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Water molecules in the extracellular matrix are essential for tissue hydration, swelling pressure, and mechanical properties[6][7][2]. Their ability to retain and transport molecules is mediated by the hygroscopic nature of ECM components (such as glycosaminoglycans, proteoglycans, and structural proteins), which bind and hold water[7][6][2][5][1]. Water supports the ECM’s ability to provide a scaffold, acts as a medium for nutrient and waste transport, and confers mechanical resistance to compression and force by maintaining tissue hydration and osmotic balance[6][7][2][8]. Water does not act as a receptor, enzyme, or protein target in the classical sense, but is critical for chemical reactions, biomolecular interactions, and the physical behavior of tissues. Disruption of ECM water balance is implicated in fibrotic, inflammatory, and malignant pathologies due to altered tissue mechanics and transport functions[6][2][5][3].
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