Small intestinal submucosa
Encyclopedia
Small intestinal submucosa (SIS) is submucosa
l tissue
in the small intestine
s of vertebrates.
SIS is harvested (typically from pigs) for transplanted structural material in several clinical
applications, because of their low immunogenicity
. Some uses under investigation include a scaffold for intervertebral disc
regeneration. Unlike other scaffold materials, the resorbable
SIS extracellular matrix
(SIS-ECM) scaffold is replaced by well-organized host tissues, including differentiated skeletal muscle
.
In its native role, the submucosa of the small intestine provides mechanical strength to the intestine, preventing it from rupturing when a big meal is eaten. Consisting primarily of a strong extracellular matrix, the submucosa contains collagens, proteoglycans such as heparin, glycosaminoglycans such as heparin and hyaluronan, glycoproteins such as fibronectin, and growth factors such as FGF-2. Cells are mainly present to maintain the matrix, or in the abundant vasculature present to carry away the nutrients digested in the intestine. This rich environment is necessary to maintain the strength while supporting the rapid cell turnover of the mucosal layer. The strong yet biochemically rich and diverse extracellular matrix of the submucosa makes it an excellent choice for a naturally derived biomaterial.
Well documented in the scientific and medical literature (over 600 publications as of August 2008), SIS has been investigated as a biomaterial graft since 1989. SIS has been published for use in over 20 applications in humans including: multiple types of hernia repair, dural repair, anal fistula closure, stress urinary incontinence treatment, pelvic organ prolapse repair, and Peyronie’s disease treatment. There are over 150 medical publications (as of August 2008) describing SIS use in a wide variety of human use clinical situations. SIS has widespread potential for use in surgical repair due to its inherent strength and complex composition. In addition, SIS can be formed into many shapes and sizes, including large sheets, tubes, cylinders, and cones. This makes it suitable for many surgical applications.
SIS is a naturally derived, extracellular matrix based biomaterial. Easy to source and process, SIS also provides a rich environment that signals the body to repair itself. SIS provides the temporary strength or filling necessary for the immediate repair, but also signals the surrounding tissue to grow into and around it, gradually replacing the SIS with native tissue that has the necessary properties to continue the repair. Ultimately, this leads to a functional, long-lasting repair without the presence of a permanent foreign body that can cause problems years later. The use of SIS or biomaterials like SIS represents the future of medicine working with the body’s own repair mechanisms instead of simple patching.
Submucosa
In the gastrointestinal tract, the submucosa is the layer of dense irregular connective tissue or loose connective tissue that supports the mucosa, as well as joins the mucosa to the bulk of underlying smooth muscle .-Contents:Blood vessels, lymphatic vessels, and nerves will run through...
l tissue
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
in the small intestine
Small intestine
The small intestine is the part of the gastrointestinal tract following the stomach and followed by the large intestine, and is where much of the digestion and absorption of food takes place. In invertebrates such as worms, the terms "gastrointestinal tract" and "large intestine" are often used to...
s of vertebrates.
SIS is harvested (typically from pigs) for transplanted structural material in several clinical
Clinical significance
In medicine and psychology, clinical significance refers to either of two related but slightly dissimilar concepts whereby certain findings or differences, even if measurable or statistically confirmed, either may or may not have additional significance, either by being of a magnitude that conveys...
applications, because of their low immunogenicity
Immunogenicity
Immunogenicity is the ability of a particular substance, such as an antigen or epitope, to provoke an immune response in the body of a human or animal.- Immunogenicity :The ability to induce humoral and/or cell-mediated immune responses....
. Some uses under investigation include a scaffold for intervertebral disc
Intervertebral disc
Intervertebral discs lie between adjacent vertebrae in the spine. Each disc forms a cartilaginous joint to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together.-Structure:...
regeneration. Unlike other scaffold materials, the resorbable
Resorption
Resorption is a process by which a structure is remodeled.Types include:* Bone resorption* Root resorption...
SIS extracellular matrix
Extracellular matrix
In biology, the extracellular matrix is the extracellular part of animal tissue that usually provides structural support to the animal cells in addition to performing various other important functions. The extracellular matrix is the defining feature of connective tissue in animals.Extracellular...
(SIS-ECM) scaffold is replaced by well-organized host tissues, including differentiated skeletal muscle
Skeletal muscle
Skeletal muscle is a form of striated muscle tissue existing under control of the somatic nervous system- i.e. it is voluntarily controlled. It is one of three major muscle types, the others being cardiac and smooth muscle...
.
Expanded Description
Small intestinal submucosa (SIS) is a naturally derived biomaterial isolated from the small intestine of pigs. After removal of the mucosal, serosal, and muscular layers of the intestine, a strong, collagenous matrix remains. Through treatments for disinfection, cell removal, and sterilization, SIS can be made into a medically useful material suitable for many clinical applications.In its native role, the submucosa of the small intestine provides mechanical strength to the intestine, preventing it from rupturing when a big meal is eaten. Consisting primarily of a strong extracellular matrix, the submucosa contains collagens, proteoglycans such as heparin, glycosaminoglycans such as heparin and hyaluronan, glycoproteins such as fibronectin, and growth factors such as FGF-2. Cells are mainly present to maintain the matrix, or in the abundant vasculature present to carry away the nutrients digested in the intestine. This rich environment is necessary to maintain the strength while supporting the rapid cell turnover of the mucosal layer. The strong yet biochemically rich and diverse extracellular matrix of the submucosa makes it an excellent choice for a naturally derived biomaterial.
Well documented in the scientific and medical literature (over 600 publications as of August 2008), SIS has been investigated as a biomaterial graft since 1989. SIS has been published for use in over 20 applications in humans including: multiple types of hernia repair, dural repair, anal fistula closure, stress urinary incontinence treatment, pelvic organ prolapse repair, and Peyronie’s disease treatment. There are over 150 medical publications (as of August 2008) describing SIS use in a wide variety of human use clinical situations. SIS has widespread potential for use in surgical repair due to its inherent strength and complex composition. In addition, SIS can be formed into many shapes and sizes, including large sheets, tubes, cylinders, and cones. This makes it suitable for many surgical applications.
SIS is a naturally derived, extracellular matrix based biomaterial. Easy to source and process, SIS also provides a rich environment that signals the body to repair itself. SIS provides the temporary strength or filling necessary for the immediate repair, but also signals the surrounding tissue to grow into and around it, gradually replacing the SIS with native tissue that has the necessary properties to continue the repair. Ultimately, this leads to a functional, long-lasting repair without the presence of a permanent foreign body that can cause problems years later. The use of SIS or biomaterials like SIS represents the future of medicine working with the body’s own repair mechanisms instead of simple patching.