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PubMed1986

Increased sweat sulfate concentrations in chronic renal failure.

Inorganic sulfate concentrations are markedly elevated in patients with chronic renal failure (CRF). During hemodialysis, sulfate is removed and circulating levels drop significantly, while chloride concentrations remain relatively constant. We measured sulfate and chloride in sweat from CRF patients collected by pilocarpine iontophoresis. Sweat sulfate concentrations in uremic patients were significantly increased (404 +/- 43 vs. 105 +/- 6 microM in 22 controls). The correlation between plasma and sweat SO4 concentrations in CRF patients was significant (r = 0.77, P less than 0.01). However, the fractional excretion of sulfate in sweat (the sweat/serum ratio) was close to that of chloride (0.26 +/- 0.01 vs. 0.19 +/- 0.02) and was essentially the same before and after dialysis (0.20 +/- 0.01 vs 0.23 +/- 0.01) despite the significant absolute change in the extracellular SO4 concentration (from 2,018 +/- 153 to 709 +/- 21 microM) and no change in chloride concentrations. In patients with CRF, we conclude that the handling of inorganic sulfate by the sweat gland is not significantly different from that for chloride. Hemodialysis reduces absolute sulfate excretion markedly and thus may reduce the likelihood of forming calcium sulfate complexes in the sweat secretions. This could be a significant factor in the dialysis-related pruritus that has been ascribed to excess calcium deposition in the skin.

Adolescent↗

PubMed1985

Coulometric titration of sweat collected with the Webster Collection System.

Presented here are chloride results obtained by direct titration of undiluted sweat collected with the Webster Sweat Collection System. Six hundred and thirty-two sweat chloride results were reported on 604 patients. Thirty-six of thirty-nine sweat chloride results of 60 mM or greater were from patients with cystic fibrosis. Three results (61, 63 and 64 mM) were from a 12-year-old female who had one episode of rectal prolapse but after one year does not have clinical evidence of cystic fibrosis. There was one patient with a cystic fibrosis variant with intermediate range sweat chloride. All others in the intermediate range (40-59 mM) did not have cystic fibrosis. One patient with a sweat chloride reported of less than 40 mM was subsequently found to have cystic fibrosis at another institution.

Chlorides↗

PubMed1974

Role of sweat in accumulation of orally administered griseofulvin in skin.

Griseofulvin, an orally effective antimicrobial agent, appears in the stratum corneum within 4-8 h after oral administration. Griseofulvin distribution was found to be highest in the outermost layers of the stratum corneum (level I, 20.8+/-1.5 ng/mg) and lowest inside (level II, 10.0+/-1.5; level III, 7.5+/-2.2 ng/mg). In order to study the precise mechanism of griseofulvin transfer to stratum corneum, the role of sweat in the accumulation of griseofulvin was considered. Heat-induced total body sweating decreased the mean stratum corneum concentration of griseofulvin by 55%, and 200-300 ng of griseofulvin accumulated per ml of sweat. A silicone hydrophobic resin was used to differentiate between "wash-off" and carrier properties of sweat for griseofulvin. Prevention of transepidermal water and sweat loss by (a) topical application of formaldehyde-releasing cream to one palm, (b) occlusion by a 2 x 2-cm patch on one arm, and (c) wearing a rubber glove for 24 h, showed a lower griseofulvin concentration when compared to control areas in the same subjects. The results of the gloved hand experiment show that a complete equilibrium is established at all three levels of stratum corneum, thereby removing the reversed gradient. These results support the hypothesis that a "wick effect" is responsible for the observed reversed drug gradient within the stratum corneum. The results of the experiments suggest that sweat and transepidermal fluid loss play an important role in griseofulvin transfer in stratum corneum.

Administration, Oral↗

PubMed1977

Phantom sweating.

Phantom sweating is a sensation in which the patient feels that sweat is about to burst out of skin pores, but in which sweating never actually occurs. In a series of 100 patients undergoing bilateral upper dorsal sympathectomy for palmar hyperihidrosis, 82 patients were specifically questioned and 48 (59%) reported phantom sweating. Phantom sweating started soon after the operation, was triggered by the same stimuli that caused hyperhidrosis preoperatively, lasted for a few seconds, and tended to diminish with time. In an average follow-up of 18 months, the phenomenon disappeared in 11 patients (23%). Phantom sweating is probably a symptom of residual sympathetic activity.

Follow-Up Studies↗

PubMed1991

Development and evaluation of the simultaneous determination of sweat sodium and chloride by ion-selective electrodes.

A method for the simultaneous determination of sweat sodium and chloride was developed and evaluated using a Monarch 2000 centrifugal analyser with ion-selective electrodes. In order to measure sodium and chloride in diluted sweat samples and sweat paper eluates an analytical working range of below 10 mmol/L was required. This was achieved by modification of the Monarch ISE software parameters for urine electrolytes together with the use of calibrators within this range. Evaluation of the method has included linearity, recovery and precision studies and the correlation between ion-selective electrode and flame photometry for sweat sodium and between ion-selective electrode and a continuous flow method for sweat chloride. Of the patients studied so far, there has been good discrimination in sweat electrolytes between those with and without cystic fibrosis.

Centrifugation↗

PubMed1994

The analysis of metabolites in human sweat: analytical methods and potential application to investigation of pressure ischaemia of soft tissues.

A straightforward technique was developed for sweat collection applicable to tissues subjected to external load without introducing distortion of underlying tissues, and for analysis of six metabolites in the collected sweat. Chloride was measured colorimetrically and lactate, urea and urate by enzymatic methods on a centrifugal analyser. Sodium and potassium were measured by flame photometry. The methods showed good precision, recovery and linearity. To assess the technique sweat was collected: (i) from the sacrum, ischium, forearm and calf in healthy individuals at 32 degrees C for 1 h; (ii) from the sacrum of healthy subjects at ambient temperature for 9 h; (iii) at ambient temperature from the sacrum of a patient with a history of pressure sores. Sweat rates were greater at the sacrum and ischium than the calf or forearm. There were differences in the concentrations of lactate and urea between sites but these were smaller when expressed as amount secreted. Sweat rates were significantly lower in groups (ii) and (iii), but sweat could be collected reliably. This technique has potential clinical application to the investigation of susceptibility to pressure sores.

Adult↗

PubMed1984

Evaluation of a paper-patch test for sweat chloride determination.

This article evaluates a recently developed qualitative sweat patch test (SPT). A battery-powered stimulator with polymer pad electrodes is used to stimulate sweating, followed by the application of a paper patch which collects the sweat and shows color change on sweat chloride levels above 40 to 50 mEq/l. Our data consist of 66 patients with cystic fibrosis, 75 control subjects, and 37 relatives of patients with cystic fibrosis, excluding 22 subjects (11%) with insufficient sweat. There were no false-negative results among 66 patients with cystic fibrosis, and in the control group, 71 of 75 subjects gave negative results and the other four gave positive results. Of the 37 relatives, eight gave positive results; all of the eight subjects are parents of patients with cystic fibrosis. Our results indicate that SPT is useful and reliable when there is sufficient sweat. This portable and simple patch test may serve as an excellent screening test for cystic fibrosis.

Adolescent↗

PubMed1997

Nasal potential difference in cystic fibrosis patients presenting borderline sweat test.

The diagnosis of cystic fibrosis (CF) can be difficult if the sweat test and routine deoxyribonucleic acid (DNA) analysis are inconclusive. Under these circumstances, measurement of nasal potential difference (NPD) was proposed as a complementary diagnostic tool, as demonstrated in subjects bearing the G551S or 3849+10KbC-->T mutations. The purpose of the present study was to verify the diagnostic value of this technique in CF patients with a borderline sweat test. NPD was measured in 18 patients with a borderline sweat test, in whom CF diagnosis was based on the presence of one CF gene mutation in each chromosome (CF borderline). These patients were compared both to non-CF controls and CF patients with an abnormal sweat test (CF controls). Basal NPD values of CF borderline patients (mean value -39+/-6 mV, range -29 to -52 mV; n=18) were in the pathological range of CF controls (-39+/-8 mV, range -28 to -57 mV; n=37), and both were statistically different from values obtained in non-CF controls (-15+/-4 mV, range -6 to -23 mV; n=24; p<0.0001). Mutation analysis confirmed a high frequency of the 3849+10KbC-->T mutation in this group of CF borderline patients (positive in 14 out of 18 subjects), whereas other mutations, such as AF508, Q552X, N1303K and R1162X, were also found to be associated with this atypical CF phenotype. These results confirm the presence of pathological values of basal NPD in CF patients with borderline sweat test, and also extend this finding to subjects bearing genotypes other than the G551S and 3849+10KbC-->T mutations. The present findings, therefore, confirm the usefulness of measurement of basal nasal potential difference in all those patients in whom diagnosis of cystic fibrosis can be suspected but the sweat test remains inconclusive.

Adolescent↗

PubMed2002

Biological variation in sweat sodium chloride conductivity.

BACKGROUND: Sweat conductivity, which is equivalent to sweat NaCl concentration, is used as a screening test to identify possible cystic fibrosis (CF) patients. No data exist on the biological variation of this variable and the influence it may have on the interpretation of sweat testing. The aim of this study was to determine the components of biological variation for sweat sodium chloride conductivity and to apply biological variation parameters in the interpretation of sweat conductivity. METHODS: Sweat conductivity was determined once a week for 5 consecutive weeks on 15 healthy volunteers, 20 healthy infants and 20 known CF patients. RESULTS: The analytical coefficient of variation (CV(A)) was 1.15% for the high-level control material, with a value of 123 mmol/L, and 1.32% for the normal-level control material with a value of 40 mmoL/L. The within-subject (CV) and between-subject (CV(G)) biological variations were 12.0% and 30.0%, respectively, for healthy controls; 18% and 20% for healthy infants; and 7.3% and 6.5% for CF patients, respectively. Using the CV(A), CV(G) and CV(I), the 95% reference ranges were determined for the above-mentioned three groups. The calculated 95% ranges for the healthy babies and CF patients were 18-60 mmoL/L and 96-144 mmoL/L. CONCLUSIONS: Our data support a decision level of > 60 mmoL/L for confirmatory CF testing. A lower decision level will result in an unacceptable high rate of unnecessary confirmation testing.

Adolescent↗

PubMed2004

Validated gas chromatographic-negative ion chemical ionization mass spectrometric method for delta(9)-tetrahydrocannabinol in sweat patches.

BACKGROUND: A sensitive gas chromatography-negative ion chemical ionization mass spectrometry (GC/MS-NICI) method was developed and validated for the measurement of Delta(9)-tetrahydrocannabinol (THC) in human sweat patches. METHODS: THC-d(0) and THC-d(3) were added to worn blank sweat patches (PharmChek; PharmChem Incorporated) and extracted with 3 mL of methanol-0.2 mol/L sodium acetate buffer (pH 5.0, 3:1 by volume) on a reciprocating shaker at ambient temperature for 30 min. Extracted solution (2 mL) was diluted with 8 mL of 0.1 mol/L sodium acetate buffer (pH 4.5) and extracted by use of solid-phase extraction columns (CleanScreen; United Chemical Technologies). Dried extracts were derivatized with trifluoroacetic acid and analyzed with an Agilent 6890 gas chromatograph interfaced with an Agilent 5973 mass selective detector operated in NICI-selected ion-monitoring mode. RESULTS: The lower limits of detection and quantification for THC in human sweat were 0.2 and 0.4 ng/patch, respectively. The calibration curve was linear from 0.4 to 10 ng/patch (R(2) >0.995). Overall recovery of THC from blank worn patches to which 0.6, 4.0, and 8.0 ng of THC had been added was 44-46%. Assay imprecision, expressed as CV, was <10% for 0.6, 4.0, and 8.0 ng/patch quality-control samples. Twenty-one potential interfering compounds (50 ng/patch) added to low quality-control samples (0.6 ng/patch) did not influence THC quantification. CONCLUSIONS: This GC/MS-NICI assay for THC in human sweat provides adequate sensitivity and performance characteristics for analyzing THC in sweat patches and meets the requirements of the proposed Substance Abuse and Mental Health Administration's guidelines for sweat testing.

Calibration↗

PubMed2001

Excretion of sweat and urine pyridinoline crosslinks in healthy controls and subjects with established metabolic bone disease.

Convenient techniques for measuring rates of bone turnover have been developed in recent years with the advent of biochemical markers of bone metabolism. One recent of these techniques is a collection method and quantitative enzyme immunoassay for free pyridinoline crosslinks in human sweat. The concentrations of pyridinoline crosslinks in 5-day sweat collections and first morning void and 24-hour urine collections from healthy subjects and subjects with established metabolic bone disorders were determined. T-scores were higher in the sweat system than in the urine system by up to 10-fold in postmenopausal subjects, women with hyperparathyroidism, and subjects with postmenopausal osteoporosis. For subjects with postmenopausal osteoporosis, receiver-operating characteristic curve analysis yielded areas under the curve of 0.699, 0.629, and 0.520 for sweat pyridinoline, first morning void urine pyridinoline, and 24 hour urine pyridinoline respectively. The areas under the curve of the sweat and first morning void urine measurements were significantly greater (p<0.05) than the 24-hour pyridinoline measurements. Healthy postmenopausal subjects and subjects with postmenopausal osteoporosis were monitored before and during estrogen replacement therapy or alendronate therapy. Sweat pyridinoline values declined by 49.0 +/- 12.4% and 19.4 +/- 19.9% for estrogen and alendronate subjects respectively. We conclude that this non-invasive technique is a sensitive and specific measure of bone resorption and is appropriate as an adjunct to techniques such as bone density and may also be useful in monitoring of response to anti-resorptive therapies.

Adult↗

PubMed1990

Sweat protein components tested by SDS-polyacrylamide gel electrophoresis followed by immunoblotting.

Sweat samples were collected in a sauna from 74 healthy volunteers (72 men and 2 women) and concentrated. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) of the individual samples revealed, in general, five main proteins and four PAS positive components. In pooled sweat, a method of SDS-PAGE followed by immunoblotting with specific antisera or antibodies against 24 human serum components was applied, and three out of the five main proteins showed the same molecular weights and antigenicities corresponding to serum albumin (67,000 Da), Zn-alpha 2-glycoprotein (42,000 Da) and lysozyme (14,000 Da). Moreover, orosomucoid, transferrin, IgG and IgA were demonstrated in the pooled sweat. Although alpha 1-antitrypsin was probably in the pooled sweat, other serum components could not be detected. On the pooled and individual sweat samples, anti-carcinoembryonic antigen (CEA) formed three bands at 42,000, 19,000 and 18,000 Da, but the antibody did not react with normal serum. It might be considered from these molecular weights that those sweat components are CEA-related antigens.

Adult↗

PubMed1995

The sweating responses of athletes trained on land and in water.

In order to examine whether different sweating responses of athletes trained on land and in water may be ascribed to changes in the central sudomotor mechanisms and/or those of the peripheral mechanisms of sweat glands, we measured the local sweating rate at the left forearm (mswf) and the left scapula (msws), the frequence of sweat expulsion (Fsw) and body temperatures (mean skin temperature and rectal temperature: Tre) in six runners and five soccer players (R group) and six swimmers (S group) during progressive thermal stress at rest (2 degrees C increase in ambient temperature every 15 min from 35 to 45 degrees C RH = 30-40%). Tre and heart rate at the end of experiment did not differ significantly between the groups (37.31 +/- 0.04 degrees C, 74.5 +/- 7.9 beats.min-1 in the S group and 37.27 +/- 0.07 degrees C, 71.1 +/- 9.0 beats.min-1 in the R group, respectively). The msws and mswf at any given mean body temperature (Tb) were greater in the S group than in the R group. Although the regression line showing the relationship between Fsw and Tb in the S group was shifted to the left of that in the R group, there was no significant difference in the slope of the lines. The msws-Fsw or mswf-Fsw regression line was not different between the two groups. These results indicate that the higher sweating rate in the S group may be ascribed to a difference in the centrally derived sudomotor neural activity, but not to that in the peripheral mechanisms of sweat gland activity.

Adult↗

PubMed1988

The sweat chloride concentration and prolactin activity in cystic fibrosis.

The purpose of this study was to elucidate the possible relationship between defective PRL and elevated sweat Cl in CF patients. Full thickness human skin was grafted onto the back of immunoincompetent, nude congenitally athymic mice. This study indicated: 1) that when skin from CF patients with high sweat chloride concentrations was grafted, the chloride concentration of sweat from the grafts was the same as of sweat from grafts of normal skin; and 2) that administration of anti-hPRL to the mice bearing the CF grafts did not increase the chloride concentration of the sweat as it had in normal skin grafts. 3) that CF may involve defective PRL production leading to failure of regulation of Cl channels in affected epithelia, 4) that the athymic mouse is a useful model for studying PRL activity in the pathophysiology of sweating of CF patients.

Animals↗

PubMed2002

Frequency dependence of hand-arm vibration on palmar sweating response.

OBJECTIVES: This study attempted to elucidate the effects of hand-arm vibration frequency on palmar sweating response. METHODS: Palmar sweating was measured before and during vibration exposure on the right palm of six healthy men. The left hand was exposed for 3 minutes to the following root mean square (rms) acceleration magnitudes and frequencies of vibration: 5 m/s2 at 31.5 Hz, 10 m/s2 at 63 Hz, 20 m/s2 at 125 Hz, 40 m/s2 at 250 Hz, and 50 m/s2 at 315 Hz. According to international standard ISO 5349, these vibration levels generate the same frequency-weighted acceleration magnitude of 2.5 m/s2 rms. A control condition consisted of grasping a handle without vibration. As the index of the activated central nervous system, plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) was measured before and immediately after each vibration exposure. RESULTS: Each condition of vibration induced a palmar sweating response. Among the six vibration conditions, vibration of 125 Hz and 63 Hz caused large palmar sweating responses compared with those of 315 Hz andthe control condition. Plasma MHPG did not increase significantly after either vibrationexposure. CONCLUSIONS: The palmar sweating response to vibration with the same frequency-weightedacceleration magnitude suggested dependency on frequency. The study suggests that the somatosympathetic reflex is associated with different palmar sweating responses.

Adult↗

PubMed2001

Assessment of sweat-testing practices for the diagnosis of cystic fibrosis.

OBJECTIVE: To describe the results of the College of American Pathologists survey questions assessing the current practice of sweat testing in North America and to identify areas in which improvement is needed. DATA SOURCE: Results of the supplemental questions to the SW-B 2000 survey. STUDY SELECTION: Supplemental questions were designed to assess variation in sweat collection, analysis, and interpretation. DATA EXTRACTION: Extractions of the data were made based on the relevance of the data to the objectives of the review. DATA SYNTHESIS: The majority of laboratories surveyed performed sweat testing according to the procedures described in the National Committee for Clinical Laboratory Standards' document. The study revealed that a number of laboratories have adopted poor practice standards and are potentially compromising patient care. Areas of concern include the number of laboratories performing few sweat tests per year, the persistence of unreliable methodology, misunderstanding of collection parameters, lack of patient education, and erroneous result reporting. CONCLUSIONS: The study identified areas of concern toward which educational efforts can be directed. Such efforts include the development of a College of American Pathologists accreditation checklist for sweat testing and targeted responses in the sweat analysis participant summary report.

Chemistry, Clinical↗

PubMed1999

Sweat ethanol concentrations are highly correlated with co-existing blood values in humans.

This study compared the concentration of ethanol, both absolute and relative to water content, in sweat and blood. Ten male volunteers consumed approximately 13 mmol (kg body weight)-1 of ethanol. Blood and sweat samples were collected approximately 1, 2 and 3 h following ingestion. Sweat was collected following pilocarpine iontophoresis using an anaerobic technique that prevented ethanol evaporation. In addition, the water content of sweat and blood samples was determined. The correlation between sweat and blood ethanol, expressed in mmol l-1, was r = 0.98. The slope of the relationship was 0.81. When corrected for the water content in each sample, and expressed as mmoles per litre of water, the correlation remained very high (r = 0.97) while the slope increased to 1.01. These results suggest that rapid and complete equilibrium of ethanol occurs across the sweat gland epithelium.

Adult↗

PubMed2001

Sweat chloride: quantitative patch for collection and measurement.

OBJECTIVE: To compare two quantitative pilocarpine iontophoresis tests for sweat chloride. DESIGN: Simultaneous right and left arm sweat tests were done with the Gibson/Cooke and the CF quantum technologies. SETTING: Sweat tests were performed in a quality controlled cystic fibrosis (CF) sweat test laboratory by an experienced technologist at the University of Minnesota CF Center. PATIENTS: Patients referred for sweat tests as well as volunteer CF and control subjects (50 CF and 114 'normals') were tested. INTERVENTIONS: Standard procedures were used for the Gibson/Cooke test (GCST). The manufacturer of the CF quantum test (CFQT) provided factory standardized materials. MAIN OUTCOME MEASURES: Sweat chloride concentration, test time, failed tests, sensitivity, specificity, and cost. RESULTS: Duplicate test comparing the CFQT and the GCST revealed good comparability (R2 = 0.9434). Sensitivity and specificity of the two methods are comparable at about 94% and 99% respectively. Rate of failed tests was 1% for the CFQT and 15% for the GCST. The CFQT and the GCST are comparable (R2 = 0.9434). Sensitivity (94%) and specificity (99%) are the same for both tests. CONCLUSIONS: The CFQT method is equal in accuracy and reliability to the more labor-intensive and costly GCST. Advantages of the CFQT are: the small sample size required (three to ten mg), decreased operator dependence, simpler to perform, and requires less equipment. It could be used in a clinic setting to diagnose CF in patients with suggestive symptoms.

Adolescent↗