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PubMed1998

Spatial extension of sudomotor axon reflex sweating in human skin.

Acetylcholine (ACh) applied to human skin is known to elicit a sweat response, which consists of a direct muscarinergic (M3) activation of sweat glands and a nicotinic axon reflex response from sudomotor terminals. To visualize the extent of axon reflex sweating after ACh-iontophoresis, iodine starch staining was used. Iontophoresis was performed under occlusion at the peroneal aspects of the lower leg and the center of the foot dorsum of healthy volunteers (n = 10). Ten minutes after stimulation, the area of dark blue staining was recorded by a video camera. Control experiments were performed with saline, histamine, pilocarpine and nicotine iontophoresis. The stained area was measured and the maximum and minimum distance of its boundary from the edge of the iontophoresis probe was determined (maximum/minimum radius). Sizes of stained areas and maximum radii were significantly greater on the lower leg compared to the foot (P < 0.01). The median sizes of the stained areas on the leg were 14.6 cm2 and on the foot dorsum 8.0 cm2. The respective median maximum radii were 3.1 cm on the leg and 2.3 cm on the foot dorsum (median minimum, leg 1.1 cm, foot 0.8 cm). These results match microneurographic findings of innervation territories of sympathetic efferent units. Area sizes of stained skin showed a close correlation between both stimulation sites (R = 0.96, P < 0.01), i.e. the sizes of sweat responses on leg and foot show a constant relation (foot/leg = 0.57) in spite of their great interindividual variability. This novel technique of establishing sweat responses provides information on the size of sudomotor innervation territories and may be useful for clinical studies in patients with suspected impairment of sympathetic functions.

Acetylcholine↗

PubMed2003

Sweating attacks: key symptom in menopausal transition only for women?

OBJECTIVES: Aging men are not as much aware of the fact as women that they, too, undergo some kind of menopausal transition and they notice the symptoms rarely. The key symptom of "hot flushes/sweating" is undisputed among women. The objective of this paper is to compare the frequency of episodes of sweating across gender and age groups. METHODS: A sample of 500 German males and a control sample of 153 women were asked to report about the frequency of types/causes of "sweating" in the course of aging. RESULTS: Overall, the various types of sweating do not show any differences in frequency between males and females. A precipitous rise in frequency can be found in the 6th decade of life for both sexes. This applies in particular to sudden, unexpected episodes of sweating or constriction/anxiety with or without sweaty skin that occur at night (less frequently during the day), i.e. occurring without any obvious physical or mental stress. This seems to be an important symptom for the changes occurring at an age of over 50 years for both sexes. CONCLUSION: Sensations of sweating occurring suddenly and unexpectedly, especially at night, but also during the day, seem to be similarly common and men and women.

Adult↗

PubMed2001

Comparison of urine to sweat patch test results in court ordered testing.

A former cocaine and methamphetamine abuser was continuously monitored with both sweat patch and urine testing for approximately 6 months. Thirteen sweat patches were applied and collected, five were positive for cocaine and/or methamphetamine, but all the urine specimens collected were negative at the analytical cut-off levels. The high incidence of false positive sweat patch tests in relation to the sensitivity, specificity, and efficiency of the sweat patch assay is discussed. Possible mechanisms, which can lead to false positive results, are presented. The results of our study raise further questions about the preferential use of the sweat patch in detecting new episodes of drug use in formerly chronic drug users.

Adult↗

PubMed2003

Sweat conductivity and chloride titration for cystic fibrosis diagnosis in 3834 subjects.

Sweat test is the standard for cystic fibrosis (CF) diagnosis. Conductivity is an alternative method not yet approved, in spite of its good correlation with chloride concentration. The aim was to assess the capacity of sweat conductivity to discriminate between CF and non-CF subjects. Automated measurements of conductivity and chloride concentration were carried out on the same sweat samples from subjects with clinical suspicion of CF. Sweat samples from 3,834 subjects, median age 1.8 years (range 1 month-54 years) were analysed, and those with chloride titration >60 mmol/l were considered as CF patients (n=294). Conductivity median values in CF and non-CF subjects were 111 mmol/l (82-148) and 36 mmol/l (12-89), respectively. The Spearman correlation between chloride titration and conductivity was r=0.60 (P<0.001). The receiver operating characteristics (ROC) curve showed very high agreement between two methods. The best conductivity cut-off value to diagnose CF was > or =90 mmol/l (sensitivity 99.7%, specificity 100%, positive and negative predictive values of 100% and 99.97%, respectively, and kappa=0.998). Likewise, the best conductivity cut-off value to exclude CF was <75 mmol/l. The sweat conductivity method showed good correlation with chloride titration, and accurately discriminated between subjects with and without CF. In accordance with this, CF diagnosis might be confirmed for conductivity values > or =90 mmol/l and excluded for <75 mmol/l. Values between 75 and 89 mmol/l should correspond to an equivocal range. However, more studies are needed to confirm the role of conductivity in definitive CF diagnosis.

Adolescent↗

PubMed1990

Induction of sweat glands by epidermal growth factor in murine X-linked anhidrotic ectodermal dysplasia.

Tabby (Ta), a murine X-linked mutant gene, produces a syndrome of ectodermal dysplasia including anhidrosis (absence of sweat glands). Development of sweat glands is related to that of dermal ridges (dermatoglyphics) and abnormal ridges may be associated with absence of sweat glands in the human syndrome of hypohidrotic ectodermal dysplasia (HED). We have found that dermal ridges occur in normal mice but are lacking in Ta mutants. Previously we showed that epidermal growth factor (EGF) reverses delayed eyelid opening and incisor eruption in Ta mice. We now report that EGF induces development of dermal ridges and functional sweat glands in Ta/Y hemizygotes, indicating a role in mammalian morphogenesis. Ta seems to be genetically homologous to human X-linked HED, as Ta maps close to loci homologous to linkage markers of HED and the two syndromes share many traits, including absence of all or most sweat glands. Absence of these glands causes hyperpyrexia, a clinical emergency in infants with HED; reversal of the trait in the mouse homologue of the disease indicates that an important genetically determined congenital defect in humans may become treatable.

Animals↗

PubMed1977

The effect of aspirin pretreatment on the sweating response of older female subjects.

Seven healthy female volunteers (aged 50 to 67 years) have been subjected to a thermal stress and their sweat rates evaluated using hygrosensors on five different locations on their body surface. It was found that the sweating rate was highest on the forehead in all but one of the subjects with the chest being the next most prominent site for the response. Five of the subjects were restudied after aspirin pretreatment. In the presence of this drug, resting body temperature was lowered, sweating occurred at a lower oral temperature and the mean sweating rate at a standardized body temperature was significantly higher. These findings are consistent with aspirin's known pharmacological actions, although in this study the increased sweating rate have been demonstrated in afebrile subjects.

Age Factors↗

PubMed1981

Cluster headache. The sweating pattern during spontaneous attacks.

Sweating in the forehead, on the eyelids, in the face and on the trunk was measured with the Evaporimeter during 31 spontaneous cluster headache attacks of varying severity in 18 patients. The evaporimeter measures evaporative water loss (sweating + transepidermal water loss) rapidly and accurately as g/m2/h. The patients themselves acted as controls. Sweating was also estimated in 25 healthy individuals at a temperature of 27 +/- 1 degree C, and a mean relative humidity of 19%. During eight severe attacks, sweating in the medial part of the forehead on the symptomatic side was invariably increased. In moderate attacks the increment was less pronounced and in the inter-cycle period, no definite increase was found. The cause of increased sweating during cluster headache attacks remains enigmatic.

Adolescent↗

PubMed1983

Chronic paroxysmal hemicrania. VIII. The sweating pattern.

Evaporimeter measurements of forehead sweating during attack were carried out in six female patients with chronic paroxysmal hemicrania. The patients served as their own controls. Increased sweating on the symptomatic side was found in two patients, both when compared to the non-symptomatic side during attack and when compared with the symptomatic side outside attack. The remaining four patients, two of whom had only weak attacks at the time of study, showed sweat values within the control range. In one patient, attacks could be precipitated by head flexion and by pressure against certain circumscribed points in the neck ("mechanical" precipitation of attacks). These attacks were also associated with increased sweating on the symptomatic side. Increased forehead sweating does not seem to be a sine qua non in CPH.

Adult↗

PubMed1993

SUNCT syndrome: forehead sweating pattern.

The forehead sweating function has been assessed in SUNCT syndrome--a short-lasting, unilateral, neuralgiform headache syndrome with autonomic phenomena on the symptomatic side (conjunctival injection, lacrimation, etc.). In the three patients (of a total of six) who could be studied during paroxysms, increased evaporation was present on the symptomatic side of the forehead compared to the non-symptomatic side during attacks or to the symptomatic side between attacks. Basal sweating was generally within control limits, so long as the attack frequency was not so high as to influence the interictal level. During attacks precipitated by eating chocolate or sour apple (in the case of one of the patients), forehead sweating was also increased on the symptomatic side. The forehead sweating responses to heating and pilocarpine were without any notable or systematic asymmetries. The forehead sweating pattern in SUNCT syndrome may differ from the patterns in unilateral headaches like cluster headache, on the one hand (in which there is generally an asymmetry during heating and pilocarpine tests), and chronic paroxysmal hemicrania (CPH) and cervicogenic headache, on the other (where there is no systematic increase during attacks.

Aged↗

PubMed1999

Immunohistochemical evidence suggests intrinsic regulatory activity of human eccrine sweat glands.

Immunohistochemistry of normal eccrine sweat glands was performed on paraffin sections of human skin. Immunoreactivity (ir) for neuron specific enolase, S100 protein (S100), regulatory peptides, nitric oxide synthase type I (NOS-I) and choline-acetyltransferase (ChAT) was found in small nerve bundles close to sweat glands. In the glands, secretory cells were labelled with anticytokeratin antibody. Using antibodies to S100, calcitonin gene-related peptide (CGRP) and substance P (SP) a specific distribution pattern was found in secretory cells. Granulated (dark) and parietal (clear) cells were immunopositive for CGRP, and S100 and SP, respectively. Immunoreactivity was diffuse in the cytoplasm for CGRP and S100, and peripheral for SP. Myoepithelial cells were not labelled. Electron microscopy revealed electron dense granules, probably containing peptide, in granulated cells. Using antibodies to NOS-I and ChAT, ir was exclusively found in myoepithelial cells. Immunoreactivity for the atrial natriuretic peptide was absent in sweat glands. These results provide evidence for the presence of both regulatory peptides involved in vasodilation and key enzymes for the synthesis of nitric oxide and acetylcholine in the secretory coil of human sweat glands. It is suggested that human sweat glands are capable of some intrinsic regulation in addition to that carried out by their nerve supply.

Adult↗

PubMed2002

Adaptive sweat gland response after spinal cord injury.

OBJECTIVE: To compare the eccrine gland cholinergic sensitivity of upper (UE) and lower (LE) extremities in untrained able-bodied individuals (UAB), untrained individuals with spinal cord injury (U/SCI), and trained wheelchair athletes (E/SCI). DESIGN: Static group comparison. SETTING: SCI population. PARTICIPANTS: A total of 25 men (mean age, 27.8+/-5.0 y; mean height, 175.8+/-9.1cm; mean weight, 76.2+/-7.7 kg) were categorized into 3 groups UAB (n=10), U/SCI (n=10), and E/SCI (n=5). Individuals with SCI had injuries ranging from C4-8. INTERVENTIONS: Peripheral sweat production was induced by using pilocarpine iontophoresis at surface landmarks relative to the flexor carpi radialis and medial gastrocnemius muscles. MAIN OUTCOME MEASURES: Peripheral sweat rate (SR), sweat gland density (SGD), and sweat per gland (S/G) were calculated for both UE and LE. RESULTS: Peripheral SR for the UAB in both UE (7.58+/-1.99 g x m(-2) x min(-1)) and LE (4.42+/-1.23 g x m(-2) x min(-1)) were significantly greater than those for U/SCI (1.08+/-1.01 g x m(-2) x min(-1), .24+/-.35 g x m(-2) x min(-1), respectively) and E/SCI (3.61+/-2.1 g x m(-2) x min(-1),.71+/-.81 g x m(-2). min(-1), respectively). Furthermore, the UE versus LE SR ratio was calculated at 1.71:1 for UAB subjects, whereas U/SCI and E/SCI subjects showed a ratio of 4.50:1 and 5.07:1, respectively. UE SGD measures in U/SCI (83.20+/-39.84 glands/cm(2)) persons were significantly less than either the UAB (120.20+/-21.42 glands/cm(2)) or the E/SCI (120.80+/-21.56 glands/cm(2)). CONCLUSIONS: These results may indicate that sweat glands below the lesion are less sensitive to cholinergic activation, regardless of central or exogenous stimulation. However, glands above the level of the lesion may exhibit increased productivity when individuals are exposed to physical training and physiologic stress.

Adaptation, Physiological↗

PubMedDate not supplied

Hypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery.

OBJECTIVE: Intrathecal morphine has been used for the relief of postoperative pain following cesarean delivery. We report a case of postoperative hypothermia down to 33.6 degrees C associated with excessive sweating in patient undergoing elective cesarean delivery under spinal bupivacaine anesthesia who received intrathecal morphine for postoperative pain management. CASE REPORT: A healthy 31-year-old multigravida presented for elective cesarean delivery. Following prehydration with 500 mL hemaccel, she had a subarachnoid block, using hyperbaric bupivacaine 12 mg and morphine 200 microgram, via a 25-gauge Whitacre needle. In the recovery room, 3 hours after induction of spinal anesthesia, the patient's sublingual temperature was 33.6 degrees C and she was noted to be sedated and sweating excessively. During the next 2 hours, the patient was still hypothermic despite active warming. She also complained of severe nausea, vomiting, and moderate pruritus. Following administration of naloxone 400 microgram sedation, vomiting, and pruritus were relieved. Also, the patient experienced excessive shivering, and her body temperature started to increase in association with a concurrent decrease of sweating. The postoperative hypothermia and excessive sweating in our patient may be related to the cephalad spread of the intrathecal morphine within the cerebrospinal fluid (CSF) to reach the level of opioid receptors in the hypothalamus, causing a perturbation of the thermoregulatory center. This effect could be counteracted by administration of naloxone. CONCLUSIONS: Intrathecal morphine may cause disruption of thermoregulation resulting in hypothermia associated with excessive sweating.

Adult↗

PubMed1997

A sweat gland-derived differentiation activity acts through known cytokine signaling pathways.

The sympathetic innervation of sweat glands undergoes a target-induced noradrenergic to cholinergic/peptidergic switch during development. Similar changes are induced in cultured sympathetic neurons by sweat gland cells or by one of the following cytokines: leukemia inhibitory factor (LIF), ciliary neurotrophic factor (CNTF), or cardiotrophin-1 (CT-1). None of these is the sweat gland-derived differentiation activity. LIF, CNTF, and CT-1 act through the known receptors LIF receptor beta (LIFRbeta) and gp130 and well defined signaling pathways including receptor phosphorylation and STAT3 activation. Therefore, to determine whether the gland-derived differentiation activity was a member of the LIF/CNTF cytokine family, we tested whether it acted via these same receptors and signal cascades. Blockade of LIFRbeta inhibited the sweat gland differentiation activity in neuron/gland co-cultures, and extracts of gland-containing footpads stimulated tyrosine phosphorylation of LIFRbeta and gp130. An inhibitor (CGX) of molecules that bind the CNTFRalpha, which is required for CNTF signaling, did not affect the gland-derived differentiation activity. Soluble footpad extracts induced the same changes in NBFL neuroblastoma cells as LIF and CNTF, including increased vasoactive intestinal peptide mRNA, STAT3 dimerization, and DNA binding, and stimulation of transcription from the vasoactive intestinal peptide cytokine-responsive element. Thus, the sweat gland-derived differentiation activity uses the same signaling pathway as the neuropoietic cytokines, and is likely to be a family member.

Animals↗

PubMed1997

Sweat rate inside a full-facepiece respirator.

The accumulation of sweat inside a full-facepiece respirator mask and the rise in facial skin temperature can be important factors for acceptability of respirators worn in the heat. This study questioned how much sweat would have to be removed from a respirator (if a design to remove accumulated sweat were possible). Results from 20 subjects sitting in a warm, humid environment (35 degrees C and 90% relative humidity) for 90 minutes indicated that the average value was about 0.203 g sweat/min from the face, head, and neck, with most of that coming from the neck region. Men were found to have higher sweating rates than women. The results indicate that a large amount of sweat could accumulate inside the mask over a typical 8-hour day. Average facial skin temperature was found to rise about 2 degrees C over the 90-minutes test, and this rise could likely be the cause of the very uncomfortable rating given to the respirator.

Equipment Design↗

PubMed1998

Continuous monitoring of sweating by electrical conductivity measurement.

A method of continuous monitoring of sweating was developed in which sweat was detected by changes in the conductivity of perfusing water. An ion-free solution was perfused at a constant flow rate through a chamber attached to the skin surface. The chamber was designed so that the electrodes were installed inside at the inlet and outlet, and a 14 mm3 channel was constructed at the bottom to wash out sweat. The 90% response time was 0.12 s. Attaching the chamber to the palm allowed measurements to be made with the subject seated in a comfortable environment. The sweat rate and heart rate were measured simultaneously with an air-ventilation chamber and a heart rate counter, respectively, with the subjects at rest, and under stresses such as grasping hands and doing mental arithmetic. This method yields sweat responses similar to those obtained with an air-ventilation chamber and simultaneous heart rate measurements. The main advantages of this method are faster response time and smaller observation area.

Electric Conductivity↗

PubMed1975

Sweat nitrogen losses by and nitrogen balance of preadolescent girls consuming three levels of dietary protein.

A nitrogen balance study was undertaken to determine the effects of three levels of nitrogen intake on the loss of nitrogen through sweat and to assess the impact of sweat nitrogen on the protein needs of preadolescent girls. Values were determined through the collection of 24-hour, total body sweat samples from 15 healthy girls with a mean age of 8 years, 7 months. Mean height and weight of the subjects were 132 cm and 28.9 kg, respectively. Mean sweat nitrogen losses, collected under uncontrolled environmental conditions, were 201 mg, 263 mg and 319 mg/day on 34 g, 57 g and 88 g of protein intake. The environmental conditions throughout the study remained fairly constant. Mean nitrogen balances per day were 0.04 g, 0.55 g and 1.42 g on the respective levels of nitrogen intake, with the inclusion of sweat nitrogen loss, however, a negative nitrogen balance per day was found in 8 and 2 subjects on 34 g and 57 g protein intake. After considering nitrogen retention of 0.3 g which has been recommended by NRC for the minimum nitrogen allowance for growth of preadolescent children, protein intakes higher than that recommended by the NRC-RDA for preadolescent girls may be required for support of normal growth.

Body Surface Area↗

PubMed1976

An estimation of mineral losses through arm sweat of preadolescent children.

Balance studies were conducted to determine the effects of three levels of nitrogen intake on the loss of nitrogen through sweat in preadolescent boys and girls. During the studies, the losses of calcium, iron, magnesium, manganese, potassium, sodium, and zinc were determined in the arm sweat of the subjects. Sweat from the forearm was collected in a polyethylene bag for 1 hr on three different occasions. Using the concentrations of nitrogen in the arm bag and in the whole body collection and the concentration of minerals in the arm bag, the total body loss of minerals were estimated. Losses of minerals through sweat, expressed as a percentage of intake, ranged from 0.12 to 1.10%. Under conditions of these studies, sweat losses of the essential minerals were not a significant factor in estimating total losses.

Calcium↗

PubMed1979

Total free amino acids, ammonia, and protein in the sweat of children.

The concentrations of total free amino acids, ammonia and protein in sweat of 44 children, 20 males, and 24 females, 6 to 8 years old, were determined. The children were divided into three groups according to their height, weight, and body weight/height ratio; group I children had heights and weights below the 10th percentile for their age, group II had heights and weights between the 10th and 90th percentile, and group III had heights and weights above the 90th percentile. Sweating was induced by allowing the child to be moderatley active. The temperature at the time of the experiment was 31 to 33 C and the relative humidity 48%. The mean concentrations of total free amino acids (mg/100 ml) in sweat from groups I, II, and III children were 318.9 +/- 52.5, 293.9 +/- 82.9 and 265.1 +/- 57.0, respectively. Alanine, glycine, phenylalanine, threonine, and serine were the principal amino acids in sweat. The concentrations of ammonia in the sweat of group I, II, and III children were 6.90 +/- 2.97, 2.35 +/- 0.81, and 1.17 +/- 0.48 mg/100 ml, respectively. Protein concentrations were 44.15 +/- 14.07, 40.70 +/- 16.60, and 35.75 +/- 5.46 mg/100 ml, respectively.

Amino Acids↗