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((Short description|Thin layer of tissue in various organs))
((more citations needed|date=March 2013))
((Infobox anatomy
| Name        = Submucosa
| Latin       = tela submucosa
| Image       = GI Organization.svg
| Caption     = <br />[[Mucous membrane|Mucosa]]<br />Submucosa<br />[[Meissner's plexus]]<br />[[Muscular layer|Circular muscle]]<br />[[Auerbach's plexus]]<br />[[Muscular coat|longitudinal muscle]]<br />[[Serous membrane|Serosa or Adventitia]]
| Image2      = Mid_esophageal_mass.jpg
| Caption2    = [[Esophagogastroduodenoscopy|Endoscopy]] and radial [[endoscopic ultrasound]] images of submucosal tumour in mid-[[esophagus]].  The submucosa is seen as a dark ring on the ultrasound image.
| System      =
))

The '''submucosa''' (or '''tela submucosa''') is a thin layer of [[tissue (biology)|tissue]] in various [[organ (anatomy)|organs]] of the [[gastrointestinal tract|gastrointestinal]], [[respiratory tract|respiratory]], and [[genitourinary system|genitourinary]] tracts. It is the layer of [[dense irregular connective tissue]] that supports the mucosa ([[mucous membrane]]) and joins it to the [[muscular layer]], the bulk of overlying [[smooth muscle]] (fibers running circularly within layer of longitudinal muscle).

The submucosa (''[[wikt:sub-#Prefix|sub-]]'' + ''mucosa'') is to a mucous membrane what the [[subserosa]] (''[[wikt:sub-#Prefix|sub-]]'' + ''serosa'') is to a [[serous membrane]].

==Structure==
[[Blood vessels]], [[lymphatic vessels]], and [[nerves]] (all supplying the [[mucosa]]) will run through here. In the intestinal wall, tiny [[parasympathetic]] ganglia are scattered around forming the [[submucous plexus]] (or "Meissner's plexus") where [[preganglionic]] parasympathetic neurons synapse with [[postganglionic]] nerve fibers that supply the [[muscularis mucosae]]. Histologically, the wall of the alimentary canal shows four distinct layers (from the lumen moving out): mucosa, submucosa, muscularis externa, and either a [[serous membrane]] or an [[adventitia]].

In the [[gastrointestinal tract]] and the [[respiratory tract]] the submucosa contains the [[submucosal gland]]s that secrete [[mucus]].

==Clinical significance==
Identification of the submucosa plays an important role in diagnostic and therapeutic [[endoscopy]], where special [[Fiber optics|fibre-optic]] cameras are used to perform procedures on the [[gastrointestinal tract]].  Abnormalities of the submucosa, such as [[gastrointestinal stromal tumor]]s, usually show integrity of the mucosal surface.

The submucosa is also identified in [[endoscopic ultrasound]] to identify the depth of tumours and to identify other abnormalities.  An injection of [[dye]], [[saline (medicine)|saline]], or [[epinephrine]] into the submucosa is imperative in the safe removal of certain [[polyp (medicine)|polyps]].

Endoscopic mucosal [[surgery|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.<ref>((Cite web |url=http://submucosa.com/ |title=What is the submucosa and why is it important? - Submucosa |access-date=2018-07-25 |archive-date=2019-06-23 |archive-url=https://web.archive.org/web/20190623151817/http://submucosa.com/ |url-status=dead ))</ref>

===Small intestinal submucosa=== <!--Anchor for redirect of [Small intestinal submucosa]; caution. -->
''Small intestinal'' submucosa (SIS) is submucosal [[tissue (biology)|tissue]] in the [[small intestine]]s of [[vertebrates]].  SIS is harvested (typically from pigs) for [[Transplantation medicine|transplant]]ed structural material in several [[Clinical significance|clinical]] applications, typically [[Biomesh|biologic meshes]]. They have low [[immunogenicity]].  Some uses under investigation include a [[Tissue engineering#Scaffolds|scaffold]] for [[intervertebral disc]] regeneration.<ref>((cite journal  |vauthors=Oelschlager BK, Pellegrini CA, Hunter J, etal |title=Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial |journal=Ann. Surg. |volume=244 |issue=4 |pages=481–90 |date=October 2006 |pmid=16998356 |pmc=1856552 |doi=10.1097/01.sla.0000237759.42831.03 ))</ref><ref>((cite journal |vauthors=Helton WS, Fisichella PM, Berger R, Horgan S, Espat NJ, Abcarian H |title=Short-term outcomes with small intestinal submucosa for ventral abdominal hernia |journal=Arch Surg |volume=140 |issue=6 |pages=549–60; discussion 560–2 |date=June 2005 |pmid=15967902 |doi=10.1001/archsurg.140.6.549 |doi-access=free ))</ref>

Unlike other scaffold materials, the [[Resorption|resorbable]] SIS [[extracellular matrix]] (SIS-ECM) scaffold is replaced by well-organized host tissues, including differentiated [[skeletal muscle]].<ref>((cite journal |vauthors=Badylak S, Kokini K, Tullius B, Simmons-Byrd A, Morff R |title=Morphologic study of small intestinal submucosa as a body wall repair device |journal=J. Surg. Res. |volume=103 |issue=2 |pages=190–202 |date=April 2002 |pmid=11922734 |doi=10.1006/jsre.2001.6349 ))</ref>

==History==
A scientific article published in March 2018<ref>Benias, 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).</ref> 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]]. 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]] positive. However, these cells are devoid of ultrastructural features indicative of endothelial differentiation, including pinocytotic vesicles and Weibel-Palade bodies.

==Additional images==
<gallery>
 File:Illu stomach2.jpg|Stomach.
 File:Gray1033.png|Section of the human [[esophagus]]. Moderately magnified.
 File:Gray1141.png|Vertical section of bladder wall.
 File:Gut wall.svg|General structure of the gut wall showing the submucosa.
</gallery>

==References==
((Reflist))

((Tissue layers))
((Urinary system anatomy))
((Connective tissue))
((Authority control))

[[Category:Membrane biology]]
[[Category:Digestive system]]

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