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Muscle fascia and force transmission

Article in Journal of bodywork and movement therapies · October 2010


DOI: 10.1016/j.jbmt.2010.01.005 · Source: PubMed

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Journal of Bodywork & Movement Therapies (2010) 14, 411e417

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FASCIA PHYSIOLOGY

PREVENTION & REHABILITATIONdFASCIA PHYSIOLOGY


Muscle fascia and force transmission
Peter P. Purslow, PhD

Department of Food Science, University of Guelph, Guelph, Ontario N1G 2W1, Canada

Received 13 October 2009; received in revised form 3 January 2010; accepted 7 January 2010

KEYWORDS Summary This paper reviews the major intramuscular extracellular matrix (IM-ECM) struc-
Muscle; tures (endomysium, perimysium and epimysium) and their possible mechanical contributions
Connective tissue; to muscle functions. The endomysium appears to provide an efficient mechanism for transmis-
Extracellular matrix; sion of contractile forces from adjacent muscle fibres within fascicles. This coordinates forces
Mechanical function; and deformations within the fascicle, protects damaged areas of fibres against over-extension,
Myofascial force and provides a mechanism whereby myofibrils can be interrupted to add new sarcomeres
transmission; during muscle growth without loss of contractile functionality of the whole column. Good
Endomysium; experimental evidence shows that perimysium and epimysium are capable in some circum-
Perimysium; stances to act as pathways for myofascial force transmission. However, an alternative role
MMPs; for perimysium is reviewed, which involves the definition of slip planes between muscle fasci-
ECM turnover cles which can slide past each other to allow large shear displacements due to shape changes
in the whole muscle during contraction. As IM-ECM is continually remodelled so as to be me-
chanically adapted for its roles in developing and growing muscles, control of the processes
governing IM-ECM turnover and repair may be an important avenue to explore in the reduction
of fibrosis following muscle injury.
ª 2010 Elsevier Ltd. All rights reserved.

Introduction pathways by which IM-ECM is remodelled and adapted due


to changing functional demands during muscle growth and
The soft connective tissues associated with muscle tissue repair, and in response to exercise training or disuse, are
have been referred to as the intramuscular extracellular addressed by Kjær and Magnusson (2008). Like most other
matrix (IM-ECM), intramuscular connective tissue (IMCT) soft connective tissue structures, the amount and compo-
and muscle fasciae (MF). Although these general names can sition of IM-ECM structures are not simply programmed
be used interchangeably, the term IM-ECM will be used during embryogenesis and subsequent post-natal matura-
here. Substantial reviews of the structure, development, tion processes. The amounts and composition of the various
composition and function of IM-ECM exist (Purslow and IM-ECM structures in living tissue represent a dynamic
Duance, 1990; Purslow 2002, 2008). The mechanisms and balance between deposition, growth, remodelling and
degradation, which is affected by the interplay between

E-mail address: ppurslow@uoguelph.ca

1360-8592/$ - see front matter ª 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jbmt.2010.01.005
412 P.P. Purslow

functional demands on the tissue and the mechanical


environment. The cellular mechanisms of mechano-
transduction in fibroblasts are reviewed by Chiquet et al.
(2009). The purpose of the current review is to highlight
information pointing to the crucial roles of IM-ECM in force
transmission and accommodation of shape changes in
functioning muscle.

General structure and biochemical


PREVENTION & REHABILITATION dFASCIA PHYSIOLOGY

composition of IM-ECM

As schematically shown in Fig. 1, each muscle is surrounded


by epimysium, a connective tissue layer that is continuous
with the tendons that attach the muscles to the bones. In
some long strap-like muscles the epimysium is composed of
two parallel sets of wavy collagen fibres in a crossed-ply Fig. 2 Light micrograph of epimysium from bovine sterno-
arrangement, embedded in a proteoglycan matrix (see mandibularis muscle, showing arrangement of collagen fibres
Fig. 2). When the muscle is at its resting length, the two in crossed-plies. The fibres are in two parallel layers lying at
sets of collagen fibres are arranged at angles of approxi- þ55 and 55 to the muscle fibre axis. From Purslow (1999),
mately 55 to the long axis of the muscle fibres. In other with permission. In epimysium from other muscles the collagen
muscles, and especially in pennate muscles, the arrange- is more aligned with the muscle fibre direction and acts as an
ment of collagen fibres in the epimysium is parallel to the exo-tendon or aponeurosis.
long axis of the muscle and forms a dense surface layer that
functions as a surface tendon. The perimysium is a contin- together the collagen fibre networks in these structures
uous network of connective tissue which divides the muscle (Scott, 1990). Listrat et al. (1999, 2000) show that collagen
up into fascicles or muscle fibre bundles. Fascicles run types I, III, IV, V, VI, XII and XIV are all expressed in muscle
along the length of the muscle from tendon to tendon, and development. Collagen typically represents 1e10% of the
the ends of muscle fibres form highly folded interdigitating dry weight of adult skeletal muscle (Bendall, 1967). Fibres
joints (the myotendinous junction) with the tendon at this of elastin can be found in the IM-ECM of some muscles,
point (Trotter, 1993). The perimysial network merges into principally in the perimysium. However, the amount of
the epimysium at the surface of the muscle and is elastin is small in most muscles and is typically less than 1%
mechanically connected to it. Within each fascicle or of muscle dry weight (Bendall, 1967).
muscle fibre bundle, the endomysium is a continuous Collagen fibres are stabilised by the formation of cova-
network of connective tissue that separates individual lent crosslinks directed by a clear set of post-translational
muscle fibres. modifications which act on the collagen molecules extra-
Each of the epimysium, perimysium, and endomysium cellularly after assembly of the collagen molecules into the
layers has its own structure and composition, but generally quarter-stagger overlapped arrangement characteristic of
these connective tissue layers are composed of collagen fibrils (Bruns and Gross, 1973). The formation of crosslinks
fibres in an amorphous matrix of hydrated proteoglycans is essential for the mechanical strength and stiffness of
(PGs) which plays a crucial role in mechanically linking collagen fibres (Bailey et al., 1998). During gestation and
post-natal maturation there are changes in the types and
amounts of covalent crosslinks that stabilise the collagen
molecules within all connective tissues in the body,
including IM-ECM. There are also non-enzymatic reactions
of collagen with glucose and other aldehydes. Formation of
additional crosslinks through advanced glycation end
products (AGEs) is typical of the changes in connective
tissues in diabetes and during ageing and glycation, and is
thought to be a significant contributor to changes in the
mechanical properties of connective tissues with age (Paul
and Bailey, 1996). Advanced glycation end products can be
incorporated into the body from dietary sources (e.g. heat
processing of some foods creates AGEs) and from tobacco
smoke (Avery and Bailey, 2008). In this way, diet and life-
style may affect the mechanical properties of IM-ECM via
AGE-cross-linking of collagens.
Fig. 1 Schematic diagram of IM-ECM structures in a skeletal
muscle. Epimysium delineates the surface of the muscle, IM-ECM changes during muscle development
perimysium separates muscle fascicles and endomysium sepa-
rates individual muscle fibres. Also depicted are the contractile During embryonic development of intramuscular connec-
myofibrils within each muscle fibre. (Artwork: Dr. L.-T. Lim). tive tissue, the amounts of the various collagens and PGs
Muscle fascia and force transmission 413

changes (Velleman et al., 1999; Listrat et al., 1999; Lawson of a network of collagen fibrils and fibres in a proteoglycan
and Purslow, 2001). Spatial variations between the endo- matrix.
mysium and perimysium within one muscle (Nishimura The thickness of the endomysium as a whole varies with
et al., 1997) and differences in expression of both collagen muscle length, becoming thicker at short muscle lengths
type I and PG components such as laminin between muscles and thinner as the muscle is extended (see Trotter and
(Lawson and Purslow, 2001) are both determined early in Purslow, 1992). Transmission electron micrography of intact
prenatal development. In bovine muscles, type I collagen endomysium in situ confirms that all of the collagen fibres
expression is always higher than type III expression at all in the network layer lie in the plane of the layer (Trotter
stages of gestation and post-natally (Listrat et al., 1999). and Purslow, 1992). The only location where this does not
Thus some differences in the composition of intramuscular hold true is in the junction zones between the perimysium

PREVENTION & REHABILITATIONdFASCIA PHYSIOLOGY


connective tissue appear to be pre-programmed in and the endomysium of muscle cells that lie in the surface
embryogenesis. However, there are some variations in the of the fascicle.
amounts of collagens as muscle development progresses. In Swatland (1975) concluded that the reticular layer was
bovine psoas and triceps muscles the total collagen a single structure shared between adjacent muscle cells,
concentration and amounts of collagen type I is maximum and that this endomysial structure forms a continuous
at the point in gestation when the expression of myosin network that runs across the whole muscle fascicle. This
within muscle fibres changes from the embryonic to the interpretation is very strongly borne out by scanning elec-
adult form (Listrat et al., 1999). After this, the growing tron microscopy of endomysial collagen networks prepared
diameter of the muscle fibres dilutes out the connective by NaOH-extraction of muscle to remove all cell compo-
tissue content of the muscle. In contrast, the pectoralis and nents, PGs, plasmalemma, and basement membrane
quadriceps muscles of the chick show steady increases in structures (Trotter and Purslow, 1992; Purslow and Trotter,
collagen type I content and laminin content through 1994; Nishimura et al., 1994, 1995; Liu et al., 1995). This
gestation and post-natally (Lawson and Purslow, 2001). preparation technique was first demonstrated on connec-
Whether these differences between bovine and chick tive tissues generally by Ohtani et al. (1988). Fig. 3 (from
muscle growth are due to avian versus mammalian phyla Purslow and Trotter, 1994) shows such a preparation. The
differences or due to functional differences in the muscles structure of the endomysium appears broadly identical in
studied remains unclear. all SEM preparations from skeletal muscle from different
muscles and species, and also in cardiac muscle (Purslow,
2008).
The amounts and composition of endomysium The planar network of collagen fibres in the thick
and perimysium vary between functionally reticular region of the endomysium is often described as
different muscles a random or quasi-random network of irregularly wavy
fibres. These collagen fibres run at almost every angle to
In fully developed adult animals, there are large differences the muscle fibre long axis, but the network is not truly
in the amounts and composition of IM-ECM between different random. Detailed image analysis of the distribution of fibre
muscles in the body. Histological comparison (see Fig. 4 in directions with respect to the long axis of adjacent muscle
Purslow, 2005) illustrates that the continuous perimysial cells reveals that there is a preferred direction in the wide
network surrounds or separates fascicles of radically distribution of collagen fibre orientations, and that this
different sizes and shapes in different muscles from the same preferred orientation changes with muscle length (Purslow
animal. This difference also results in different thicknesses of and Trotter, 1994). At short muscle lengths, more of the
perimysial connective tissue. A comparison of the connective collagen fibres in the endomysial network are aligned cir-
tissue content of 14 bovine muscles shows that the endomy- cumferentially, and at long muscle lengths there is a higher
sial collagen content is between 0.47% and 1.2% of dry weight, preference for fibres to be aligned longitudinally. The
but the perimysial collagen content in the same muscles reorientation of collagen fibres in this network at short and
ranges from 0.43% up to 4.6% of dry weight (Purslow, 1999). long muscle lengths also involves some stretching out of the
The amount of perimysium in muscles varies far more than the wavy fibres, but at all sarcomere lengths a very large
amount of endomysium. These variations, especially in the proportion of the collagen fibres are still wavy. The
amount and spatial organisation of the perimysium have long mechanical consequence of this is that the planar network
been taken to show that IM-ECM must play strong roles in the will be very compliant in tension at all physiologically
normal physiological functioning of each muscle. As reviewed relevant muscle lengths, and can easily deform to follow
in the following two sections, some possible explanations of changing muscle lengths in vivo. Although this behaviour
these roles are emerging but are far from complete. potentially provides overload protection at high deforma-
tions, such protection will only occur at muscle lengths well
above those experienced in normal function. These impli-
Structure and functional roles of the cations are confirmed by detailed modelling of the in-plane
endomysium tensile properties of the endomysium (Purslow and Trotter,
1994). Their models of the tensile properties of the endo-
As reviewed by Purslow and Duance (1990), each muscle mysial network are in agreement with experimental force-
cell is surrounded by its own plasmalemma and basement length measurements by Podolsky (1964) and Magid and
membrane. Filling the intervening region between the Law (1985) who compared the tensile properties of relaxed
basement membranes of two adjacent muscle cells is the single muscle fibres with and without endomysium. The
much more substantial reticular layer, which is comprised difference that the removal of the endomysium makes to
414 P.P. Purslow

bands internal to the muscle and occasionally have myo-


muscular junctions where two muscle fibres have interdig-
itating folded joints between them, the most common
termination is a gentle tapering down to an end. These
tapering fibres have no terminating structure that would
link them directly to another muscle fibre or to the tendon
(Trotter, 1993). The fibres are staggered by about one
quarter of their length with respect to the adjacent muscle
fibres, so that the tapering end of one fibre terminates with
the endomysial network surrounding it forming a seamless
PREVENTION & REHABILITATION dFASCIA PHYSIOLOGY

connection to the endomysium of its neighbours (Purslow


and Trotter, 1994). The endomysium is the only structure
that links muscle fibres together within fascicles. In series-
fibred muscles, transmission of tension generated in intra-
fascicularly terminating fibres to the ends of the fascicles
absolutely necessitates transmission of force through the
endomysial network, as this is the only structure continu-
ously linking the fibres (Trotter et al., 1995). Trotter and
Purslow (1992) show that the endomysium is compliant in
tension, so that force transmission is unlikely by this means,
but they also suggest that force transmission is by shear
through its thickness. The key idea is that the endomysium,
while very compliant to tensile forces acting within the
plane of the network, is much more efficient in providing
a non-compliant linkage by shear through its thickness. A
formal derivation from fibre composites theory shows that,
for practical purposes, the stiffness of the endomysium in
shear through its thickness varies only slightly with the
orientation of the collagen fibrils in the plane of the
endomysium (Purslow, 2002). Any linkage that transmits
forces from intrafascicularly terminating muscle fibres to
tendinous attachments must be non-compliant (i.e. high
stiffness) in order to be efficient. Especially in isometric
muscle contractions, any significant stretching in the length
of the fascicle due to stretchy connections would result in
a very poor transmission of contractile force. The series-
elastic nature of this shear linkage can be represented as an
Fig. 3 Scanning electron micrographs of the collagen fibre apparent longitudinal stiffness Eapp (Purslow, 2002) given by
scaffolding in IM-ECM structures in bovine sternomandibularis
 . 2
muscle as revealed by NaOH-digestion of myofibrils, cytoskel-
Eapp ZG L T ð1Þ
etal proteins, cell membranes, and proteoglycans. Upper
panel; low-magnification view, showing thicker perimysial
sheets surrounding fascicles. Lower panel; high-magnification where G is the translaminar shear modulus of the endomy-
oblique view, showing endomysial networks. From Purslow and sium, T is its thickness and L the muscle fibre length. Even if
Trotter (1994) with permission. we take a fibre as short as 1 cm in length, L/T is in the order of
2000, so that Eapp is going to be in the order of 4  106 greater
than the true translaminar shear modulus of the endomy-
the passive elasticity of single fibres is very small at phys- sium. In a ‘‘composite’’ consisting of two parallel muscle
iologically relevant sarcomere lengths, showing that the cells with the endomysium sandwiched between them, the
endomysium is extremely compliant in tension along the apparent longitudinal stiffness of endomysium as it deforms
muscle fibre direction over normal working muscle lengths in shear will still be orders of magnitude higher than the
in vivo. tensile stiffness of the muscle fibres themselves. Due to this
Many muscles in species from many phyla contain muscle high value of Eapp the longitudinal stiffness of the entire
fibres that do not run along the entire length of fascicles, assembly is going to be dominated by stretching in the muscle
but terminate before reaching the myotendinous junction fibres themselves rather than in the linking endomysium. This
(Gans and Gaunt, 1991; Trotter, 1993; Trotter et al., 1995). shear linkage through the thickness of the endomysium
Muscle fibres in series-fibred muscles are relatively short provides a force transduction pathway from one muscle cell
compared to the length of the fascicle except in humans, to its neighbours which is highly efficient. However, the
which appear to have relatively longer fibres in their series- endomysium can deform easily in the plane of the network,
fibred muscles. due to its low tensile stiffness, and so does not restrict
Although some intrafascicularly terminating muscle changes in muscle fibre length and diameter as muscles
fibres do seem to have attachments to connective tissue contract and relax.
Muscle fascia and force transmission 415

Lateral load sharing through the endomysium is an (Fang et al., 1999). The collagen fibres lie in the plane of the
important concept that also explains how it is possible for perimysium, do not run through its thickness, and all the
muscles to grow and to repair damaged sarcomeres. Lateral collagen fibres in each ‘‘ply’’ are parallel to each other and
load sharing and coordination of deformations means that lie at 55 to the muscle fibre axis at the resting length of the
a fibre can be interrupted for the addition of new sarco- muscle. This angle changes with muscle length, varying from
meres necessary for muscle lengthening during growth, around 80 at an extremely short sarcomere length of 1.1 mm
without loss of function of an entire contractile column. By to approximately 20 at a long sarcomere length of 3.9 mm
the same mechanism, the contractile capacity of the (Purslow, 1989). Mathematical modelling of the tensile
weakness of a sarcomere in which damaged myofibrils are properties in the plane of this network using fibrous
being broken down and remodelled during muscle repair composites theory (Purslow, 1989), and direct measure-

PREVENTION & REHABILITATIONdFASCIA PHYSIOLOGY


does not lead to tearing of the fibre at this point, as the ments of the tensile strength and stiffness of perimysial
endomysial connections between adjacent fibres serve to sheets dissected from muscle (Lewis and Purslow, 1989;
keep the strains uniform throughout the tissue. In sub- Purslow, 1999), show that the perimysium is easily deformed
maximal contractions not all the motor units in the muscle in tension until the collagen fibres have become aligned along
are recruited, so that many non-contracting fibres are the stretching direction and the waviness in the fibres pulled
usually adjacent to contracting fibres. Coordination by out straight. This shows that the perimysium can build up
shear linkages through the endomysium explains how a high tensile stiffness and carry large loads in tension, but
sarcomere lengths in non-contacting fibres keep in register only at very large extensions well beyond the range of
with those in adjacent, contracting fibres. This maintains working lengths in living muscle.
uniform sarcomere lengths in the muscle. The continuous The tensile properties of the perimysium are, therefore,
meshwork of endomysium that connects adjacent muscle similar is nature to the endomysium. Both are initially
fibres together, therefore, forms a connecting matrix that easily deformed networks that can follow length and
coordinates force transmission between fibres in a fascicle diameter changes imposed by the muscle fibres and fasci-
and keeps fibres in uniform register (Purslow, 2008). cles contracting and being lengthened by the action of
antagonistic muscles. It is tempting to extend the analogy
between endomysium and perimysium by proposing that
Functional anatomy of the perimysium the perimysium could also act to transmit the forces
generated in fascicles to their adjacent neighbours by
Two sizes of fascicles and, therefore, two levels of peri- translaminar shear. Although it can be shown that force
mysial structure can be distinguished in cross-sections of transmission by such a mechanism can be invoked in
muscle. Small (primary) fascicles or muscle fibre bundles circumstances of extreme muscle damage or by cutting the
are delineated by primary perimysium. Groups of primary tendinous attachments to some fascicles (Huijing, 2009),
fascicles are then organised into larger, secondary fascicles there are two considerations that we can raise that
by secondary perimysium, which tends to be thicker than diminish the likelihood of this mechanism being involved in
primary perimysium. In porcine semitendinosus muscle, the living muscle, at least under normal working conditions.
thicker secondary perimysium is in the order of 10 mm thick Firstly, considering again that the series-elastic nature of
at birth and increases to approach 50 mm in 55 month old a shear linkage can be represented as an apparent longi-
pigs (Fang et al., 1999). The thickness of primary perimy- tudinal stiffness Eapp and that Eapp given by Eq. (1) above
sium in cattle muscles ranges from 54.6 m to 133 mm (Brooks then even if the perimysium can be up to 50 times thicker
and Savell, 2004). than endomysium, the (L/T )2 term in this equation could
Both of these perimysial layers form a fenestrated be up to 2500 times smaller for the same length of peri-
network that extends across the entire cross-section of the mysium than for the endomysium. If the translaminar shear
whole muscle. The perimysium does not form a distinct modulus of the perimysium and endomysium would even be
sheath that surrounds one fascicle, but rather is a shared within an order of magnitude of each other, this means that
structure lying between two fascicles (Purslow and Trotter, thicker perimysium would have a far smaller Eapp, i.e., it
1994). Nodes form at the junction between perimysial sheets would be far more compliant in shear than the endomy-
and the fascicles occupy polygonal ‘‘holes’’ in this network, sium. This would represent a rather sloppy and inefficient
in a manner similar to muscle fibres occupying polygonal force transmission pathway.
‘‘holes’’ in the endomysial network (but at a larger scale). At The second consideration revolves around the observa-
the surface of the muscle the perimysium merges and tion that the amounts and structure of endomysium are
seamlessly joins with the epimysium (Nishimura et al., 1994). relatively constant and only slightly vary between different
The perimysial layer separating two fascicles is primarily muscles, whereas the amounts of perimysium, its thickness,
comprised of crossed-plies of wavy collagen fibres in and the size and shape of primary and secondary muscle
a proteoglycan matrix. In a few muscles (e.g. bovine sem- fascicles vary tremendously. The endomysial structures
itendinosus) there are substantial amounts of elastin fibres providing tight shear linkages between adjacent muscle
associated with the collagenous network (Rowe, 1981). The fibres are reasonably conservative and do not vary so much
collagen fibre bundles are far larger in diameter than the fine from muscle to muscle. So, if the perimysial network
fibres and fibrils in the endomysium and have a regular functions similarly, why should its amounts and spatial
sinusoidal waviness, with all collagen fibre bundles lying arrangement vary so much more?
parallel to each other in each ply, and having the same wave Schmalbruch (1985) cites a model originally proposed
periodicity. In porcine semitendinosus muscle the degree of by Feneis which proposes that the perimysium provides
waviness has been observed to increase with animal age ‘neutral’ connections between adjacent fascicles. These
416 P.P. Purslow

connections permit fascicles to slide past each other, and et al., 2009). Beta-adrenergic agonists (e.g. clenbuterol, rac-
also facilitate shape changes in the muscle during contrac- topamine, cimaterol, salbutamol) mimic this effect and
tion. All fan-shaped, fusiform, and especially pennate chronic administration of these growth promoters leads to
muscles change shape when contracting, and in order to muscle hypertrophy or amelioration of muscle wasting
accommodate this there must be slippage, or sliding, of some (Navegantes et al., 2002). Although some reports associate the
elements within the muscle (i.e. shear deformations). For effect of catecholamines on protein metabolism with c-AMP
pennate muscles it is easy to formally calculate the shear dependent kinase, Yamaguchi et al. (1997) showed that the
strains within the muscles as they contract and the pennation p38 MAPK pathway can be activated by beta-adrenergic
angles change. In ultrasonic images of human muscles, receptors in kidney cells. Expression of MMPs 1 and 13 is acti-
‘‘boundaries’’ between fascicles can be seen, and vated by the p38 MAPK pathway in keratinocytes (Johansson
PREVENTION & REHABILITATION dFASCIA PHYSIOLOGY

measurement of changes in the angle of these during et al., 2000). Recent work in our laboratory (Cha and Purslow,
contraction allows shear strains to be predicted. Shear unpublished data) shows that both skeletal muscle fibroblasts
strains within working human muscles are substantial and and myoblasts increase MMP expression in the presence of
vary considerably between human muscles such as quadri- epinephrine, but with different time-courses and degrees of
ceps, vastus lateralis and gastrocnemius (Purslow, 2002). If correlation with expression of AMP-activated protein kinase.
the endomysium maintains adjacent muscle fibres in tight Cardiac muscle is obviously different from striated muscle
shear register, then where can these large and variable shear functionally and structurally, yet there are striking similari-
strains be accommodated? Simple observations on rigor ties about the organisation and function of ECM structures
muscle that is manipulated to produce internal shear show between the two muscle types (Purslow, 2008). A change in
that deformations preferentially occur at the boundaries the balance between synthesis and degradation of ECM in the
between fascicles, and that very little shear displacements myocardium is a characteristic of many types of heart
occur within a fascicle (Purslow, 1999). If the theory that the failure, including hypertensive heart failure and infarction/
division of muscle into fascicles is to facilitate shear defor- ischemia (Berk et al., 2007; Graham et al., 2008). Banfi et al.
mations that are necessary for contracting muscle to change (2005) reported increased plasma levels of MMPs 2&9 in
shape is correct, then it seems to offer an explanation of why patients with chronic heart failure and also a significant
the amount and distribution of perimysium changes so very correlation between norepinephrine and MMP2 levels.
markedly from muscle to muscle. Thin perimysia surrounding Cardiac fibroblasts are known to react to both mechanical
small fascicles in long strap-like muscles may be associated stimuli and catecholamines in terms of both proliferation and
with relatively small shear displacements, whereas thicker expression (Villareal and Kim, 1997), and cardiomyocytes
perimysial sheets and larger primary fascicles may relate to from chick embryos are known to react to stimulation of the
larger shear displacements. However, comprehensive data alpha-adrenergic receptor via noradrenaline by activation of
on the relationship between perimysial thickness, fascicle p38 MAPK (Tsang and Rabkin, 2009). Ongoing studies to
size, and the actual distributions of shear strains in working provide fundamental information about the control of
muscles need to be collected to test this theory. expression of IM-ECM forming cells may have far-reaching
impact on muscle ageing, injury, and repair.
Control of turnover of IM-ECM as a possible
treatment in muscle injury and repair of References
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