonstrated that the fasciae have a crucial role in proprioception, muscular force transmission, skin vascularization and tropism, and wound healing. Indeed, the fasciae are a dynamic multifaceted meshwork of connective tissue comprised of diverse cells settled down in the extracellular matrix and nervous fibers; each constituent plays a particular role in the fasciae adapting in various ways to the diverse stimuli. This review intends to deepen the discussion on the possible fascial role in diabetic wounds. In diabetes, the thickening of collagen, the fragmentation of elastic fibers, and the changes in glycosaminoglycans, in particular hyaluronan, leads to changes in the stiffness, gliding, and the distribution of force transmission in the fasciae, with cascading repercussions at the cellular and molecular levels, consequently feeding a vicious pathophysiological circle. A clear scientific perception of fascial role from microscopic and macroscopic points of view can facilitate the identification of appropriate treatment strategies for wounds in diabetes and create new perspectives of treatment.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
- Correspondence:
| | - Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
| | - Nina Pirri
- School of Medicine and Surgery, University of Messina, 98125 Messina, Italy;
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy; (C.F.); (L.P.); (C.F.); (R.D.C.); (C.S.)
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A Closer Look at the Cellular and Molecular Components of the Deep/Muscular Fasciae. Int J Mol Sci 2021; 22:ijms22031411. [PMID: 33573365 PMCID: PMC7866861 DOI: 10.3390/ijms22031411] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The fascia can be defined as a dynamic highly complex connective tissue network composed of different types of cells embedded in the extracellular matrix and nervous fibers: each component plays a specific role in the fascial system changing and responding to stimuli in different ways. This review intends to discuss the various components of the fascia and their specific roles; this will be carried out in the effort to shed light on the mechanisms by which they affect the entire network and all body systems. A clear understanding of fascial anatomy from a microscopic viewpoint can further elucidate its physiological and pathological characteristics and facilitate the identification of appropriate treatment strategies.
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Xuebing B, Ruizhi W, Yue Z, Chunhua L, Yonghong S, Yingxin Z, Baitao D, Tarique I, Ping Y, Qiusheng C. Tissue Micro-channels Formed by Collagen Fibers and their Internal Components: Cellular Evidence of Proposed Meridian Conduits in Vertebrate Skin. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2020; 26:1069-1075. [PMID: 32883394 DOI: 10.1017/s1431927620024381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In order to clarify fine structures of the hypothetical meridian conduits of Chinese traditional medicine (CTM) in the skin, the present study used light and transmission electron microscopy to examine fasciae in different vertebrate species. Collagen fiber bundles and layers were arranged in a crisscross pattern, which developed into a special tissue micro-channel (TMC) network, in a manner that was analogs to the proposed skin meridian conduits. It was further revealed that tissue fluid in lateral TMC branches drained into wide longitudinal channels, which were distinctly different from lymphatic capillary. Mast cells, macrophages, and extracellular vesicles such as ectosomes and exosomes were distributed around telocytes (TCs) and their long processes (Telopodes, Tps) within the TMC. Cell junctions between TCs developed, which could enable the communication between contiguous but distant Tps. On the other hand, winding free Tps without cell junctions were also uncovered inside the TMC. Tissue fluid, cell junctions of TCs, mast cells, macrophages, and extracellular vesicles within the TMC corresponded to the circulating "" ("Qi-Xue", i.e., information, message, and energy) of meridian conduits at the cytological level. These results could provide morphological evidence for the hypothesis that "meridians are the conduit for Qi-Xue circulation" in CTM.
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Affiliation(s)
- Bai Xuebing
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Wu Ruizhi
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Zhang Yue
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Liang Chunhua
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Shi Yonghong
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Zhang Yingxin
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Ding Baitao
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Imran Tarique
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Yang Ping
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
| | - Chen Qiusheng
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province210095, China
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Leśniewicz A, Furtak M, Żyrnicki W, Dawidowicz J, Maksymowicz K, Szotek S. Investigations of Human Fascia Lata Elemental Composition-the Effect of Different Preservation and Mineralisation Methods. Biol Trace Elem Res 2019; 187:357-366. [PMID: 29948909 DOI: 10.1007/s12011-018-1389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/16/2018] [Indexed: 11/28/2022]
Abstract
Influence of fixation medium and storage conditions as well as impact of sample mineralisation procedure on determination of minerals in human fascia lata was examined and discussed. Freezing and storage in 10% neutral buffered formalin solution and in 2.5% glutaraldehyde were used as the preservation methods of the samples. The concentrations of, both essential and toxic, elements were measured by ICP-OES method in fascia lata samples mineralised with concentrated nitric acid in a closed microwave system and in open vessels heated on a hot plate. Freezing was found as the best preserving method of fascia lata samples because of the number of elements determined and determination precision. The trace element (Cd, Cr, Cu, Fe, Ni, Sr, Zn) concentrations obtained in samples decomposed using the conventional hot plate were different from analogous measurements in solutions obtained after application of closed vessels and microwave energy assistance. Differences between the mineral compositions of fascia samples variously preserved and mineralised were statistically evaluated and discussed. Interelement correlations were analysed taking into account an impact of various methods of sample conservation. Strong, positive association between element content was discovered for Cr-Ba, Mn-Ba, P-Ba, Sr-Ba, Sr-Ca, Zn-Ca, Mn-Cr, Pb-Cr, Sr-Cr, Mg-Fe, P-Fe, Pb-Ni, Ti-Ni and Sr-P pairs of elements.
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Affiliation(s)
- Anna Leśniewicz
- Analytical Chemistry and Chemical Metallurgy Division, Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże St. Wyspiańskiego 27, 50-370, Wrocław, Poland.
| | - Milena Furtak
- Analytical Chemistry and Chemical Metallurgy Division, Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże St. Wyspiańskiego 27, 50-370, Wrocław, Poland
| | - Wiesław Żyrnicki
- Analytical Chemistry and Chemical Metallurgy Division, Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże St. Wyspiańskiego 27, 50-370, Wrocław, Poland
| | | | - Krzysztof Maksymowicz
- Faculty of Medicine, Department of Forensic Medicine, Wrocław Medical University, J. Mikulicza-Radeckiego 4, 50-368, Wrocław, Poland
| | - Sylwia Szotek
- Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Łukasiewicza 7/9, 50-371, Wrocław, Poland
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Avila Gonzalez CA, Driscoll M, Schleip R, Wearing S, Jacobson E, Findley T, Klingler W. Frontiers in fascia research. J Bodyw Mov Ther 2018; 22:873-880. [PMID: 30368329 DOI: 10.1016/j.jbmt.2018.09.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/06/2018] [Indexed: 01/07/2023]
Abstract
Basic sciences are the backbone of every clear understanding of how the body is composed and how different structures and functions are connected with each other. It is obvious that there is a huge variability in human beings - not only in terms of the outer appearance such as measurements of height, weight, muscle mass and other physical properties, but also with respect to metabolic and functional parameters. This article highlights recent developments of research activities in the field of fascia sciences with a special emphasis on assessment strategies as the basis of further studies. Anatomical and histological studies show that fascial tissue is highly variable in terms of density, stiffness, and other parameters such as metabolic and humoral activity. Moreover, it encompasses nerves and harbours a system of micro-channels, also known as the primo vascular system. As ultrasound is a widely available method, its use is appealing not only for imaging of fascial structures, but also for thorough scientific analysis. Unlike most other imaging technologies, US has the advantage of real-time analysis of active or passive movements. In addition, other assessment methods for fascial tissue are discussed. In conclusion, fascial tissue plays an important role not only in functional anatomy, but also in evolutionary and molecular biology, sport, and exercise science as well as in numerous therapeutic approaches. A high density of nerves is found in fascial tissue. Knowledge of individual characteristics, especially by visualizing with ultrasound, leads to personalized therapeutic approaches, such as in pain therapy.
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Affiliation(s)
- Carla Alessandra Avila Gonzalez
- Department of Anaesthesiology, Intensive Care, Palliative Care, and Pain Medicine, BG University Hospital Bergmannsheil, Ruhr University Bochum, Germany; Department of Anaesthesiology and Intensive Care Medicine, Hessing Foundation, Augsburg, Germany.
| | - Mark Driscoll
- Department of Mechanical Engineering, McGill University, Canada
| | - Robert Schleip
- Fascia Research Group, Department of Experimental Anaesthesiology, Ulm University, Germany
| | - Scott Wearing
- Faculty of Health School - Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Eric Jacobson
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, USA; Motion Analysis Laboratory, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, USA
| | - Tom Findley
- Rutgers New Jersey Medical School, State University of New Jersey, USA
| | - Werner Klingler
- Fascia Research Group, Department of Experimental Anaesthesiology, Ulm University, Germany; Faculty of Health School - Clinical Sciences, Queensland University of Technology, Brisbane, Australia
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Bordoni B, Marelli F, Morabito B, Castagna R. A New Concept of Biotensegrity Incorporating Liquid Tissues: Blood and Lymph. J Evid Based Integr Med 2018; 23:2515690X18792838. [PMID: 30124054 PMCID: PMC6102753 DOI: 10.1177/2515690x18792838] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The definition of fascia includes tissues of mesodermal derivation, considered as
specialized connective tissue: blood and lymph. As water shapes rocks, bodily fluids
modify shapes and functions of bodily structures. Bodily fluids are silent witnesses of
the mechanotransductive information, allowing adaptation and life, transporting
biochemical and hormonal signals. While the solid fascial tissue divides, supports, and
connects the different parts of the body system, the liquid fascial tissue feeds and
transports messages for the solid fascia. The focus of this article is to reconsider the
model of biotensegrity because it does not take into account the liquid fascia, and to try
to integrate the fascial continuum with the lymph and the blood in a new model. The name
given to this new model is RAIN—Rapid Adaptability of Internal Network.
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Affiliation(s)
- Bruno Bordoni
- 1 Institute of Hospitalization and Care with Scientific Address, Foundation Don Carlo Gnocchi IRCCS, Milan, Italy.,2 CRESO, School of Osteopathic Centre for Research and Studies, Gorla Minore (VA) Piazza XXV Aprile 4, Italy.,3 CRESO, School of Osteopathic Centre for Research and Studies, Via Fanella, Fano (Pesaro Urbino), Italy
| | - Fabiola Marelli
- 2 CRESO, School of Osteopathic Centre for Research and Studies, Gorla Minore (VA) Piazza XXV Aprile 4, Italy.,3 CRESO, School of Osteopathic Centre for Research and Studies, Via Fanella, Fano (Pesaro Urbino), Italy
| | - Bruno Morabito
- 2 CRESO, School of Osteopathic Centre for Research and Studies, Gorla Minore (VA) Piazza XXV Aprile 4, Italy.,3 CRESO, School of Osteopathic Centre for Research and Studies, Via Fanella, Fano (Pesaro Urbino), Italy
| | - Roberto Castagna
- 2 CRESO, School of Osteopathic Centre for Research and Studies, Gorla Minore (VA) Piazza XXV Aprile 4, Italy
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Bordoni B, Marelli F, Morabito B, Castagna R, Sacconi B, Mazzucco P. New Proposal to Define the Fascial System. Complement Med Res 2018; 25:257-262. [PMID: 29550826 DOI: 10.1159/000486238] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
At the beginning of the third millennium, we still do not have a definition of 'fascia' recognized as valid by every researcher. This article attempts to give a new definition of the fascial system, including the epidermis, by comparing the mechanical-metabolic characteristics of the connective tissue and the skin. In fact, according to the latest classification deriving from the Fascia Nomenclature Committee, the outer skin layer is not considered as part of the fascial continuum. This article highlights the reasons for taking the functional characteristics of the tissue into consideration, rather than its mere structure. A brief discussion will address the questions as to what is considered as fascial tissue and from which embryonic germ layer the epidermis is formed. The notion that all the layers intersect will be highlighted, demonstrating that quoting precise definitions of tissue stratification in the living organism probably does not correspond to what happens in vivo. What we propose as a definition is not to be regarded as a point of arrival but as another departure.
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Abstract
A new cell type named telocyte (i.e. cell with distinctive prolongations called telopodes) has recently been identified in the stroma of various organs in humans. However, no study has yet reported the existence of telocytes in the synovial membrane of diarthrodial joints. This work was therefore undertaken to search for telocytes in the normal human synovium using transmission electron microscopy, immunohistochemistry and immunofluorescence. Ultrastructural analyses demonstrated the presence of numerous spindle-shaped telocytes in the whole synovial sublining layer. Synovial telocytes exhibited very long and thin moniliform telopodes and were particularly concentrated at the boundary between the lining and sublining layers and around blood vessels. Light microscopy confirmed the presence of CD34-positive telocytes in the aforementioned locations. Moreover, synovial telocytes coexpressed CD34 and platelet-derived growth factor receptor α. Double immunostaining further allowed to unequivocally differentiate synovial telocytes (CD34-positive/CD31-negative) from vascular endothelial cells (CD34-positive/CD31-positive). The in vitro examination of fibroblast-like synoviocyte primary cultures revealed the coexistence of different cell types, including CD34-positive telocytes projecting typical moniliform telopodes. In conclusion, our work provides the first evidence that telocytes do exist in the human synovium and lays the groundwork for future studies on synovial telocytes in a variety of degenerative and destructive joint diseases.
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