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Renin-like (angiotensinogenase) activity in human eccrine sweat.

The presence of renin or renin-like activity (RLA) was demonstrated in human eccrine sweat incubated with purified sheep angiotensinogen, using rat bioassay and angiotensin I radioimmunoassay. Following cholinergic stimulation, sweat RLA was found to range between 0 (unmeasurable) and 266 ng/ml.h, i.e. RLA-values of sweat can be about 10 times higher than those of plasma. Therefore, renin synthesis in sweat glands could be assumed. RLA following activation of beta-adrenergic receptors by the administration of isoprenaline (Aludrin) did not exceed the mean values obtained by cholinergic activation. After beta-adrenergic receptor blockade by propranolol (Dociton), RLA became unmeasurably low. Higher RLA-values were found after local injection of dibutyryl-c-AMP (90--210 ng/ml.h). The results indicate a beta-adrenergic regulation of RLA-release in human sweat glands. Human sweat glands appear to be useful for studying extrarenal renin release.

Animals↗

Effect of local cooling on sweating rate and cold sensation.

Subjects resting in a 39 degrees C environment were stimulated in different skin regions with a water cooled thermode. This local cooling produced decreases in sweating rate measured at the thigh and increases in magnitude estimates of the cold sensation. The are of cold stimulation varied from 111 cm2 to 384 cm2. Sensitivity coefficients of the changes in sweating rate and magnitude estimate were corrected for differences in size of the area of stimulation and change in skin temperature and were normalized to the responses of the chest. The normalized coefficients showed the following relative sensitivities for changes in sweat rate and magnitude estimate respectively: forehead 3.3, 2.2; back 1.2, 1.4; lower leg 1.1, 0.9; chest 1.0, 1.0; thigh 0.9, 1.0; abdomen 0.8, 0.8. Varying the area stimulated from 122 cm2 to 384 cm2 produced greater changes in the sweating response than in the magnitude estimate. Rate of skin cooling during the period of stimulation had more effect on the sweating response than on the magnitude estimate. We conclude that cooling different body regions produces generally equivalent changes in the sweat rate and sensation, with the forehead showing a much greater sensitivity per unit area and temperature decrease than other areas.

Abdomen↗

Control of sweating in man after work-induced thermal load and symmetrically applied cooling.

To examine the compensatory effects of work-induced thermal load and symmetrically applied local cooling on local sweat rates, two kinds of experiment were carried out on eight male subjects in a climatic chamber: 1) Experiments at 36 degrees C ambient temperature with a work load of about 25 W by the right leg. 2) Experiments at 36 degrees C ambient temperature with a work load of about 25 W by the right leg as in 1., but with additional compensatory cooling of the left leg controlled throughout by heat balance calculations at 75-85 W, equal to the heat produced in the working leg, the necessary air temperature being dependent on local sweat rate. Work load without cooling brought about a significant increase in core temperatures, metabolism, heart rate and local sweat rates. With unchanged local skin temperatures local sweat rate increase was higher in the working leg. Therefore the existence of muscle thermoreceptors should be assumed, the afferent information from which is processed and weighted in a different way to that provided by skin receptors. Work load combined with additional cooling reduced local and mean skin temperatures and heart rate, but had no significant influence on core temperature or metabolism. However, local sweat rate was generally lower in both thighs, with a major reduction in the cooled leg confirming control of local sweat rate by local temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocardiography↗

Sweat electrolytes in chronic pancreatitis.

Sweat electrolytes were carried out in 84 adult patients with calcific pancreatitis, 51 with noncalcific pancreatitis, and the results compared to 37 adult controls. Of the patients with calcific pancreatitis, 33.5% had sweat sodium levels greater than 90 mEq/liter and 14.4% a level greater that 120 mEq/liter. Patients with noncalcific pancreatitis also had a high incidence of elevated sweat sodium levels. Sweat potassium levels were less discriminating, and there appeared to be high sweat calcium levels in a few patients so tested. The reasons for the elevated sweat sodium levels in pancreatitis is not readily apparent, and the possible relationship to heterozygous forms of cystic fibrosis is discussed.

Adolescent↗

Mechanisms of potentiation in sweating induced by long-term physical training.

To evaluate the mechanism of potentiation of sweating after long-term physical training, we compared sweating function in trained and untrained subjects using the frequency of sweat expulsion (fsw) as an indicator of central sudomotor activity. Nine trained male subjects (trained group) and eight untrained male subjects (untrained group) performed 30-min cycle exercise at 35% maximal oxygen uptake at 25 degrees C ambient temperature and 35% relative humidity. Oesophageal temperature (T(oes)), mean body temperature (Tb), chest sweating rate (msw,chest), forearm sweating rate (msw,forearm), and fsw were measured. The slopes of the msw,chest versus body temperature (T(oes) and Tb) and versus fsw relationships in the trained group were significantly greater than those in the untrained group (both, P < 0.05), while there was no difference between the groups in the slopes of the msw,forearm versus body temperature or versus fsw relationships. Neither the body temperature threshold for initiation of chest or forearm sweating nor the slope of the fsw-Tb relationship differed between groups. We concluded that, during light exercise at moderate ambient temperature, the msw,chest in the subjects who had undergone long-term physical training was greater than that in the untrained subjects while the msw,forearm was not changed. The greater msw,chest in the trained subjects was concluded to be due to an increase of sensitivity of peripheral mechanisms.

Adult↗

The effects of vasoactive intestinal polypeptide and substance P on methacholine-induced sweating and vascular flare in diabetic neuropathy.

Vasoactive intestinal polypeptide (VIP) and substance P (SP) immunoreactivity are reduced in the cutaneous nerves of diabetic patients with peripheral neuropathy. The functional significance of this finding was studied by measuring the forearm sweat response to intradermal methacholine and the effect of coadministration of VIP and SP in six normal subjects, and in six diabetic patients with neuropathy and eight without. Flare responses to the two peptides were also measured. Methacholine-induced sweat output was significantly greater in neuropathic patients compared with the other groups (p < 0.05), suggesting upper limb denervation supersensitivity. VIP and SP alone did not evoke sweating in any subject. Injection of VIP or SP reduced methacholine-induced sweating to a similar degree in all groups, except that the reduction was smaller in the non-neuropathic group than in the others (p = 0.028 versus normal subjects, p = 0.014 versus neuropathic diabetic patients). Flare responses to the peptides were markedly reduced in the neuropathic patients compared with the other groups (p < 0.01). In neuropathic patients, increased sweat responses and decreased flare coexist with diminished neurophysiological measurements; cutaneous sweating and flare responses provide valuable additional information to conventional methods of neurological assessment in diabetic neuropathy.

Adult↗

Impairment of calcitonin gene-related peptide-induced potentiation of cholinergic sweat secretion in patients with multiple system atrophy.

Loss of sweating is a characteristic feature of multiple system atrophy (MSA) with autonomic failure, and widespread anhidrosis may lead to hyperthermia and collapse in a hot environment. Calcitonin gene-related peptide (CGRP) is present in the periglandular nerves around sweat glands and is a strong stimulant of methacholine (MCH)-mediated cholinergic sweating. The present study evaluated CGRP-related regulation of cholinergic sweating in patients with MSA. CGRP-induced potentiation of MCH-mediated cholinergic sweating was significantly reduced in MSA patients as compared with normal age-matched controls. These results suggest that regulation of sweating is extensively affected in MSA as a consequence of peptidergic dysfunction.

Autonomic Nervous System Diseases↗

Sweating dysfunctions in Parkinson's disease.

There is a high frequency of dyshidrosis in Parkinson's disease. Daily use of an antiparkinsonian drug does not affect sweating. Mental sweating relates to the contraction period and seriousness. However, hyperthermic sweating does not necessarily relate to the contraction period or seriousness. Abnormalities in mental sweating are not necessarily correlated with cardiovascular autonomic disturbances. As the autonomic disturbance becomes more advanced, dyshidrosis becomes more common. Hyperhidrosis may develop with dyskinesia. Hyperhidrosis may be improved by the temporally administration of levodopa. Dyshidrosis might be caused by a centrally-acting abnormality during its early stage. However, postganglional abnormalities as well as central changes may increase as the disease progresses. The presence of dyshidrosis affects the QOL and depression in patients with Parkinson's disease. The only therapy for hyperhydrotic sweating disorders is the administration of levodopa or dopaminagonist. Additional studies including therapy for sweating disorders are necessary.

Humans↗

Effect of cold ambient temperature on palmar sweating response to vibration stress.

We investigated the effect of cold ambient temperature on the palmar sweating response to vibration stress. Ten healthy, male subjects were exposed to eight ambient temperatures (5, 7, 10, 14, 18, 22, 24 and 28 degrees C). At each ambient temperature, each subject gripped the handle of a vibration generator with his left hand with a grasp strength of 49 N. This hand was then exposed to a 125-Hz sinusoidal vibration with an acceleration of 50 m/s(2) (rms) for 3 min at each ambient temperature. Palmar sweating and skin temperature were measured simultaneously on the palm and the fourth finger, respectively, of the subjects' right palm. The palmar sweating response showed a significant change among eight ambient temperatures. The palmar sweating measured at an ambient temperature of 5 degrees C was found to be significantly larger than those measured at 10, 14, 18, 22, 24 and 28 degrees C. Vibration exposure caused a significant increase in the palmar sweating response. Our results suggest that a cold environment plays a significant role in the palmar sweating response to vibration stress.

Adult↗

Sweat distribution before and after repeated heat exposure.

We investigated the impact of short-term, moderate humidity heat acclimation upon sweat distribution. Eight males completed six daily heat exposures [cycling: ambient temperature 39.5 (0.2) degrees C, relative humidity 59.2 (0.8)%], during which auditory canal temperature (T(ac)) was maintained 1.4 degrees C above pre-exposure levels for 70 min by manipulating the work rate. On days 1 and 6, T(ac) and local sweat rates (m(sw): eight sites) were monitored. The pre-exposure, resting T(ac) and the T(ac) sweat threshold decreased from day 1 to day 6 [36.83 (0.05) degrees C vs 36.62 (0.05) degrees C, and 36.90 (0.05) degrees C vs 36.75 (0.05) degrees C, respectively; both P < 0.05]. However, the sweat-onset time, sweat sensitivity (delta m(sw)/deltaT(ac)) and established m(sw) were unaltered (P > 0.05). There was also no evidence of a post-acclimation redistribution in established m(sw) between the eight skin regions, though both the sweat sensitivity and established m(sw) for the forehead and hand were significantly greater than at the remaining sites (P < 0.05). It is concluded that the 5-day heat acclimation regimen provided only a minimal stimulus for sudomotor adaptation.

Adaptation, Physiological↗

Negative sweat test in hypertrypsinaemic infants with cystic fibrosis carrying rare CFTR mutations.

UNLABELLED: Persistent hypertrypsinaemia in newborn screening for cystic fibrosis (CF) recognises subjects at high risk to be affected. Diagnosis is confirmed by a positive sweat test and/or by the presence of two mutations in the cystic fibrosis transmembrane regulator gene. The aim of the present study was to evaluate the occurrence of a negative sweat test (chloride < 60 mmol/l) during the first months of life, in hypertrypsinaemic infants, which would lead to a delayed diagnosis. We reviewed clinical charts of CF patients born between January 1993 and September 1998, when the neonatal screening programme consisted of an immunoreactive trypsinogen (IRT)/DNA (F508del) + IRT strategy. Laboratory and clinical data were collected for patients diagnosed after 12 months of life. Out of 446,492 newborns, 104 CF patients were diagnosed giving an overall incidence of 1:4293. Of these, six had a blood IRT level above the cut off value (99th percentile) and a negative sweat test in the first trimester of life. At a mean age of 3.5years, the patients were again referred to our CF Centre for re-evaluation in order to confirm or exclude the disorder. Molecular analysis identified the following genotypes: F508del/A309D, F508del/3849 + 10kbC-->T, F508del/R117H (in two patients), R117H/ L997F, and F508del/R117L. CONCLUSION: Infants with cystic fibrosis bearing a spectrum of mild cystic fibrosis transmembrane regulator gene mutations may present as hypertrypsinaemic newborns with a sweat chloride within the normal range. Reference values for normal sweat test during the first months of life should be revised. A wide molecular genetic analysis is recommended for newborns presenting persistent hypertrypsinaemia and a sweat test result > 30 mmol/l in order to diagnose atypical forms of the disease.

Child↗

Exercise- and methylcholine-induced sweating responses in older and younger men: effect of heat acclimation and aerobic fitness.

The purpose of this investigation was to examine the effects of aging and aerobic fitness on exercise- and methylcholine-induced sweating responses during heat acclimation. Five younger [Y group-age: 23 +/- 1 (SEM) years; maximal oxygen consumption (VO2max): 47 +/- 3 ml.kg-1.min-1], four highly fit older (HO group- 63 +/- 3 years; 48 +/- 4 ml.kg-1.min-1) and five normally fit older men (NO group -67 +/- 3 years; 30 +/- 1 ml.kg-1.min-1) who were matched for height, body mass and percentage fat, were heat acclimated by daily cycle exercise (approximately 35% VO2max for 90 min) in a hot (43 degrees C, 30% RH) environment for 8 days. The heat acclimation regimen increased performance time, lowered final rectal temperature (Tre) and percentage maximal heart rate (%HRmax), improved thermal comfort and decreased sweat sodium concentration similarly in all groups. Although total body sweating rates (Msw) during acclimation were significantly greater in the Y and HO groups than in the NO group (P < 0.01) (because of the lower absolute workload in the NO group), the Msw did not change in all groups with the acclimation sessions. Neither were local sweating rates (msw) on chest, back, forearm and thigh changed in all groups by the acclimation. The HO group presented greater forearm msw (30-90 min) values and the Y group had greater back and thigh msw (early in exercise) values, compared to the other groups (P < 0.001). In a methylcholine injection test on days immediately before and after the acclimation, the order of sweat output per gland (SGO) on chest, back and thigh was Y > HO > NO, and on the forearm Y = HO > NO. No group differences were observed for activated sweat gland density at any site. The SGO at the respective sites increased in the post-acclimation test regardless of group (P < 0.01), but on the thigh the magnitude of the increase was lower in the NO (P < 0.02) and HO (P = 0.07) groups than in the Y group. These findings suggest that heat tolerance and the improvement with acclimation are little impaired not only in highly fit older but also normally fit older men, when the subjects exercised at the same relative exercise intensity. Furthermore, the changes induced by acclimation appear associated with an age-related decrease in VO2max. However methylcholine-activated SGO and the magnitude of improvement of SGO with acclimation are related not only to VO2max but also to aging, suggesting that sensitivity to cholinergic stimulation decreases with aging.

Adaptation, Physiological↗

Serum CA 19-9 levels as a diagnostic marker in cystic fibrosis patients with borderline sweat tests.

Patients with normal or borderline sweat tests present a diagnostic challenge. In spite of the availability of genetic analysis and measurement of nasal potential difference, there is still uncertainty in diagnosing cystic fibrosis in some patients. CA 19-9 is a tumor-associated antigen whose levels were previously found to be elevated in some cystic fibrosis patients. We investigated whether serum CA 19-9 levels can contribute to establishing the diagnosis of cystic fibrosis in patients with a borderline sweat test, and evaluated the influence of different clinical variables on CA 19-9 levels. Serum CA 19-9 levels were measured in 82 cystic fibrosis patients grouped according to their genotype and in 38 healthy individuals. Group A included 50 patients who carried two mutations previously found to be associated with a pathological sweat test and pancreatic insufficiency (DeltaF508, W1282X, G542X, N1303K, and S549R). Group B included 13 compound heterozygote cystic fibrosis patients who carried one mutation known to cause mild disease with a borderline or normal sweat test and pancreatic sufficiency (3849+10kb C-->T, 5T). Group C included 38 normal controls. Nineteen cystic fibrosis patients carried at least one unidentified mutation. An association between CA 19-9 levels and age, pulmonary function, pancreatic status, sweat chloride, previous pancreatitis, serum lipase, meconium ileus, distal intestinal obstruction, liver disease, and diabetes was investigated. The distribution of CA 19-9 levels was significantly different between the three groups ( p<0.01); high CA 19-9 levels were found in 60% (30/50) of group Apatients and in 46.6% (6/13) of group B patients, but in only 5.2% (2/38) of the controls. CA 19-9 levels were inversely related to forced expiratory volume in 1 s, while no association was found with the other clinical parameters examined. Our findings suggest that the serum CA 19-9 in cystic fibrosis patients originates in the respiratory system, and has a useful ancillary role, particularly when diagnostic uncertainty exists. Hence, the diagnosis of cystic fibrosis should be considered in patients with borderline sweat tests and high CA 19-9 levels, but normal levels do not exclude cystic fibrosis.

Adolescent↗

The use of sweat to monitor lead absorption through the skin.

It is usually assumed that lead can be absorbed through the skin only if it is present as an organolead compound such as tetraethyllead or lead naphthanate. It has been found, however, that finely-powdered lead metal or lead nitrate solution placed on the skin results in rapid absorption of lead, and transport of the metal around the body. The absorbed lead appears in sweat and saliva, but not in blood or urine. The application of 6 mg of lead as 0.5 M lead nitrate to the left arm resulted in an increase in lead concentration in pilocarpine-induced iontophoresis sweat samples taken from the right arm, from an initial value of 15-25 micrograms Pbl-1 to greater than 300 micrograms Pbl-1 after 2 days. Saliva lead increased from 2.5 to 15 micrograms Pbl-1 in the same period. The rate of lead absorption through the skin increases with increased sweating of the skin. Since no measurable increase in blood lead has been found, the lead must be transported in the plasma and rapidly concentrated into the extracellular fluid pool (sweat and saliva), without significant uptake by the erythrocytes, and with a very low transient concentration in the plasma. Workers occupationally exposed to lead have extremely high levels of lead in sweat even though their lead in blood is only moderately elevated. Lead absorbed through the skin may be eliminated via sweat and other extracellular fluids, and hence not be as great a health hazard as ingested lead, but this will need to be proved by further studies.

Environmental Pollution↗

Neurodegeneration in sweat glands and skin of aged rats.

In order to compare age-associated neurodegenerative changes in peripheral nerves of laboratory mammals and humans, we have investigated the density and pattern of different nerve populations innervating sweat glands of ageing rats and compared our results with a previous study of the innervation of human sweat glands. We have also studied age-changes in subepidermal afferent nerves that may be involved in reflex activation of sweat glands. Total nerve density, measured by immunohistochemical staining for the general neuronal marker, protein gene product (PGP9.5) and image analysis, showed a significant decline around secretory coils of sweat glands of old compared to young rats. Marked reductions of acetylcholinesterase (AChE) histochemical staining and of vasoactive intestinal polypeptide (VIP)- and calcitonin gene-related peptide (CGRP)-like immunoreactivity were observed in nerves around sweat glands. In the sub-epidermis, PGP- and CGRP-like immunoreactive nerves were significantly reduced in old rats. The age-related changes in sweat gland innervation of old rats were comparable to those reported in elderly human subjects suggesting that these tissues may provide a suitable model for experimental studies of neuronal ageing.

Acetylcholinesterase↗

Sweating in the intact ox and isolated perfused ox skin.

1. Heated, intact oxen discharged sweat as a steady continuous output rising abruptly and synchronously approximately every 5 min. 2. I.V. adrenaline (Adr) or large doses of phenylephrine (PhE) induced sweating but isoprenaline (Isop) did not. 3. In isolated perfused skin, alpha-adrenergic drugs induced sweating which was blocked by phentolamine. 4. Vasodilator drugs reduced the sweat output induced by Adr, whereas the beta-antagonist propranolol increased it. These effects were possibly due to microvascular changes. 5. Natural fluctuations in sweat rate seem likely to be due to contraction of sweat gland myoepithelium, but it is uncertain whether myoepithelial contraction was ever induced by drugs.

Animals↗

Biologically active interleukin 1 in human eccrine sweat: site-dependent variations in alpha/beta ratios and stress-induced increased excretion.

Human eccrine sweat devoid of epidermal protein contamination was collected from palms, soles, and different sites on the trunk. Interleukin 1 alpha (IL 1 alpha) and interleukin 1 beta (IL 1 beta) content were analyzed for immunoreactivity by enzymo-immunoassay and immunoblotting and for bioactivity by the stimulation of prostaglandin E2 (PGE2) production in human dermal fibroblasts. The bioassay was validated by using blocking antibodies against IL 1 alpha and beta. All sweat samples were found to contain significant amounts of immunoreactive and biologically active IL 1. The immunoreactive forms were at 17 kDa as shown by immunoblotting analysis, indicating that they were mature (secreted), undegraded IL 1 peptides. Whereas IL 1 alpha was detectable in sweat samples obtained from both truncal and palmo-plantar regions, IL 1 beta was only detectable in the sweat of palms and soles (IL 1 alpha/beta ratio greater than 700 in trunk and 5.4 in palms and soles) indicating a site-dependent difference in the excretion of the two IL 1 molecules. IL 1 concentration was high in spontaneous (IL 1 alpha, 3.7; IL 1 beta, 0.3 ng/mL) and pilocarpine induced sweat (IL 1 alpha, 3.9; IL 1 beta, 1.2 ng/mL), and it was much increased during jogging and sauna (IL 1 alpha, 22.6; IL 1 beta, 3.3 ng/mL). This does not appear to represent an excretory process aimed at clearing blood IL 1, but rather a stress-induced increased production of IL 1 by sweat gland cells.

Adult↗

Low and high frequency acupuncture stimulation inhibits mental stress-induced sweating in humans via different mechanisms.

The effects of acupuncture stimulation at 5 Hz and 100 Hz on mental stress-induced sweating were analyzed, and the mechanisms involved were examined using the rate of sweat expulsion as an estimate of central sudomotor outflow. Mental arithmetic was imposed on 25 young healthy volunteers for 2 min before, during and after the stimulation. Acupuncture stimulation was delivered to either the Zusanli (leg) or Hegu (hand) acupoint, and the sweat rate was measured quantitatively during mental arithmetic on the palm or the sole, respectively. When stimulation at 5 Hz was applied to the Zusanli acupoint, the palmar sweat rate (paSR), rate of sweat expulsion (Fsw) and paSR/Fsw were reduced during the stimulation, whereas when it was applied to the Hegu acupoint, plantar SR (plSR) and Fsw were reduced, but plSR/Fsw was not altered. When stimulation at 100 Hz was applied to Zusanli, paSR and paSR/Fsw were reduced, but Fsw was unchanged whereas when it was applied to Hegu, neither plSR, Fsw nor plSR/Fsw was altered. The results suggest that acupuncture stimulation at 5 Hz affects both the supraspinal rhythm-generating mechanism and the mechanisms situated below (probably the spinal cord), whereas stimulation at 100 Hz only affects the mechanisms below the rhythm-generating mechanism. Thus, acupuncture stimulation at 5 Hz and at 100 Hz may reduce mental stress-induced sweating through different mechanisms.

Acupuncture↗