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Connective tissue, as the name implies, is a term given to several different tissues of the body that serve to connect, support, and help bind tissues in the body. They can be found in many parts of the body including the muscles and the nervous system (as a protective sheath for the nerves). Connective tissue can be broken down further into three categories: loose connective tissue, dense connective tissue, and specialized connective tissue. These tissues are comprised of tendonous structures, fascia, ligaments, vessels, the capsule of most organs, cartilage, bone, adipose, and mucus-secreting epithelia. Elastin and proteoglycans are responsible, in part, for the elastic properties of tissues. During growth, and at each step of development, there are changes in the distribution and deposition of connective tissue proteins and glycosaminoglycans. [1,2] In other words, these tissues play a significant role in the human body. So, what will happen if they are not taken care of?
One outcome of it will be Mixed Connective Tissue Disease (MCTD): an autoimmune connective tissue disorder characterized by an autoantibody to ribonucleoprotein (RNP). It is also known as systemic sclerosis, SLE, and polymyositis. Symptoms of this disease include cough, dyspnea, or pleuritic chest pain. Pulmonary hypertension is the most severe pulmonary consequence and often leads to premature death. Another outcome is Rotator Cuff Injury. The rotator cuff is comprised of four tendons localized in the shoulder region. These tendons originate from the muscles – subscapularis, supraspinatus, infraspinatus, and teres minor. Rotator cuff injuries can present as debilitating pain, reduced shoulder movement and function, and shoulder weakness. Physical therapy can be used to treat this injury as well as corticosteroid injections. Other ways to treat are surgical techniques, but studies have proven an equivocal benefit with the surgical approach. Patients with rotator cuff tendon injuries are also at high risk for repeated tears throughout their lifetime. [1] With this in mind, it is imperative to ensure that our connective tissues remain strong and healthy; and it should be of no surprise that the most effective way to do so, is by managing our diet.
Diet has a great effect when it comes to modifying connective tissue metabolism. Often, there is a strong genetic interaction between diet and the expression of connective tissue lesions. [2] Posttranslational modifications are particularly influenced by diet because many vitamins and minerals are cofactors in steps such as the extracellular formation of covalent cross-links between polypeptide chains or various transfer reactions. [2] Nutrients that help maintain strong connective tissues are copper, manganese, zinc, ascorbic acid, pyridoxine thiamine, and fat-soluble vitamins (A, E, D, and K). Their descriptions, functions, metabolic defects, and food sources are as follows:
- Copper
o Copper is an essential mineral
o Copper contributes to collagen and elastin cross-linking, perhaps in sulfation or glycosylation of proteoglycans
o A deficiency in copper will result in skin friability, aneurysms, bone fragility, and loss of coat color and structural integrity
o Some food sources high in copper include beef liver, oysters, potatoes, shiitake mushrooms, cashews, Dungeness crab, sunflower seeds, and turkey giblets
- Manganese
o Manganese is an essential trace element
o Manganese is a cofactor for glycosyl transferases
o A deficiency in manganese will result in decreased proteoglycan accumulation, chondrodystrophy, and perosis in growing chicks
o Some food sources high in manganese include mussels, hazelnuts, pecans, brown rice, oysters, clams, and chickpeas
- Zinc
o Zinc is an essential mineral
o Zinc contributes to cell differentiation and histone assembly and structure
o A deficiency in zinc will result in poor wound healing, poor growth, and skeletal and cranial anomalies in young animals
o Some food sources high in zinc include oysters, beef, crab, and lobster
- Ascorbic acid
o This is also known as vitamin C, an essential water-soluble vitamin
o Ascorbic acid is a cofactor in prolyl and lysyl hydroxylation, perhaps a cofactor in certain glycosylation reactions
o A deficiency in ascorbic acid will result in poor wound healing, decreased collagen synthesis, impaired bone development, and loss of basement membrane integrity
o Some food sources high in vitamin C include sweet red and green peppers, oranges/orange juice, grapefruit juice, and kiwis
- Pyridoxine
o This is also known as vitamin B6, an essential vitamin
o Pyridoxine may help with elastin and collagen cross-linking
o A deficiency in pyridoxine will result in poor growth, abnormal protein synthesis and amino acid metabolism, and homocystinuria
o Some food sources high in pyridoxine include chickpeas, beef liver, tuna, and salmon
- Thiamine
o This is also known as vitamin B, an essential micronutrient
o Thiamine helps with collagen synthesis
o A deficiency in thiamine will result in poor wound healing and decreased NADP production and neurological defects
o Some food sources high in thiamine include enriched white rice, fortified cereals, enriched egg noodles, and bone-in pork chops
- Vitamin A
o Vitamin A is an essential fat-soluble vitamin
o Vitamin A creates a differentiation of epithelium and putative role in proteoglycan synthesis
o A deficiency in vitamin A will result in poor wound healing and keratinization of epithelial tissue
o Some food sources high in vitamin A include beef liver, sweet potato, spinach, pumpkin pie, carrots, and ice cream
- Vitamin E
o Vitamin E is an essential fat-soluble vitamin
o Vitamin E may help with collagen cross-linking
o A deficiency in vitamin E will result in altered wound healing
o Some food sources high in vitamin E include wheat germ oil, sunflower seeds, almonds, sunflower oil, safflower oil, and hazelnuts
- Vitamin D
o Vitamin D is an essential fat-soluble vitamin
o Vitamin D helps with bone collagen synthesis and osteoblast differentiation
o A deficiency in vitamin D will result in poor bone growth and development, with an excess, decreased collagen synthesis
o Some food sources high in vitamin D include cod liver oil, trout, salmon, white mushrooms, and fortified dairy products or non-dairy alternatives
- Vitamin K
o Vitamin K is an essential fat-soluble vitamin
o Vitamin K is a cofactor in gamma-carboxylations of glutamyl residues in osteocalcin
o A deficiency in vitamin K will result in altered bone mineralization
o Some food sources high in vitamin K include collard greens, spinach, turnip greens, kale, and broccoli [2]
In addition to vitamins and minerals, proteins and calorie intake can also affect the connective tissue. Studies of the composition of tissues from malnourished animals show that the relative concentrations within the whole carcass and most tissues usually increase in collagen related to the slower turnover rate of most collagens, compared with turnover rates of the more labile cytosolic and muscle proteins. [2]
At the end of the day, knowing our limits, whether it is our food intake, vitamin and minerals intake, or caloric intake, it remains to be the most important to be mindful that we should never consume too little, or too much, of anything. Every nutrient has a role to play in our bodies. To nourish them and strengthen them so that we can live a safe and healthy life; it’s always important to keep in mind what we feed our body, and if we should ever feel concerned about it, seeking professional help is always the safest and best way to counter that problem.
References:
1. Anatomy, Connective Tissue - Statpearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538534/.
2. Tinker, D, et al. “Role of Selected Nutrients in Synthesis, Accumulation, and Chemical Modification of Connective Tissue Proteins.” Physiological Reviews, 1 July 1985, https://journals.physiology.org/doi/abs/10.1152/physrev.1985.65.3.607.
Contributors:
Author: Georgia Sukendro
Editor: Kayjah Taylor
Health scientist: Aseelah Saiyed
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