The submucosa (or tela submucosa) is a thin layer of tissue in various

organs In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a f ...

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 GI tract contains all the major organs of the digestive system, in humans and ...

respiratory The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies grea ...

, and

genitourinary The genitourinary system, or urogenital system, are the organs of the reproductive system and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathwa ...

tracts. It is the layer of

dense irregular connective tissue Dense irregular connective tissue has fibers that are not arranged in parallel bundles as in dense regular connective tissue. Dense irregular connective tissue consists of mostly collagen fibers. It has less ground substance than loose connecti ...

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 is ...

) 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 an involuntary non-striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit mus ...

(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 tissue membrane of mesothelium lining the contents and inner walls of body cavities, which secrete serous fluid to allow lubricated sliding movements between opposing surfaces. The serous membrane ...

Structure

Blood vessels The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away f ...

lymphatic vessels The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessel ...

, and

nerves A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...

(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 enteric nervous system is sometimes considered part of t ...

ganglia are scattered around forming the submucous plexus (or "Meissner's plexus") where

preganglionic In the autonomic nervous system, fibers from the CNS to the ganglion are known as preganglionic fibers. All preganglionic fibers, whether they are in the sympathetic division or in the parasympathetic division, are cholinergic (that is, these ...

parasympathetic neurons synapse with

postganglionic In the autonomic nervous system, fibers from the ganglion to the wikt:effector, effector organ are called postganglionic fibers. Neurotransmitters The neurotransmitters of postganglionic fibers differ: * In the parasympathetic division, neuro ...

nerve fibers that supply the

muscularis mucosae The lamina muscularis mucosae (or muscularis mucosae) is a thin layer (lamina) of muscle of the gastrointestinal tract, located outside the lamina propria, and separating it from the submucosa. It is present in a continuous fashion from the es ...

. Histologically, the wall of the alimentary canal shows four distinct layers (from the lumen moving out): mucosa, submucosa, muscularis externa, and either a

or an

adventitia The adventitia () is the outer layer of fibrous connective tissue surrounding an organ. The outer layer of connective tissue that surrounds an artery, or vein – the tunica externa, is also called the ''tunica adventitia''. To some degree, its ...

. In the

gastrointestinal tract 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 GI tract contains all the major organ (biology), organs of the digestive syste ...

and the

respiratory tract The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to th ...

the submucosa contains the submucosal glands 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 and mucous cells. It is ...

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 An optical fiber, or optical fibre in Commonwealth English, is a flexible, transparent fiber made by drawing glass (silica) or plastic to a diameter slightly thicker than that of a human hair. Optical fibers are used most often as a means to ...

cameras are used to perform procedures on the

. Abnormalities of the submucosa, such as

gastrointestinal stromal tumor Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs arise in the smooth muscle pacemaker interstitial cell of Cajal, or similar cells. They are defined as tumors whose behavior is ...

s, usually show integrity of the mucosal surface. The submucosa is also identified in

endoscopic ultrasound Endoscopic ultrasound (EUS) or echo-endoscopy is a medical procedure in which endoscopy (insertion of a probe into a hollow organ) is combined with ultrasound to obtain images of the internal organs in the chest, abdomen and colon. It can be used ...

to identify the depth of tumours and to identify other abnormalities. An injection of

dye A dye is a colored substance that chemically bonds to the substrate to which it is being applied. This distinguishes dyes from pigments which do not chemically bind to the material they color. Dye is generally applied in an aqueous solution an ...

, 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 and ...

into the submucosa is imperative in the safe removal of certain

polyps A polyp in zoology is one of two forms found in the phylum Cnidaria, the other being the medusa. Polyps are roughly cylindrical in shape and elongated at the axis of the vase-shaped body. In solitary polyps, the aboral (opposite to oral) end i ...

. 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 in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the p ...

s of

vertebrates Vertebrates () comprise all animal taxa within the subphylum Vertebrata () ( chordates with backbones), including all mammals, birds, reptiles, amphibians, and fish. Vertebrates represent the overwhelming majority of the phylum Chordata, ...

. SIS is harvested (typically from pigs) for transplanted structural material in several clinical applications, typically biologic meshes. They have low

immunogenicity Immunogenicity is the ability of a foreign substance, such as an antigen, to provoke an immune response in the body of a human or other animal. It may be wanted or unwanted: * Wanted immunogenicity typically relates to vaccines, where the injectio ...

. Some uses under investigation include a

scaffold Scaffolding, also called scaffold or staging, is a temporary structure used to support a work crew and materials to aid in the construction, maintenance and repair of buildings, bridges and all other man-made structures. Scaffolds are widely used ...

for

intervertebral disc An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the vertebrae, to act as a ligament to hold t ...

regeneration. Unlike other scaffold materials, the resorbable SIS

extracellular matrix In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide stru ...

(SIS-ECM) scaffold is replaced by well-organized host tissues, including differentiated

skeletal muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...

History

A scientific article published in March 2018Benias, 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 Endomicroscopy is a technique for obtaining histology-like images from inside the human body in real-time,Jabbour, J.M., et al., Confocal Endomicroscopy: Instrumentation and Medical Applications. Annals of biomedical engineering, 2011. a process kn ...

. 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 technics, 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 descri ...

positive. However, these cells are devoid of ultrastructural features indicative of endothelial differentiation, including pinocytotic vesicles and Weibel-Palade bodies.

Additional images

File:Illu stomach2.jpg, Stomach. File:Gray1033.png, Section of the human

esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...

. 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