Tropical Malaysians and temperate Koreans exhibit significant differences in sweating sensitivity in response to iontophoretically administered acetylcholine

Effects of individual characteristics and local body functions on sweating response: A review

In this study, we conducted a literature review to deepen our understanding of the sweating response of the thermoregulatory system, focusing on the influence of individual characteristics and local body functions. Among the factors related to individual characteristics, improvement in aerobic fitness had a positive effect on the sweating response, whereas aging exerted an inhibitory effect. Short-term artificial acclimation and seasonal heat acclimatization promoted sweating, whereas long-term geographical acclimatization suppressed sweating. Male exhibited higher sweat rates than female when the metabolic heat production was high. Individuals with smaller surface area-to-mass ratios tended to have higher sweat rates than those with larger ratios. Regarding local body functions, sweat distribution in the resting state showed high regional sweat rates in the lower limbs and torso, with higher values in the lower limbs when in the supine position and higher values in the torso when in the seated position. During exercise, the regional sweat rates was high in the torso, whereas the limbs exhibited relatively low sweat rates. These differences in sweat distribution stem from the thermoregulatory potential of each body region, which aims to efficiently regulate body temperature. Local effects have only been examined in the thigh and forearm, with temperature coefficient Q10 ranging from 2 to 5. Only the forehead showed significantly high thermosensitivity among all body regions.

Transcriptome profiling of anhidrotic eccrine sweat glands reveals that olfactory receptors on eccrine sweat glands regulate perspiration in a ligand-dependent manner

Sweat maintains systemic homeostasis in humans. Although sweating disorders may cause multifaceted health problems, therapeutic options for sweat disorders have not yet been established. To gain new insight into the mechanism underlying the regulation of perspiration, we compared eccrine sweat gland transcriptomes from hidrotic and anhidrotic lesions from patients with anhidrosis and found out that olfactory receptors were expressed differentially in anhidrotic and hidrotic eccrine sweat glands. We then confirmed OR51A7 and OR51E2 expression in human eccrine sweat glands by in situ hybridization and immunohistochemistry. An alkaline phosphatase-TGFα shedding assay revealed that β-ionone activates G-proteins through OR51A7 or OR51E2. The effect of topically applied β-ionone on sweating was examined with the quantitative sudomotor axon reflex test, which showed that responses to β-ionone differed between sexes. Topical β-ionone attenuated female sweating and augmented male sweating. Taken together, this study suggests that olfactory receptors expressed in eccrine sweat glands may regulate sweating in response to odorous ligands on the basis of sex. These unexpected results indicate that olfactory receptors may modulate sweating and that olfactory receptor modulators may contribute to the management of sweat disorders.

Coffee intake may promote sudomotor function activation via the contribution of caffeine

Objectives

To determine whether drinking coffee with caffeine accelerates the sympathetic response to acetylcholine (ACh).

Methods

Tests were performed twice at 1-week intervals following the intake of coffee. Subjects were randomly divided into two groups: Group A was administered 16 fluid oz of water (CON), while Group B was given 16 fluid oz of coffee (Coffee). After 1 week, Group A was administered 16 fluid oz of coffee (Coffee), while Group B was given 16 fluid oz of water (CON). The quantitative sudomotor axon reflex test (QSART) was performed after intake of coffee and water and a 40 min break. QSART with iontophoresis and 10% ACh was performed to determine axon reflex (AXR) mediated with and without iontophoresis [AXR (1) and AXR (2), respectively], and directly activated sweating (DIR).

Results

The sweat onset time of the AXR was shorter in the Coffee compared with the CON (p < 0.05). The sweat rates in AXR (1) AXR (2) and DIR were significantly higher in the Coffee than in the CON (p < 0.05, p < 0.05, p < 0.01, respectively). In addition, the Coffee showed significantly higher density of activated sweat glands and activated sweat gland output than the CON (p < 0.05, p < 0.01, respectively). The overall results of this study showed that coffee intake could stimulate higher activation in both AXR and DIR sweat responses.

Conclusion

Coffee intake can improve sweating sensitivity in both the AXR and DIR by the contribution of caffeine contained in coffee. This suggests that other compounds in coffee may not inhibit the sympathetic response to ACh. Therefore, coffee may be clinically worth considering as a supplement for the activation of the cholinergic and sudomotor function.

How humans adapt to hot climates learned from the recent research on tropical indigenes

This review mainly aimed to introduce the findings of research projects comparing the responses of tropical and temperate indigenes to heat. From a questionnaire survey on thermal sensation and comfort of Indonesians and Japanese, we found that the thermal descriptor “cool” in tropical indigenes connotes a thermally comfortable feeling, suggesting that linguistic heat acclimatization exists on a cognitive level. Ten male students born and raised in Malaysia were invited to Fukuoka, Japan, and compared their responses with 10 Japanese male students with matched physical fitness and morphological characteristics. Cutaneous thermal sensitivity: The sensitivities were measured at 28 °C. The forehead warm sensitivity was significantly blunted in Malaysians. The less sensitivity to the warmth of tropical indigenes is advantageous in respect to withstanding heat stress with less discomfort and a greater ability to work in hot climates. Passive heat stress: Thermoregulatory responses, especially sweating, were investigated, during the lower leg hot bathing (42 °C for 60 min). The rectal temperature at rest was higher in Malaysians and increased smaller during immersion. There was no significant difference in the total amount of sweating between the two groups, while the local sweating on the forehead and thighs was lesser in Malaysians, suggesting distribution of sweating was different from Japanese. Exercise: Malaysian showed a significantly smaller increase in their rectal temperature during 55% maximal exercise for 60 min in heat (32 °C 70% relative humidity), even with a similar sweating and skin blood flow response in Japanese. The better heat tolerance in Malaysians could be explained by the greater convective heat transfer from the body core to the skin due to the greater core-to-skin temperature gradient. In addition, when they were hydrated, Malaysian participants showed better body fluid regulation with smaller reduction in plasma volume at the end of the exercise compared to the non-hydrated condition, whereas Japanese showed no difference between hydration conditions. We further investigated the de-acclimatization of heat adaptation by longitudinal observation on the heat tolerance of international students who had moved from tropical areas to Fukuoka for several years.

Establishment of normative data for autonomic function tests in indian population

Background:

Normative data for autonomic function tests (AFT) is not available for Indian population.

Objective:

The aim of the study was to establish normative data in AFT and its correlation with age, gender, and body mass index.

Material and Methods:

The study was done on 254 healthy subjects of age ≥18 years. All AFTs were done in autonomic laboratory at the Department of Neurology, Christian Medical College and Hospital, Ludhiana. Cardiovascular tests (heart rate response to deep breathing, HR changes in Valsalva maneuver and head-up tilt test (HUT)) and quantitative sudomotor axon reflex testing (QSART) were performed in all the subjects. Fifty subjects underwent thermoregulatory sweat test (TST).

Results:

The mean age (SD) of study participants was 43 (16.0) years (range 20–84), and 129 (50.8%) were men. The normative value range (2.5–97.5 percentile) for HR difference, E: I ratio, and Valsalva ratio (VR) was 3.5–47.0, 1.05–1.93, and 1.11–2.64, respectively, for all the subjects. HR difference and E: I ratio showed an significant inverse relation with age (r = -0.623 and r = -0.584, respectively). VR also showed an inverse relation with age (r = -0.575, P =< 0.001), and female had a lower value than male (1.63 vs 1.78, P =< 0.001). In QSART, mean (SD) sweat volume was higher in males 0.630 (0.230) compared to females 0.513 (0.132) for all sites, P < 0.001, and similar trend was noticed for sweat area in TST.

Discussion and Conclusion:

Normative AFT data has been established for Indian population for the first time. The values are comparable to previously published studies.

Technological opportunities for sensing of the health effects of weather and climate change: a state-of-the-art-review

Sensing and measuring meteorological and physiological parameters of humans, animals, and plants are necessary to understand the complex interactions that occur between atmospheric processes and the health of the living organisms. Advanced sensing technologies have provided both meteorological and biological data across increasingly vast spatial, spectral, temporal, and thematic scales. Information and communication technologies have reduced barriers to data dissemination, enabling the circulation of information across different jurisdictions and disciplines. Due to the advancement and rapid dissemination of these technologies, a review of the opportunities for sensing the health effects of weather and climate change is necessary. This paper provides such an overview by focusing on existing and emerging technologies and their opportunities and challenges for studying the health effects of weather and climate change on humans, animals, and plants.

Sex-related differences in sudomotor function in healthy early twenties focused on activated sweat gland density

The purpose of this study was to quantitatively assess the difference in sudomotor function between healthy males and females in their early twenties by measuring skin surface area and activated sweat gland density (ASGD). The quantitative sudomotor axon reflex test (QSART), a method for evaluating autonomic nervous system activity, was used for quantification. In QSART, the sweat glands are activated directly or indirectly by the subcutaneous application of neurotransmitters, such as acetylcholine, through iontophoresis. This series of mechanisms is called the sudomotor axon reflex. After recording age, height, weight, and several measurements of the forearm, QSART was performed on 101 healthy controls aged 21-26 years to measure ASGD. The mean temperature and humidity on the measurement days were 11.4°C and 58.1% on May 3, 2018, and 14.7°C and 70.3% on May 10, 2018. The result of independent sample t-test showed higher ASGD in women (P < 0.05). The body surface area and the surface area of the forearms were higher in men (P < 0.001), but the number of activated sweat glands was not significantly different according to sex. The activated sweat gland counts of the body and forearms were analyzed through linear regression by age for males and females. Except for the activated sweat gland count of the male body, the analysis showed a tendency to decrease with increasing age but was not statistically significant in any case (P > 0.05). Showing insufficient coefficient of determination (R²), multiple regression analyses with sex and ages did not correct this insignificance between age and activated sweat gland count.

Physiology of sweat gland function: The roles of sweating and sweat composition in human health

The purpose of this comprehensive review is to: 1) review the physiology of sweat gland function and mechanisms determining the amount and composition of sweat excreted onto the skin surface; 2) provide an overview of the well-established thermoregulatory functions and adaptive responses of the sweat gland; and 3) discuss the state of evidence for potential non-thermoregulatory roles of sweat in the maintenance and/or perturbation of human health. The role of sweating to eliminate waste products and toxicants seems to be minor compared with other avenues of excretion via the kidneys and gastrointestinal tract; as eccrine glands do not adapt to increase excretion rates either via concentrating sweat or increasing overall sweating rate. Studies suggesting a larger role of sweat glands in clearing waste products or toxicants from the body may be an artifact of methodological issues rather than evidence for selective transport. Furthermore, unlike the renal system, it seems that sweat glands do not conserve water loss or concentrate sweat fluid through vasopressin-mediated water reabsorption. Individuals with high NaCl concentrations in sweat (e.g. cystic fibrosis) have an increased risk of NaCl imbalances during prolonged periods of heavy sweating; however, sweat-induced deficiencies appear to be of minimal risk for trace minerals and vitamins. Additional research is needed to elucidate the potential role of eccrine sweating in skin hydration and microbial defense. Finally, the utility of sweat composition as a biomarker for human physiology is currently limited; as more research is needed to determine potential relations between sweat and blood solute concentrations.

A prediction tool for hospital-acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Surgical patients are prone to developing hospital-acquired pressure ulcers (HAPU). Therefore, a better prediction tool is needed to predict risk using preoperative data. This study aimed to determine, from previously published HAPU risk factors, which factors are significant among our surgical population and to develop a prediction tool that identifies pressure ulcer risk before the operation. A literature review was first performed to elicit all the published HAPU risk factors before conducting a retrospective case-control study using medical records. The known HAPU risks were compared between patients with HAPU and without HAPU who underwent operations during the same period (July 2015-December 2016). A total of 80 HAPU cases and 189 controls were analysed. Multivariate logistic regression analyses identified eight significant risk factors: age ≥ 75 years, female gender, American Society of Anaesthesiologists ≥ 3, body mass index < 23, preoperative Braden score ≤ 14, anaemia, respiratory disease, and hypertension. The model had bootstrap-corrected c-statistic 0.78 indicating good discrimination. A cut-off score of ≥6 is strongly predictive, with a positive predictive value of 73.2% (confidence interval [CI]: 59.7%-84.2%) and a negative predictive value of 80.7% (CI: 74.3%-86.1%). SPURS contributes to the preoperative identification of pressure ulcer risk that could help nurses implement preventive measures earlier.

Extreme Terrestrial Environments: Life in Thermal Stress and Hypoxia. A Narrative Review

Living, working and exercising in extreme terrestrial environments are challenging tasks even for healthy humans of the modern new age. The issue is not just survival in remote environments but rather the achievement of optimal performance in everyday life, occupation, and sports. Various adaptive biological processes can take place to cope with the specific stressors of extreme terrestrial environments like cold, heat, and hypoxia (high altitude). This review provides an overview of the physiological and morphological aspects of adaptive responses in these environmental stressors at the level of organs, tissues, and cells. Furthermore, adjustments existing in native people living in such extreme conditions on the earth as well as acute adaptive responses in newcomers are discussed. These insights into general adaptability of humans are complemented by outcomes of specific acclimatization/acclimation studies adding important information how to cope appropriately with extreme environmental temperatures and hypoxia.

Decreased thermal sweating of central sudomotor mechanism in African and Korean men

OBJECTIVE

Tropical natives sweat less and preserve more body fluid than temperate natives, tolerating heat stress. However, the mechanisms involved in such sweating reduction have not been fully elucidated. We examined the sudomotor responses of men of African (n = 36) and Korean (n = 41) ancestry during hot water (43 °C) leg immersion (central sudomotor response). Correlations between mean body temperature, basal metabolic rate (BMR), and sweat rate were also examined.

METHODS

All procedures were done in an automated climate chamber. Local skin temperatures and BMR were measured and mean body temperature was calculated. Sweating activities which include evaporative loss rate, sweat onset time, sweat rate, sweat volume, and whole-body sweat loss volume were examined.

RESULTS

In the heat load test, Africans showed lower mean body and local skin temperatures than Koreans before and after heating. Before and after heating, BMR declined significantly in Africans, while that of Koreans declined less. Local sweat onset time increased more in Africans than in Koreans. Local evaporative loss rate, local sweat volume, local sweat rate, and whole body sweat loss volume were reduced in Africans compared with Koreans. There were positive associations of mean body temperature and resting BMR with mean sweat rate.

CONCLUSION

In conclusion, we observed a larger reduction of sudomotor activity in tropical Africans than in temperate Koreans, which was associated with their lower mean body temperature and lower resting BMR.

Comparison of density and output of sweat gland in tropical Africans and temperate Koreans

Modification of sweating could be due to changes in activated sweat gland density (ASGD) and/or activated sweat gland output (ASGO). The present study determined regional and inter-ethnic differences in ASGD and ASGO during passive heating between tropical natives (African, n=22) and temperate natives (Republic of Korean, n=25). Heat load was carried out by immersing the half body into a hot water bath for 30min. Tympanic temperature (Tty) and skin temperature (Ts) were measured. Mean body temperature (mTb) was calculated. Sudomotor activities including sweat onset time, sweat rate, ASGD, and ASGO were examined in eight regions of the skin. Africans had smaller increase in mTb during passive heating than Koreans. The onset time of sweating was much more delayed in Africans compared to Koreans. In response to thermal load, ASGD and ASGO differed between body regions in Africans and Koreans. In most skin regions, ASGD and ASGO were lower in tropical Africans compared to those in temperate Koreans. Trunk portion including chest, upper back, lower back, abdomen had greater swear rate, ASGD, and ASGO compared to peripheral segments including upper arm, forearm, leg, and thigh in both ethnic groups. Distribution patterns of ASGD over the body appeared to be similar in both Africans and Koreans at the peak of thermal loading. In conclusion, the present study demonstrates that sudomotor activity in tropical Africans is reduced with lower ASGD and ASGO over the body surface compared to temperate Koreans.

Improved sweat gland function during active heating in tennis athletes

BACKGROUND

Relatively few studies on the peripheral sweating mechanisms of trained tennis athletes have been conducted. The purpose of this study was to compare the sweating capacities of tennis athletes against untrained subjects (controls).

METHODS

Thirty-five healthy male volunteers participated including 15 untrained subjects and 20 trained tennis athletes (nationally ranked). Active heat generation was performed for 30 min (running at 60% VO 2 max ) in a climate chamber (temperature, 25.0°C ± 0.5°C; relative humidity, 60% ± 3%, termed active heating). Sweating data (local sweat onset time, local sweat volume, activated sweat glands, sweat output per gland, whole body sweat loss volume) were measured by the capacitance hygrometer-ventilated capsule method and starch-iodide paper. Mean body temperature was calculated from tympanic and skin temperatures.

RESULTS

Local sweat onset time was shorter for tennis athletes (p < 0.001). Local sweat volume, activated sweat glands of the torso and limbs, sweat output per gland, and whole body sweat loss volume were significantly higher for tennis athletes than control subjects after active heating (p < 0.001). Tympanic and mean body temperatures were lower among tennis athletes than controls (p < 0.05).

CONCLUSION

These results indicate that tennis athletes had increased regulatory capacity of their sweat gland function.

Seasonal acclimation in sudomotor function evaluated by QSART in healthy humans

The quantitative sudomotor axon reflex testing (QSART) is a classic test of routine postganglionic sudomotor function. We investigated sudomotor function by QSART after summer (July 2012) and winter (January 2013) seasonal acclimation (SA) in the Republic of Korea. QSART with acetylcholine (ACh) iontophoresis were performed to determine directly activated (DIR) and axon reflex-mediated (AXR1, 2) sweating rate. Onset time of axon reflex, activated sweat gland density (ASGD), activated sweat gland output (ASGO), tympanic and skin temperatures (Tty, Tsk), basal metabolic rate (BMR), and evaporative loss volume changes were measured. Tympanic and mean body temperature (Tb; calculated from Tty, Tsk) were significantly lower after summer-SA than that of winter-SA. Sweat onset time was delayed during winter-SA compared to that after summer-SA. BMR, AXR(1), AXR(2), and DIR sweat rates, ASGD and ASGO, and evaporative loss volume were significantly diminished after winter-SA relative to after summer-SA. In conclusion, changes in sweating activity measured by QSART confirmed the involvement of the peripheral nervous system in variation of sudomotor activity in seasonal acclimation.

Thermoregulatory Responses to Graded Exercise Differ among Sasang Types

We compared sweat rate and variables such as workload (W e ), metabolic heat production (H prod), and temperature increment load (T inc) across Sasang types. 304 apparently healthy participants aged 20-49 years with their Sasang type determined were enrolled. Local sweat rates on the chest (LSRchest) and back (LSRback) were measured using a perspiration meter during a maximum treadmill exercise test. Oxygen uptake was measured continuously using a breath-by-breath mode indirect calorimeter. The TaeEum (TE) type had a larger body size, a higher percent body fat, and a lower body area surface area (BSA) to body mass compared with the other Sasang types, particularly the SoEum (SE) type. The TE type tended to have a shorter exercise time to exhaustion and lower maximal oxygen uptake (mL·kg(-1)·min(-1)) than the other types. LSRchest in TE types was greater than that of the SE and SoYang (SY) types in men, whereas LSRback was higher in the TE type than that of the other types in women. After normalizing LSR for W e , H prod, T inc, and BSA, this tendency still remained. Our findings suggest that the thermoregulatory response to graded exercise may differ across Sasang types such that the TE type was the most susceptible to heat stress.

Increased levels of FFA during passive heat loading after a 2-week repeated heat load in Koreans

The purpose of this study was to determine whether repeated heat load is closely related to circulating levels of free fatty acids (FFA) during repeated passive heat loading (PHL), defined as immersion of the lower body up to an umbilical level in hot water, 42 ± 0.5 °C (three times/week, 30 min/day) for 2 weeks. There were significant correlations between mean body temperature and FFA before and after repeated heat load (p < 0.001, respectively), and the level of FFA was significantly higher after repeated heat load during PHL (p < 0.01). The threshold of mean body temperature for lipolysis was lowered by repeated heat load and enhanced lipolysis during PHL. However, caution is needed for diabetic individuals.

Seasonal Acclimatization in Summer versus Winter to Changes in the Sweating Response during Passive Heating in Korean Young Adult Men

We investigated the sweating response during passive heating (partial submersion up to the umbilical line in 42±0.5℃ water, 30 min) after summer and winter seasonal acclimatization (SA). Testing was performed in July during the summer, 2011 [summer-SA; temp, 25.6±1.8℃; relative humidity (RH), 82.1±8.2%] and in January during the winter, 2012 (winter-SA; temp, -2.7±2.9℃; RH, 65.0±13.1%) in Cheonan (126°52'N, 33.38'E), Republic of Korea. All experiments were carried out in an automated climatic chamber (temp, 25.0±0.5℃: RH, 60.0±3.0%). Fifteen healthy men (age, 23.4±2.5 years; height, 175.0±5.9 cm; weight, 65.3±6.1 kg) participated in the study. Local sweat onset time was delayed during winter-SA compared to that after summer-SA (p< 0.001). Local sweat volume, whole body sweat volume, and evaporative loss volume decreased significantly after winter-SA compared to those after summer-SA (p<0.001). Changes in basal metabolic rate increased significantly after winter-SA (p< 0.001), and tympanic temperature and mean body temperature were significantly lower after summer-SA (p<0.05). In conclusion, central sudomotor acitivity becomes sensitive to summer-SA and blunt to winter-SA in Rebubic of Korea. These results suggest that the body adjusts its temperature by economically controlling the sweating rate but does not lower the thermal dissipation rate through a more effective evaporation scheme after summer-SA than that after winter-SA.

Sweat, the driving force behind normal skin: an emerging perspective on functional biology and regulatory mechanisms

The various symptoms associated with excessive or insufficient perspiration can significantly reduce a patient's quality of life. If a versatile and minimally invasive method could be established for returning sweat activity to normalcy, there is no question that it could be used in the treatment of many diseases that are believed to involve perspiration. For this reason, based on an understanding of the sweat-gland control function and sweat activity, it was necessary to conduct a comprehensive search for the factors that control sweating, such as the central and peripheral nerves that control sweat-gland function, the microenvironment surrounding the sweat glands, and lifestyle. We focused on the mechanism by which atopic dermatitis leads to hypohidrosis and confirmed that histamine inhibits acetylcholinergic sweating. Acetylcholine promotes the phosphorylation of glycogen synthesis kinase 3β (GSK3β) in the sweat-gland secretory cells and leads to sensible perspiration. By suppressing the phosphorylation of GSK3β, histamine inhibits the movement of sweat from the sweat-gland secretory cells through the sweat ducts, which could presumably be demonstrated by dynamic observations of the sweat glands using two-photon microscopy. It is expected that the discovery of new factors that control sweat-gland function can contribute to the treatment of diseases associated with dyshidrosis.

Beneficial effect of Oligonol supplementation on sweating response under heat stress in humans

Oligonol is a low-molecular weight polyphenol that possesses antioxidant and anti-inflammatory properties. However, nothing is known regarding the impact of Oligonol on sudomotor activity. This study investigated the effects of Oligonol supplementation on sudomotor activity during heat load in humans. Initially, we conducted a placebo-controlled, cross-over trial where participants took a daily dose of Oligonol 200 mg or placebo for one week. After a 2 week washout period, the subjects were switched to the other study arm. As a heat load, half-body immersion into hot water (42 ± 0.5 °C for 30 min) was performed in an automated climate chamber. Tympanic and skin temperatures were measured. Sudomotor activity, including onset time, sweat rate (SR) and volume (SV), active sweat gland density (ASGD), and sweat gland output (SGO), was tested in four or eight areas of skin. When compared with placebo, Oligonol attenuated increases in tympanic and skin temperatures after the heat load. There was an increasing trend in local sweat onset time, but there was a decrease in local SR, SV, ASGD, and SGO for Oligonol compared to placebo. The mean ASGD was significantly higher in the Oligonol group than in the placebo group for 10, 20, and 30 min. This study demonstrates that Oligonol appears to be worthy of consideration as a natural supplement to support more economical use of body fluids against heat stress.

Long distance runners present upregulated sweating responses than sedentary counterparts

Relatively few studies have investigated peripheral sweating mechanisms of long-distance runners. The aim of this study was to compare peripheral sweating mechanisms in male long-distance runners, and sedentary counterparts. Thirty six subjects, including 20 sedentary controls and 16 long-distance runners (with 7-12 years of athletic training, average 9.2±2.1 years) were observed. Quantitative sudomotor axon reflex testing (QSART) with iontophoresis (2 mA for 5 min) and 10% acetylcholine (ACh) were performed to determine axon reflex-mediated and directly activated (DIR, muscarinic receptor) sweating. Sweat onset time, sweat rate, number of activated sweat glands, sweat output per gland and skin temperature were measured at rest while maximum oxygen uptake (VO2max) were measured during maximal cycling. Sweat rate, activated sweat glands, sweat output per gland, skin temperature and VO2max were significantly higher in the trained runners than in the sedentary controls. Sweat onset time was significantly shorter for the runners. In the group of long-distance runners, significant correlations were found between VO2max and sweat onset time (r2 = 0.543, P<0.01, n = 16), DIR sweat rate (r2 = 0.584, P<0.001, n = 16), sweat output per gland (r2 = 0.539, P<0.01, n = 16). There was no correlation between VO2max and activated sweat glands. These findings suggest that habitual long-distance running results in upregulation of the peripheral sweating mechanisms in humans. Additional research is needed to determine the molecular mechanism underlying these changes. These findings complement the existing sweating data in long-distance runners.

A comparison of hydration effect on body fluid and temperature regulation between Malaysian and Japanese males exercising at mild dehydration in humid heat

BACKGROUND

This study investigated the effect of hydration differences on body fluid and temperature regulation between tropical and temperate indigenes exercising in the heat.

METHODS

Ten Japanese and ten Malaysian males with matched physical characteristics (height, body weight, and peak oxygen consumption) participated in this study. Participants performed exercise for 60 min at 55% peak oxygen uptake followed by a 30-min recovery at 32°C and 70% relative air humidity with hydration (4 times each, 3 mL per kg body weight, 37°C) or without hydration. Rectal temperature, skin temperature, heart rate, skin blood flow, and blood pressure were measured continuously. The percentage of body weight loss and total sweat loss were calculated from body weight measurements. The percentage change in plasma volume was estimated from hemoglobin concentration and hematocrit.

RESULTS

Malaysian participants had a significantly lower rectal temperature, a smaller reduction in plasma volume, and a lower heart rate in the hydrated condition than in the non-hydrated condition at the end of exercise (P <0.05), whereas Japanese participants showed no difference between the two hydration conditions. Hydration induced a greater total sweat loss in both groups (P <0.05), and the percentage of body weight loss in hydrated Malaysians was significantly less than in hydrated Japanese (P <0.05). A significant interaction between groups and hydration conditions was observed for the percentage of mean cutaneous vascular conductance during exercise relative to baseline (P <0.05).

CONCLUSIONS

The smaller reduction in plasma volume and percentage body weight loss in hydrated Malaysians indicated an advantage in body fluid regulation. This may enable Malaysians to reserve more blood for circulation and heat dissipation and thereby maintain lower rectal temperatures in a hydrated condition.

Decreased sudomotor function is involved in the formation of atopic eczema in the cubital fossa

BACKGROUND

Eczema in the cubital fossa, which is susceptible to sweat, is frequently observed in atopic dermatitis (AD). However, there has been no direct evidence that sweating causes eczema in the cubital fossa.

METHODS

To investigate this issue, axon reflex-mediated sweating volume (AXR) and skin barrier function in the cubital fossa were measured in subjects with AD and in healthy volunteers, and were applied to clinical feature of the cubital fossa.

RESULTS

AXR in the cubital fossa decreased in AD subjects; it positively correlated only with water-holding capacity in healthy subjects but not in patients with in AD. Furthermore, AD subjects with lichenoid eczema and either prurigo or papules over the cubital fossa showed extremely decreased AXR.

CONCLUSIONS

These results suggest that decreased sweating is a major source of water in the stratum corneum, and decreased sudomotor function may be involved in both the cause and aggravation of representative atopic eczema in the cubital fossa.

Dynamic analysis of histamine-mediated attenuation of acetylcholine-induced sweating via GSK3β activation

Sweating has been associated with the exacerbation of atopic dermatitis (AD) in diverse ways. Acetylcholine (ACh)-mediated sweating is known to be attenuated in AD, but its cause remains obscure. To address this issue, the impact of histamine on ACh-induced sweating was evaluated. Sweating was measured by counting the number of active sweat pores by the starch-iodine reaction and dynamic optical coherence tomography; sweat was visualized using two-photon excitation fluorescence microscopy in mice and the quantitative sudomotor axon reflex test in humans. Both histamine receptor antagonists and H1 receptor (H1R)-knockout (KO) mice were used to determine methodological specificity. Histamine demonstrably inhibited ACh-induced sweating in both mice and humans via H1R-mediated signaling. In sweat glands, ACh inactivated glycogen synthase kinase 3β (GSK3β), a kinase involved in endocytosis and secretion, whereas simultaneous stimulation with histamine activated GSK3β. Results of two-photon excitation fluorescence microscopy confirmed the dynamic motion of sweat and sweat glands after ACh treatment, showing that simultaneous stimulation with histamine altered their dynamic properties. These results indicate that histamine inhibits sweat gland secretions by blocking ACh-induced inactivation of GSK3β. Histamine-mediated hypohidrosis might be involved in the mechanism of abnormal skin dryness in patients with AD.

Heat acclimation affects circulating levels of prostaglandin E2, COX-2 and orexin in humans

We examined serum levels of prostaglandin E2 (PGE2), cyclooxygenase (COX)-2 and orexin before and after heat acclimation (HA) to test the hypothesis that decreased basal body temperature due to HA correlate with circulating levels of these key thermoregulatory molecules. Nine healthy human male volunteers were recruited (age, 21.9±2.7 years). The subjects were exposed to half-body immersion in hot water (42±0.5°C) at the same time of day (2-5p.m.) on alternate days for 3 weeks. The HA protocol included 10 bouts of 30min immersion. All experiments were performed in an automated climate chamber (temperature, 26.0±0.5°C; relative humidity, 60±3.0%; air velocity, <1m/s). Tympanic and skin temperatures were measured, and mean body temperature was calculated. The difference in body weight was used to estimate total sweat loss. Serum levels of PGE2, COX-2 and orexin were analyzed before and after HA. Body temperature decreased significantly (P<0.05) after HA, whereas sweat volume increased significantly (P<0.01). Serum PGE2, COX-2 and orexin concentrations decreased significantly compared to those at pre-acclimation (P<0.001, P<0.01, P<0.01, respectively). Our data suggest that decreased basal body temperature after HA is associated with decreases in thermoregulatory molecules, such as PGE2, COX-2 and orexin.

Effects of duration of stay in temperate area on thermoregulatory responses to passive heat exposure in tropical south-east Asian males residing in Japan

BACKGROUND

In this study, we investigated the effects of duration of stay in a temperate area on the thermoregulatory responses to passive heat exposure of residents from tropical areas, particularly to clarify whether they would lose their heat tolerance during passive heat exposure through residence in a temperate country, Japan.

METHODS

We enrolled 12 males (mean ± SE age 25.7 ± 1.3 years) from south-east Asian countries who had resided in Japan for a mean of 24.5 ± 5.04 months, and 12 Japanese males (age 24.1 ± 0.9 years). Passive heat exposure was induced through leg immersion in hot water (42°C) for 60 minutes under conditions of 28°C air temperature and 50% relative humidity.

RESULTS

Compared with the Japanese group, the tropical group displayed a higher pre-exposure rectal temperature (P < 0.01) and a smaller increase in rectal temperature during 60 minutes of leg immersion (P = 0.03). Additionally, the tropical group showed a tendency towards a lower total sweat rate (P = 0.06) and lower local sweat rate on the forehead (P = 0.07). The tropical group also had a significantly longer sweating onset time on the upper back (P = 0.04) compared with the Japanese groups. The tropical group who stayed in Japan for > 23 months sweated earlier on the forehead and upper back than those who stayed in Japan < 11 months (P < 0.01 and P = 0.03 for the forehead and upper back, respectively). There was a positive correlation between duration of stay in Japan and total sweat rate (r = 0.58, P <0.05), and negative correlations between duration of stay and sweating onset time on the forehead (r = -0.73, P = 0.01) and on the upper back (r = -0.66, P = 0.02). Other physiological indices measured in this study did not show any difference between the subjects in the tropical group who had lived in Japan for a shorter time and those who had lived there for a longer time.

CONCLUSIONS

We conclude that the nature of heat acclimatization of the sweating responses to passive heat exposure that are acquired from long-term heat acclimatization is decayed by a stay in a temperate area, as shown by the subjects in our tropical group. We did not find any evidence of a decay in the other physiological indices, indicating that heat tolerance acquired from long-term heat acclimatization is not completely diminished through residence in a temperate area for less than 4 years, although some aspects of this heat tolerance may be decayed.

Abnormal axon reflex-mediated sweating correlates with high state of anxiety in atopic dermatitis

BACKGROUND

Sweating plays a key role in skin homeostasis, including antimicrobial and moisturizing effects, and regulation of skin surface pH. Impaired axon reflex-mediated (AXR) sweating has been observed in patients with atopic dermatitis (AD). However, the mechanism of such abnormal sudomotor axon reflex remains to be revealed.

METHODS

To investigate this mechanism, sudomotor function was analyzed using a quantitative sudomotor axon reflex test (acetylcholine iontophoresis) in patients with AD (n = 26) and healthy volunteers (n = 12). Correlation between sudomotor function and certain background factors, including Spielberger State Trait Anxiety Inventory score, Severity Scoring of Atopic Dermatitis (SCORAD) score, number of circulating eosinophils, and serum concentrations of thymus and activation-regulated chemokine and immunoglobulin E radioimmunosorbent test, was validated.

RESULTS

Latency time was significantly prolonged in AD (p = 0.0352), and AXR sweating volume (mg/0-5 min) was significantly lower in AD patients than in healthy controls (p = 0.0441). Direct sweating volume (mg/0-5 min) was comparable in AD patients and healthy controls. A significant correlation between the evaluation results of quantitative sudomotor axon reflex tests and certain background factors was not observed. The latency time in non-lesioned and lesioned areas for AD patients versus continuous anxiety value in the Spielberger State Trait Anxiety Inventory and the AXR versus SCORAD showed significant correlations (p = 0.0424, p = 0.0169, and p = 0.0523, respectively).

CONCLUSIONS

Although the number of study subjects was little, abnormal AXR sweating in patients with AD was observed. Correlative analysis suggests possible involvement of continuous anxiety and the immune system in such abnormal sudomotor function.

Sweat output measurement of the post-ganglion sudomotor response by Q-Sweat test: a normative database of Chinese individuals

Background

Q-Sweat is a model used for evaluating the post-ganglionic sudomotor function by assessing sweat response. This study aimed to establish the normative database of Q-Sweat test among Chinese individuals since this type of information is currently lacking.

Results

One hundred and fifty (150) healthy volunteers, 76 men and 74 women with age range of 22–76 years were included. Skin temperature and sweat onset latency measured at the four sites (i.e., the forearm, proximal leg, distal leg, and the foot) did not significantly correlate with age, gender, body height (BH), body weight (BW), and body mass index (BMI) but the total sweat volume measured in all four sites significantly correlated with sex, BH, and BW. Except for the distal leg, the total sweat volume measured at the other three sites had a significant correlation with BMI. In terms of gender, men had larger total sweat volume, with median differences at the forearm, proximal leg, distal leg, and foot of 0.591 μl, 0.693 μl, 0.696 μl, and 0.358 μl, respectively. Regarding BW difference (≥62 and < 62 Kg), those with BW ≥62 Kg had larger total sweat volume. Median differences at the forearm, proximal leg, distal leg, and foot were 0.538 μl, 0.744 μl, 0.695 μl, and 0.338 μl, respectively. There was an uneven distribution of male and female participants in the two BW groups. In all conditions, the total sweat volume recorded at the foot site was the smallest.

Conclusion

This is the first report to show the normative database of sweat response in Chinese participants evaluated using Q-Sweat device. This normative database can help guide further research on post-ganglionic sudomotor or related clinical practice involving a Chinese population.

Comparison of heat dissipation response between Malaysian and Japanese males during exercise in humid heat stress

This study investigated the differences in heat dissipation response to intense heat stress during exercise in hot and humid environments between tropical and temperate indigenes with matched physical characteristics. Ten Japanese (JP) and ten Malaysian (MY) males participated in this study. Subjects performed exercise for 60 min at 55% peak oxygen uptake in 32°C air with 70% relative humidity, followed by 30 min recovery. The increase in rectal temperature (T(re)) was smaller in MY during exercise compared to JP. The local sweat rate and total body mass loss were similar in both groups. Both skin blood flow and mean skin temperature was lower in MY compared to JP. A significantly greater increase in hand skin temperature was observed in MY during exercise, which is attributable to heat loss due to the greater surface area to mass ratio and large number of arteriovenous anastomoses. Also, the smaller increase in T(re) in MY may be explained by the presence of a significantly greater core-skin temperature gradient in MY than JP. The thermal gradient is also a major factor in increasing the convective heat transfer from core to skin as well as skin blood flow. It is concluded that the greater core-skin temperature gradient observed in MY is responsible for the smaller increase in T(re).

Comparison of thermoregulatory responses to heat between Malaysian and Japanese males during leg immersion

The objective of this study was to investigate thermoregulatory responses to heat in tropical (Malaysian) and temperate (Japanese) natives, during 60 min of passive heating. Ten Japanese (mean ages: 20.8 ± 0.9 years) and ten Malaysian males (mean ages: 22.3 ± 1.6 years) with matched morphological characteristics and physical fitness participated in this study. Passive heating was induced through leg immersion in hot water (42°C) for 60 min under conditions of 28°C air temperature and 50% RH. Local sweat rate on the forehead and thigh were significantly lower in Malaysians during leg immersion, but no significant differences in total sweat rate were observed between Malaysians (86.3 ± 11.8 g m(-2) h(-1)) and Japanese (83.2 ± 6.4 g m(-2) h(-1)) after leg immersion. In addition, Malaysians displayed a smaller rise in rectal temperature (0.3 ± 0.1°C) than Japanese (0.7 ± 0.1°C) during leg immersion, with a greater increase in hand skin temperature. Skin blood flow was significantly lower on the forehead and forearm in Malaysians during leg immersion. No significant different in mean skin temperature during leg immersion was observed between the two groups. These findings indicated that regional differences in body sweating distribution might exist between Malaysians and Japanese during heat exposure, with more uniform distribution of local sweat rate over the whole body among tropical Malaysians. Altogether, Malaysians appear to display enhanced efficiency of thermal sweating and thermoregulatory responses in dissipating heat loss during heat loading. Thermoregulatory differences between tropical and temperate natives in this study can be interpreted as a result of heat adaptations to physiological function.

Effect of the Heat-exposure on Peripheral Sudomotor Activity Including the Density of Active Sweat Glands and Single Sweat Gland Output

Tropical inhabitants are able to tolerate heat through permanent residence in hot and often humid tropical climates. The goal of this study was to clarify the peripheral mechanisms involved in thermal sweating pre and post exposure (heat-acclimatization over 10 days) by studying the sweating responses to acetylcholine (ACh), a primary neurotransmitter of sudomotor activity, in healthy subjects (n=12). Ten percent ACh was administered on the inner forearm skin for iontophoresis. Quantitative sudomotor axon reflex testing, after iontophoresis (2 mA for 5 min) with ACH, was performed to determine directly activated (DIR) and axon reflex-mediated (AXR) sweating during ACh iontophoresis. The sweat rate, activated sweat gland density, sweat gland output per single gland activated, as well as oral and skin temperature changes were measured. The post exposure activity had a short onset time (p<0.01), higher active sweat rate [(AXR (p<0.001) and DIR (p<0.001)], higher sweat output per gland (p<0.001) and higher transepidermal water loss (p<0.001) compared to the pre-exposure measurements. The activated sweat rate in the sudomotor activity increased the output for post-exposure compared to the pre-exposure measurements. The results suggested that post-exposure activity showed a higher active sweat gland output due to the combination of a higher AXR (DIR) sweat rate and a shorter onset time. Therefore, higher sudomotor responses to ACh receptors indicate accelerated sympathetic nerve responsiveness to ACh sensitivity by exposure to environmental conditions.

Heat Acclimatization in Hot Summer for Ten Weeks Suppress the Sensitivity of Sweating in Response to Iontophoretically-administered Acetylcholine

To determine the peripheral mechanisms involved in thermal sweating during the hot summers in July before acclimatization and after acclimatization in September, we evaluated the sweating response of healthy subjects (n=10) to acetylcholine (ACh), a primary neurotransmitter involved in peripheral sudomotor sensitivity. The quantitative sudomotor axon reflex test (QSART) measures sympathetic C fiber function after iontophoresed ACh evokes a measurable reliable sweat response. The QSART, at 2 mA for 5 min with 10% ACh, was applied to determine the directly activated (DIR) and axon reflex-mediated (AXR) sweating responses during ACh iontophoresis. The AXR sweat onset-time by the axon reflex was 1.50+/-0.32 min and 1.84+/-0.46 min before acclimatization in July and after acclimatization in September, respectively (p<0.01). The sweat volume of the AXR(1) [during 5 min 10% iontophoresis] by the axon reflex was 1.45+/-0.53 mg/cm(2) and 0.98+/-0.24 mg/cm(2) before acclimatization in July and after acclimatization in September, respectively (p<0.001). The sweat volume of the AXR(2) [during 5 min post-iontophoresis] by the axon reflex was 2.06+/-0.24 mg/cm(2) and 1.39+/-0.32 mg/cm(2) before and after acclimatization in July and September, respectively (p<0.001). The sweat volume of the DIR was 5.88+/-1.33 mg/cm(2) and 4.98+/-0.94 mg/cm(2) before and after acclimatization in July and September, respectively (p<0.01). These findings suggest that lower peripheral sudomotor responses of the ACh receptors are indicative of a blunted sympathetic nerve response to ACh during exposure to hot summer weather conditions.