Abstract
Fascial tissues form a ubiquitous network throughout the whole body, which is usually regarded as a passive contributor to biomechanical behavior. We aimed to answer the question, whether fascia may possess the capacity for cellular contraction which, in turn, could play an active role in musculoskeletal mechanics. Human and rat fascial specimens from different body sites were investigated for the presence of myofibroblasts using immunohistochemical staining for α-smooth muscle actin (n = 31 donors, n = 20 animals). In addition, mechanographic force registrations were performed on isolated rat fascial tissues (n = 8 to n = 18), which had been exposed to pharmacological stimulants. The density of myofibroblasts was increased in the human lumbar fascia in comparison to fasciae from the two other regions examined in this study: fascia lata and plantar fascia [H(2) = 14.0, p < 0.01]. Mechanographic force measurements revealed contractions in response to stimulation by fetal bovine serum, the thromboxane A2 analog U46619, TGF-β1, and mepyramine, while challenge by botulinum toxin type C3–used as a Rho kinase inhibitor– provoked relaxation (p < 0.05). In contrast, fascial tissues were insensitive to angiotensin II and caffeine (p < 0.05). A positive correlation between myofibroblast density and contractile response was found (rs = 0.83, p < 0.001). The hypothetical application of the registered forces to human lumbar tissues predicts a potential impact below the threshold for mechanical spinal stability but strong enough to possibly alter motoneuronal coordination in the lumbar region. It is concluded that tension of myofascial tissue is actively regulated by myofibroblasts with the potential to impact active musculoskeletal dynamics.
Highlights
Compared with more discrete elements of the locomotor system— e.g., muscles, bones, disks, ligaments — the bag-like or planar collagenous connective tissue structures, commonly referred to as fascia, have received minor attention within musculoskeletal research (Grimm, 2007; Guimberteau et al, 2010; Kwong and Findley, 2014)
The resulting immunohistological as well as mechanographic data are available upon request from the first author. This is the first study examining the question whether active cellular contractility of fascial tissues may be able to impact musculoskeletal dynamics
Due to the contractile behavior of inherent MFBs, human lumbar fascia may be able to change its stiffness in a time frame of minutes to hours and thereby possibly affect motoneuronal coordination
Summary
Compared with more discrete elements of the locomotor system— e.g., muscles, bones, disks, ligaments — the bag-like or planar collagenous connective tissue structures, commonly referred to as fascia, have received minor attention within musculoskeletal research (Grimm, 2007; Guimberteau et al, 2010; Kwong and Findley, 2014). Fascia is usually considered as a relatively inert tissue that is assumed to serve a passive role only in musculoskeletal biomechanics In contrast to this common assumption there have been sporadic indications of a more active role of fascia due to an inherent ability to actively contract. It is generally assumed that the tissue shortening and stiffening observed in these pathological circumstances is driven by myofibroblasts (MFBs), and that the resulting tissue contracture is accomplished by an incremental combination of cellular contraction, collagen cross-linking and matrix remodeling in a slip and ratchet-like manner (Tomasek et al, 2002) It is, not surprising, that active tissue contractions—observed within time frames of several minutes post stimulation—have been successfully recorded in vitro with several of these pathologic tissues in response to pharmacological stimulation (Hurst et al, 1986; Naylor et al, 1994; Irwin et al, 1997; Raykha et al, 2013; Türker et al, 2013)
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