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Effect of skin temperature on the ion reabsorption capacity of sweat glands during exercise in humans.

The effect of skin temperature on the ion reabsorption capacity of sweat glands during exercise in humans is unknown. In this study, eight healthy subjects performed a 60-min cycling exercise at a constant intensity (60% VO(2max)) under moderate (25 degrees C) and cool (15 degrees C) ambient temperatures at a constant relative humidity of 40%. The sweating rate (SR), index of sweat ion concentration (ISIC) by using sweat conductivity, esophageal temperature (Tes), mean skin temperature, and heart rate (HR) were measured continuously under both ambient temperatures. The SR and ISIC were significantly lower at the cool ambient temperature versus the moderate temperature. There were no significant differences in the changes in HR and esophageal temperature between these ambient temperature conditions, while the mean skin temperature was significantly lower at the cool ambient temperature by almost 3 degrees C (P < 0.05). The slopes of the relationships between Tes and the SR and ISIC were significantly lower and the thresholds of these relationships were significantly higher at the cool ambient temperature (P < 0.05). The ion reabsorption capacity of the sweat glands was significantly lower (P < 0.05) in a cool environment (0.21 +/- 0.04 vs. 0.52 +/- 0.06 mg/cm(2)/min at 15 and 25 degrees C, respectively) as evaluated using the relationships for SR and ISIC. The results suggest that the ion reabsorption capacity of the sweat glands is influenced by skin temperature during exercise in humans.

Body Temperature Regulation↗

Influence of abnormal Cl- impermeability on sweating in cystic fibrosis.

Parameters of electrolyte transport in single sweat glands in normal subjects and cystic fibrosis (CF) patients were monitored and compared. Results indicate that in both normal and CF sweat ducts, Na+ is reabsorbed by an active process in which Cl- follows passively while K+ is secreted. However, while net NaCl reabsorption is markedly lower, the electrical potential associated with sweat emerging from the sweat duct is significantly more negative in CF than in normal subjects. Comparison of the differences in apparent electrochemical potential experienced by ions in the sweat duct during secretion indicates that Na+ is held out of the lumen of both groups of ducts against a large but similar gradient, but that Cl- is held in the CF duct against a much larger gradient than in the normal duct. These results indicate that the mechanism for Na+ reabsorption is not inhibited in the CF duct, but that the decreased NaCl transport in the defective duct is due to an abnormally low permeability to Cl-. Analysis of the electrical potential as a function of the Cl- gradient in the sweat suggests that the normal and defective route of Cl- uptake may be transcellular.

Adolescent↗

SWEAT CHLORIDES IN SALT-DEPRIVED CYSTIC FIBROSIS HETEROZYGOTES.

Sweat chlorides of 10 sets of parents of children with cystic fibrosis and 11 controls were studied in an attempt to develop a test for the diagnosis of cystic fibrosis heterozygotes by subjecting both the parents and controls to a low sodium diet and comparing sweat chloride values as the diet progressed. It was hoped that the sweat chloride levels of the parents, the heterozygotes, would remain stationary throughout the diet, since their children, the homozygotes, reveal this finding under similar conditions of salt deprivation. The sweat chloride levels of the controls, because of effects of aldosterone, were expected to decrease steadily from the commencement of the diet to its termination.A decrease in sweat chloride values of similar magnitude was found in both parents and controls as the diet continued. It is concluded that the study of sweat electrolyte levels in salt-deprived subjects is of no value in the diagnosis of cystic fibrosis heterozygotes.

Aldosterone↗

[Secretory performance of eccrine sweat glands from the nephrologic viewpoint].

The question is of nephrological interest, whether the secretory product of eccrine sudoriferous glands apart from the well known function for thermoregulation is useful as excretory product for the therapy of renal insufficiency. In 17 healthy subjects and 39 patients with renal insufficiency thermal sweat was obtained by exposition in the sauna and four-tub bath. Control of the trainability of sweating in 23 patients during six weeks in the Kneipp cure sanatory. For the daily fluid balance remarkable quantities of sweat could be achieved. The sweat performance is trainable. The content of soluta in the sweat of patients with renal insufficiency surmounts that of healthy test persons. The excretion of nitrogen metabolites, electrolytes and acidity is quantitatively different and is analysed individually. Apart from the reliable methods of the conservative and invasive therapy of the uraemia the thermically stimulated sweating can be recommended as an adjuvant therapeutic regime.

Acid-Base Equilibrium↗

Immunoelectron microscopic localization of epidermal growth factor in the eccrine and apocrine sweat glands.

We studied the localization of the epidermal growth factor (EGF) in eccrine and apocrine sweat glands with light microscopic and electron microscopic immunohistochemistry. Anti-human EGF (anti-hEGF) polyclonal antiserum and anti-hEGF monoclonal antibody (MAb) were used for the study. Light microscopic immunohistochemistry with monoclonal and polyclonal antibodies showed that hEGF-like immunoreactivity was strongly positive in the myoepithelial cells and weakly positive in the secretory cells of eccrine sweat glands. In apocrine sweat glands, it was strongly positive in the secretory cells as well as in the myoepithelial cells. Immunoelectron microscopy with polyclonal antibody showed that hEGF-like immunoreactivity was present in secretory granules of apocrine secretory cells. These granules had mitochondrion-like internal structure. No reactivity was observed on the eccrine secretory cells by immunoelectron microscopy. Neither dark cell granules nor mitochondria in eccrine secretory cells were labeled with anti-hEGF antibody. In both eccrine and apocrine sweat glands, hEGF-like immunoreactivity was diffusely present in the cytoplasm of myoepithelial cells. However, nuclei and mitochondria of myoepithelial cells were devoid of immunoreactivity for hEGF. Our observations indicate that apocrine sweat glands may secrete more hEGF in the sweat than eccrine sweat glands.

Antibodies, Monoclonal↗

[Comparison of conductivity with sodium determination in the same sweat sample]

OBJECTIVE: To correlate sweat conductivity by Wescor with quantitative sodium determination in the same sample. METHODS: We analyzed 206 sweat samples, being 31 obtained from patients with cystic fibrosis (CF). Sweat was collected by quantitative pilocarpine iontophoresis in the Macroduct system for 30 minutes. Samples were immediately determined by Sweat-Chek analyzer (Wescor) and sodium quantification with a flame photometer. RESULTS: In non-CF subjects sweat (n=175), mean conductivity and quantitative sodium were 41mmol/L (16-75mmol/l) and 36mEq/ l (12-75mEq/l) respectively. In CF subjects (n=31), mean values of conductivity and sodium were 119mmol/L (84-155mmol/l) and 113mEq/l (80 - 146mEq/l) respectively. None of CF patients showed values lower than 80mmol/L. There was a correlation between sweat conductivity and sodium determination (r= + 0.99; p<0.0001). CONCLUSION: Sweat conductivity by Wescor simplifies the analysis with lower volumes and is well correlated to sodium concentration.

Journal Article↗

Chronological changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with palmar hyperhidrosis.

OBJECT: The author sought to investigate the temporal changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with primary palmar hyperhidrosis. METHODS: The author examined 91 consecutive patients for this prospective 6-year study. The patients were interviewed at least twice during a 6-month interval; the first follow up was conducted at a median of 1.7 years after surgery (range 2.5-60.5 months). Overall, 24 patients (26.4%) were followed for more than 2 years. Attention was focused on patient satisfaction and the incidence of compensatory hyperhidrosis and recurrent sweating. The overall mean patient satisfaction rate was 78%, with a median 80% improvement on a visual analog scale from 0% (poor) to 100% (excellent). Overall, 88 patients (96.7%) developed compensatory hyperhidrosis, with the mean initial occurrence at 8.2 weeks. The symptoms of compensatory hyperhidrosis progressively worsened to the maximum degree within another 2 weeks after onset (mean 10.3+/-1.83 weeks). In 19 patients (21.6%), symptoms of compensatory hyperhidrosis improved spontaneously within 3 months after sympathectomy (mean 13.3 weeks). Postoperative compensatory hyperhidrosis occurred in 71.4% of patients within the 1st year. Recurrent sweating occurred in only 17.6% of patients. None of these patients required repeated operation. The earliest onset of recurrent sweating was noted at 2 weeks postoperatively by three patients, and the mean initial postoperative reccurrence was 32.7 weeks after surgery. CONCLUSIONS: Compensatory hyperhidrosis and recurrent sweating are normal thermoregulatory responses that occurred after upper thoracic sympathectomy. Compensatory hyperhidrosis was more prevalent and developed earlier than recurrent sweating. The severity of both compensatory hyperhidrosis and recurrent sweating symptoms remained stable 6 months after surgery.

Adolescent↗

The cholinergic nervous system and immediate hypersensitivity. 1. Eccrine sweat responses in allergic patients.

The cholinergically innervated human eccrine sweat gland is a readily available organ permitting the assessment in allergic patients of cholinergic reactivity with few or no adrenergic influences. The sweat responses of four matched groups (male allergic, female allergic, male control, and female control) to intradermal Mecholyl from 0.1 mug to 100 mug was compared; the 45 male and 45 female allergic patients demonstrated statistically significant increases in sweat responses to essentially all concentrations of Mecholyl examined. No difference in the sweat responses of patients with allergic rhinitis alone was compared with patients with both allergic rhinitis and allergic asthma was noted. Five patients with intrinsic asthma most closely resembled the allergic groups in their responses and 8 patients with vasomotor rhinitis sweated at or below the control groups. The increased sensitivity of allergic patients to cholinergic stimulation as measured by eccrine sweat responses suggest that this hyperresponsiveness may be one of the underlying defects in allergic disease.

Contraceptives, Oral↗

Salt conditions a flavor preference or aversion after exercise depending on NaCl dose and sweat loss.

Sodium supplementation during or after exertion improves hydration. We hypothesized that it may therefore improve well being after exercise-induced sodium loss. To avoid cognitive-biased interpretations of the taste of salt, we used untasted salt in swallowed capsules to condition preference for the flavor of a drink. In four 90 min exercise sessions, 2-3 days apart, participants drank 100 ml of a novel drink and swallowed a capsule, either empty (placebo), or containing 200, 400 or 600 mg NaCl (n=20 in each group). We found both increases and decreases in flavor preference conditioning, depending on salt dose and level of sweat loss: in groups receiving salt supplementation, high levels of sweat loss induced greater flavor conditioning of preference than low levels of sweating. However, 600 mg NaCl conditioned a flavor aversion relative to placebo, which was greater in exercisers sweating little. We conclude that since untasted salt conditioned flavor preference in direct proportion to the amount of sweat lost, replenishment of the sodium lost in sweat induces a rewarding physiological state. The results provide further evidence for the physiological determinants of human salt appetite, and buttress the evidence that post-ingestive effects condition food preferences. Conditioned flavor preference may also provide a useful measure of the benefits of other nutrient additives in sports drinks.

Adult↗

Pubertal induction of sweat gland activity.

1. To study the difference in sweat rate between men and women the rates of cholinergic-induced sweating were measured in normal people before and after puberty and in response to androgens and anti-androgens. 2. Sweat rate in men was more than double that in women. 3. This difference did not occur in prepubertal boys and girls in whom the rate, corrected for surface area, was comparable with that in women. 4. Application or injection of androgen locally did not stimulate sweat production in the adult female. 5. Anti-androgen topically or systemically did not decrease sweat rate in men. 6. It is concluded that the rate of sweat rate in men is caused by androgen-induced gene expression at puberty and not by androgen modulation in adult life.

Acne Vulgaris↗

Regional differences in the effect of exercise intensity on thermoregulatory sweating and cutaneous vasodilation.

To investigate regional body differences in the effect of exercise intensity on the thermoregulatory sweating response, nine healthy male subjects (23.2 +/- 0.4 year) cycled at 35, 50 and 65% of their maximal O2 uptake (VO2max) for 30 min at an ambient temperature of 28.3 +/- 0.2 degrees C and a relative humidity of 42.6 +/- 2.4%. Local sweating rate (msw) on the forehead, chest, back, forearm and thigh increased significantly with increases in the exercise intensity from 35 to 50% VO2max and from 50 to 65% VO2max (P < 0.05). The mean values for the density of activated sweat glands (ASG) at 50 and 65% VO2max at the five sites were significantly greater than at 35% VO2max. The mean value of the sweat output per gland (SGO) also increased significantly with the increase in exercise intensity (P < 0.05). The patterns of changes in ASG and SGO with an increase in exercise intensity differed from one region of the body to another. Although esophageal temperature (Tes) threshold for the onset of sweating at each site was not altered by exercise intensity, the sensitivity of the sweating response on the forehead increased significantly from 35 to 50 and 65% VO2max (P < 0.05). The threshold for cutaneous vasodilation tend to increase with exercise intensity, although the exercise intensity did not affect the sensitivity (the slope in the relationship Tes vs. percentage of the maximal skin blood flow) at each site. Tes threshold for cutaneous vasodilation on the forearm was significantly higher at 65% VO2max than at either 35 or 50% VO2max, but this was not observed at the other sites, such as on the forehead and chest. These results suggest that the increase in msw seen with an increasing intensity of exercise depends first on ASG, and then on SGO, and the dependence of ASG and SGO on the increase in msw differs for different body sites. In addition, there are regional differences in the Tes threshold for vasodilation in response to an increase in exercise intensity.

Adult↗

DNA image cytometry in malignant and benign sweat gland tumours.

The histopathological differentiation between well-differentiated carcinomas and atypical adenomas of sweat gland origin may be difficult, even if immunohistochemical methods are used. Therefore, additional techniques may be helpful. We previously demonstrated that DNA image cytometry (ICM-DNA) can be useful in distinguishing between malignant and benign clear cell hidradenoma. In the present study, a larger series of sweat gland tumours, with a clear-cut diagnosis as malignant or benign on histopathological criteria, was examined by ICM-DNA. Enzymatic cell separation specimens were prepared from paraffin-embedded tissues of 18 sweat gland carcinomas (14 porocarcinomas, one classic eccrine adenocarcinoma, two microcystic adnexal carcinomas and one mostly ductal apocrine carcinoma) and 47 benign sweat gland tumours (three syringocystadenomas, five spiradenomas, 14 cylindromas, three syringomas, seven nodular hidradenomas, 10 cutaneous mixed tumours, four poromas and one apocrine hidrocystoma). Specimens were examined by ICM-DNA according to the current recommendations of the European Society for Analytical Cellular Pathology with the AutoCyte QUIC-DNA workstation using mesenchymal cells as an internal reference. DNA aneuploidy was detected by the stemline interpretation according to Böcking and/or at least three 5[c]-exceeding events. DNA aneuploidy was detected in 16 of 18 (89%) of the sweat gland carcinomas, but in none of the 47 adenomas. These results suggest that the detection of DNA aneuploidy in sweat gland tumours using ICM-DNA is a clear and specific indicator of prospective malignancy.

Adenoma, Sweat Gland↗

Continuous monitoring of single-sweat-gland activity.

A conductivity measurement system using a small ion-free-solution perfusion chamber has been developed to monitor single sweat-gland activity (SSGA) continuously at the skin surface. The chamber has a small open space of 0.2 mm2 at the bottom and has a transparent window. Single sweat pores were visualized by the starch/iodine method and the chamber was attached onto a single sweat pore using a magnifying lens affixed at the window. Silver electrodes were installed inside the chamber, and, by perfusing ion-free solution through the chamber at a constant flow rate, the conductivity of the solution was measured at the inlet and the outlet of the chamber. Continuous SSGA was monitored at the palm, finger tip and chest skin surface when the subjects were seated in a resting position and under stresses such as hand grasping with a dynamometer and performing mental arithmetic. Different types of response were observed from different sweat pores. The response time of this system was less than 0.15 s. The present results reveal that continuous sweat activity can be monitored even from a single sweat gland.

Equipment Design↗

Assessing function and pathology in familial dysautonomia: assessment of temperature perception, sweating and cutaneous innervation.

This study was performed to assess cutaneous nerve fibre loss in conjunction with temperature and sweating dysfunction in familial dysautonomia (FD). In ten FD patients, we determined warm and cold thresholds at the calf and shoulder, and sweating in response to acetylcholine iontophoresis over the calf and forearm. Punch skin biopsies from calf and back were immunostained and imaged to assess nerve fibre density and neuropeptide content. Mean temperature thresholds and baseline sweat rate were elevated in the patients, while total sweat volume and response time did not differ from controls. The average density of epidermal nerve fibres was greatly diminished in the calf and back. There was also severe nerve loss from the subepidermal neural plexus (SNP) and deep dermis. The few sweat glands present within the biopsies had had reduced innervation density. Substance P immunoreactive (-ir) and calcitonin gene related peptide-ir (CGRP-ir) were virtually absent, but vasoactive intestinal peptide-ir (VIP-ir) nerves were present in the SNP. Empty Schwann cell sheaths were observed. Temperature perception was more impaired than sweating. Epidermal nerve fibre density was found to be profoundly reduced in FD. Decreased SP and CGRP-ir nerves suggest that the FD gene mutation causes secondary neurotransmitter depletions. Empty Schwann cell sheaths and VIP-ir nerves suggest active denervation and regeneration.

Adolescent↗

Neoplasms with sweat gland differentiation express various glycoproteins of the carcinoembryonic antigen (CEA) family.

Carcinoembryonic antigen (CEA) is a well-established marker for sweat gland differentiation in adnexal neoplasms. In contrast to previous assumptions, CEA does not represent a single oncofetal antigen but comprises a family of homologous glycoproteins, i.e. the classical CEA-180, biliary glycoprotein (BGP), and non-specific crossreacting antigens (NCA). The aim of the study was to evaluate the distribution of the respective glycoproteins of the CEA family in sweat gland neoplasms, as compared to normal sweat glands. A panel of mono-specific antibodies was applied to a total of 83 samples of hyperplastic and cystic alterations of sweat glands, sweat gland neoplasms, and cutaneous metastases of different origin. Within a single group of neoplasms the immunohistochemical profile was rather consistent. Staining for both CEA-180 and NCA-90 indicated ductal differentiation of both eccrine and apocrine glands. Co-expression of CEA-180, NCA-90, and BGP was consistent with differentiation towards the secretory part of eccrine glands or the transitional portion of proximal ducts. Neoplasms with signs of apocrine secretion showed a preferential immunoreactivity for NCA-90 and BGP. In conclusion, a specification of the members of the CEA family may be of some value in the differential diagnosis of adnexal neoplasms, but not in the discrimination of sweat gland carcinoma from metastatic carcinoma.

Adnexal Diseases↗

Ultrastructural localization of carcinoembryonic antigen (CEA) glycoproteins and epithelial membrane antigen (EMA) in normal and neoplastic sweat glands.

Glycoproteins of the carcinoembryonic antigen family (CEA) and epithelial membrane antigen (EMA) are established markers for glandular and mucosal tissues. However, their precise ultrastructural distribution in sweat glands has not been determined as yet. Therefore, normal human skin, 19 cases of various sweat gland neoplasms, Paget's disease, and cutaneous metastases of visceral carcinomas were stained with well-defined antibodies using a postembedding immunogold technique. In some cases, a new method of re-embedding paraffin material for immunoelectron microscopy was applied. In normal sweat glands, immunoreactivity of the endoplasmic reticulum and vesicles indicated biosynthesis and processing of CEA and EMA. Along the luminal surfaces both CEA and EMA represented an integral part of microvilli. However, a differential expression of CEA and EMA was demonstrated in apocrine epithelia, mucous cells of eccrine glands, and sweat ducts. In fetal glands, CEA was associated with formation of secretory and ductal lumina. The overall cellular distribution of CEA and EMA was highly preserved in benign sweat gland neoplasms whereas malignant neoplasms were characterized by loss of protein targeting and cellular polarity. In conclusion, these immunoelectron microscopical findings suggest a role of CEA and EMA for cell differentiation and secretory mechanisms of sweat gland epithelia.

Adult↗

Relationship of sweat electrolytes to apparent life-threatening events (ALTE): a case control study.

Twenty infants aged 25 days to 6 months who were consecutively investigated for apparent life-threatening events (ALTE) with negative results and 20 matched normal controls underwent an iontophoresis sweat test. A statistically significant elevated sweat potassium level (22.1 +/- 8.9 versus 12.4 +/- 6.5 mol/l) was noted in the ALTE patients compared with the control group (p < 0.001). No difference was found, however, between sweat sodium and chloride levels in the two groups. Na/K ratio in sweat was significantly different between the groups (p < 0.001). A between-groups discriminant analysis, using Na/K ratio as a discriminant variable, resulted in 80% accuracy in group assignment. A significant increase in sweat potassium concentration at night compared with day time was evident in ALTE patients. Elevated sweat potassium levels specifically characterized infants who experienced ALTE and may possibly indicate an underlying mechanism involving enhanced sympathetic activity.

Circadian Rhythm↗

The local training effect of secretory activity on the response of eccrine sweat glands.

1. The influence of repeatedly raising the body temperature by radiant heat to a level at which acclimatization to heat is normally acquired was investigated in two series of experiments, the first without the subjects sweating, the second with sweating.2. In a second investigation local sweat-gland activity was induced by drug injections on successive days without raising the body temperature.3. These experiments show that the increased sweating capacity characteristic of acclimatization to heat is a result of sweat-gland activity and does not appear to be induced by or to depend on an elevated body temperature.4. Secretory activity results in a loss of glycogen from sweat-gland cells on the first day of heat exposure but not after the glands have been ;trained' by acclimatization to heat.5. The state of acclimatization has no influence on the threshold concentration of acetylcholine required to elicit sweating when injected intradermally.

Acclimatization↗