THE LIVING MATRIX - American Academy of Osteopathy

THE LIVING MATRIX
R. Paul Lee, DO, FAAO, FCA
Orlando, FL
March 23, 2013

What I want to say today
Describe a model for PRM in the
extracellular matrix.
Discuss the role of cells, water and
connective tissue.

Connective Tissue
Bones
Joints
Ligaments
Muscles

Connective Tissue
Fascia
Extracellular Matrix
Cytoskeleton

Extracellular Matrix
• Also known as the Ground Substance or
“Matrix”
• Additional info:
1. Lee, RP (2001). The primary respiratory
mechanism beyond the craniospinal axis.
AAOJ, 11(1):24-34.
2. Lee, RP (2005). Interface: Mechanisms of
Spirit in Osteopathy. Stillness Press.

Histology of the Matrix
• Enmeshed in matrix:
– Cells
– Capillaries
– Nerves
– Lymphatics

Histology of Matrix
• Functions:
– Delivery of nutrients.
– Elimination of waste.
– Communication among cells.
– Intimate connection of all parts of the body.
• Fibroblasts:
– Manufacture matrix components.
– Syncytium

Fibroblasts form
syncytium

Matrix Behaves as a Primitive
Nervous System

Matrix mediates functions for cells.
• Nerves terminate in the matrix not on the
cells.
• Vessels excrete their nutrients into the
matrix not into the cells.
• Lymph originates in the fluid of the
extracellular matrix.

Matrix Displays Immune Function
• Mast cells reside in the matrix.
• Macrophages, PMNs, and lymphocytes pass
through the matrix.
• Detoxification processes occur in the matrix.
• Acidic products of cellular metabolism are
neutralized in the alkaline matrix.

PROTEOGLYCAN
1.Hyaluronan
2.Proteoglycan
a. Core protein
b. Keratin sulfate
c. Chondroitin
sulfate

GAGs and Proteoglycans bind water
forming a gel.

Gabarel and Roques’ theory of the
generation of the PRM
• Based on the amount of free water vs. bound
water in the extracellular matrix.
• When matrix is depolymerized by increased
concentration of electrolytes, water is freed.
• Concentration of electrolytes decreases with
free- and increases with bound-water, creating
oscillating feedback loop.

Phase Transitions
• Most familiar – melting or freezing water.
• Definition: a change in shape, size,
permeability, hardness, chemical and/or
electrical activity.
• Stimuli: change in pH, temperature, salt,
electric field, mechanical stress.

Phase Transitions in Matrix
[Gabarel & Roques]
• Gels are prone to phase transitions.
• A change in viscosity (the state of free or
bound water).

“Injury Potential”
[Nordenström]
• A measurable change in the electric
potential of the tissue when injured.

“Energy Sink”
• Robert Fulford, DO used this term to refer
to areas of tissue that are palpably altered
from trauma.
• A palpatory confirmation of an injury
potential, that is, a palpable mechanical
change that corresponds with an electric
change.

Electric Potentials
in Organs
[Nordenström]

Fluctuation of Polarity in Tissues
[Nordenström]
Fluctuation of polarity is created when an
a. injury potential or
b. physiological polarization
is accompanied by an opposite reaction to
balance the polarity.
As entropy increases in this process,
fluctuation is established.

Characteristics of Fluctuations
[Nordenström]
• Fluctuations occur in the vascular and interstitial
fluids.
• Healing results from ebb and flow of ions.
• Fluctuations occur in injured and normal tissue
and in morphogenesis.
• Oxidation/Reduction reactions occur in the fluids
next to fibrous membranes.

Fluids are Good Conductors
[Nordenström]
Electrical reactions from flows of ions and
electrons occur readily in water because of
a. The characteristics of water itself.
b. Dissolved electrolytes.
c. Dissolved proteins.

“Ionars”
[Nordenström]
• Ionars are groups of ions.
• Collect in the extracellular fluid because of
metabolic activities and local differences in
a. capillary bed circulation
b. matrix properties
c. ionic size and mobility

“Ionars”
[Nordenström]
• Represent an electromotive force.
• Participate in the fluctuation of charge.
• Responsible for actual structural modifications.
• Associated with movement of water.

Pischinger
• Fundamental importance of the ground
substance (matrix) in the extracellular
space.
• All cells, nerves, and vessels are imbedded
in and functionally connected by matrix.

Matrix is Piezoelectric
[Pischinger]
• Vibrations stimulate electric activity and
electric activity stimulates vibrations.
• Vibrations (mechanical stimuli) travel at
the speed of sound through the tissues.
• Electric stimuli travel at the speed of light.

The matrix provides the milieu for
the healthy function of cells.
[Pischinger]
• Disturbances in the matrix are the starting
point of many diseases.
• The matrix is involved in every disease
and in its healing.
• Fundamentally, the same concept as Dr.
Still proposed.

Pischinger Expanded Virchow’s
Hypothesis
• Virchow declared that the cell is the basic unit of
life.
• Pischinger included with the cell, the connective
tissue (matrix), capillary bed, and lymphatics as
the basic unit of life.
• Dr. Still proposed same concept with his idea of
“biogen.”

Szent Gyorgyi
Fibers and
proteins are
semiconductors

Shininess of connective tissue
[Oschman]
• Shininess of connective tissue at surgery
indicates the health of the tissue and the
amount of electrons in the matrix.
• The amount of electrons correlates with
the alkalinity of the tissue and its ability to
quench acidic toxins.

Matrix is a storage compartment
[Pischinger]
• The matrix holds toxins until they can be
disposed of.
• At night when the body is at rest, the
lymph and blood clear the matrix and
deliver toxins to the liver for disposal.

Matrix is an open system
[Pischinger]
• Open systems are subject to energetic and
material influences from outside.
• Parenchymal cells, immune cells, nerve cells,
and blood capillaries all influence the matrix
driving an oscillatory mechanism.
• GAGs and proteoglycans are changed in specific
ways by all these influences.

Matrix and Cell Membrane
[Pischinger]

Glycocalyx and Cytoskeleton
[Pischinger]
• Glycocalyx transfers
input from the
extracellular matrix
into the mechanisms
of the cell even down
to the genes.
• Matrix influences cell
growth, cell division,
and cell movement.

Water carries information
[Pischinger]

“Fluids, Matter in Motion”
• Lee (2002), Fluids, Matter in Motion,
Cranial Letter, volumes 55 and 56.

Biodynamics
[Pischinger]
• Biodynamics: Transformation between
energy and mass.
• A clear example of biodynamics is the
energy flow between the sugar
biopolymers (GAGs and proteoglycans)
and water in the matrix.

Biodynamics
[Pischinger]
• Spontaneously generating patterns that
spread themselves through the matrix are
an expression of life-retaining interactions
between matter and energy.

Etheric Body
[Pischinger]
• Matrix is physical aspect of etheric body, the
energetic aspect of which provides pattern to
form physical body.
• The matrix is the interface of the material and
etheric bodies – biodynamics.
• Dr. Fulford emphasized working with the etheric
body.

Summary of three books
• Matrix is where the action is.
• It is both changeable and stable.
• Influences from cells, nerves, vessels and lymph all
mingle.
• Matrix gives direction to cell’s functioning.
• Redox reactions occur routinely along fibrous and
cellular membranes in the fluids.

Summary of books
• Matrix is naturally a gel blocking the passage of
substances unless its viscosity is reduced.
• Alterations of viscosity occur from changes in
pH, temperature, electric fields, mechanical
stress, and electrolyte concentration.
• Matrix is characterized by varying viscosity,
changing charges, and fluxes of fluids and ions.

Summary of books
• Information is carried in the matrix
by the structure of water
by patterns of sugar polymers
by patterns of dissolved substances.
• Information is transmitted instantaneously
• Matrix integrates entire system.

Summary
• Injury to tissue changes the electro-mechanical
quality of the matrix.
• Flows of ions and water are the means by which
healing occurs.
• Biodynamic transformations between energy and
matter occur with changing patterns in sugar
polymers and water.

Summary
• Matrix represents the etheric body in the
physical form.

Matrix is Osteopathic
• Matrix expresses unity (unifies whole body and
represents the etheric body).
• Its structure and function are reciprocally interrelated.
(As viscosity changes so does function.)
• Its substance contains all the necessary resources for
maintenance and healing. (Acts as a nervous, immune,
detox, and storage system. Delivers information from
chemicals, nerves, water, patterns of GAGs, etc.)
• Treating the matrix is osteopathic.

Yuri Moskalenko, D.Sc.
• Bioimpedence measures fluctuating fluids
of the brain tissue.
• Dopplerography measures changes in
arterial blood flow.
• These both show obvious fluctuations in
cranium.

Boris Vern, MD, PhD
• Measured oscillations of oxidative
metabolism in the brain cortex.
• Neurons that have increased oxidative
metabolism are actively working.
• Same cells have increased cellular volume.

Berridge & Rapp
• Among many cellular oscillations cited,
oscillations of the concentration of
secondary messengers – cyclic AMP and
calcium ions – occur at rates that are
compatible with the Tide.
(Berridge & Rapp, A comparative survey of the function, mechanism
and control of cellular oscillators. J Exp Biol, 81:221-224.)

Calcium Waves
• Overwhelming number of references in the
scientific literature about calcium ion fluxes.
• Multiple rates of calcium waves stimulate
intracellular functions.
• An extracellular flux of calcium ions occurs at a
rate consistent with the PRM.

Calcium and the Matrix
• As calcium ion concentration increases in the
matrix with the calcium wave, the proteoglycans’
bonds with hyaluronan break.
• Bound water is freed to flow as the matrix
depolymerizes.
• This fits Gabarel & Roques’ model, what
Nordenström implied, and what Pischinger
predicted.

Calcium Wave

Counterions
• Movement of calcium ions is accompanied by a
balancing movement of opposite charge –
electrons – in the proteins.
• Proteins are semiconductors and share electrons
that are free to move.
• Ions flow in water; electrons flow in proteins.

Tensegrity
• Tissue tensegrity system is composed of the
extracellular matrix, integrins, and cytoskeleton.
• Mechanical (vibrational) information, transferred
via the integrins from the matrix to the
cytoskeleton, changes the cell’s shape and
influences the expression of DNA.
(Pienta & Coffey (1991). Cellular harmonic information transfer
through a tissue tensegrity-matrix system. Med Hypoth, 34:88-95.)

Tensegrity
• Magnets attached to integrins showed that
twisting them altered cytoskeletal
arrangement and metabolism.
(Wang, Butler, & Ingber (1993). Mechanotransduction across the
cell surface and through the cytoskeleton. Science, 260:1124-1127.)

Mechanotransduction
• Expression of enzyme systems can be
altered by mechanically approximating
enzyme chains attached to microtubules in
the cytoskeleton.

Cell Contraction
• Calcium ion binds to integrins (membrane
receptor) and causes cell contraction.
• Integrins cause contraction of
microfilaments (actin).

Terminal lymph channel

Theoretic Model – Lymphatics
• Microfilaments outside the cell support the lymphatic capillary
endothelial cells.
• With the calcium wave, microfilaments contract, thus opening the
fenestrations between the endothelial cells allowing free water to
enter.
• After the calcium wave, the fenestrations close, thus trapping water
inside the terminal lymphatic channel.
• With the next calcium wave, more water enters the terminal
capillary forcing the previous water to move proximally along the
lymph channel.

Theoretic Model – Blood Vessels
• The gel phase of the matrix osmotically
draws more water from the capillary bed
to resupply the matrix.

Model – Summary
• Thus, we have a theoretical model for
fluctuations in the tissues involving:
– Extracellular matrix
– Parenchymal cells
– Capillary bed
– Lymphatics

Model – Summary
• Nutrients and waste products must cross
the no-man’s land of the normally
gelatinous matrix.
• Only the forces for life can permit this
through two emissaries, calcium and
water.

Summary of Model