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Davis N, Heikenfeld J, Milla C, Javey A. The challenges and promise of sweat sensing. Nat Biotechnol 2024; 42:860-871. [PMID: 38212492 DOI: 10.1038/s41587-023-02059-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024]
Abstract
The potential of monitoring biomarkers in sweat for health-related applications has spurred rapid growth in the field of wearable sweat sensors over the past decade. Some of the key challenges have been addressed, including measuring sweat-secretion rate and collecting sufficient sample volumes for real-time, continuous molecular analysis without intense exercise. However, except for assessment of cystic fibrosis and regional nerve function, the ability to accurately measure analytes of interest and their physiological relevance to health metrics remain to be determined. Although sweat is not a crystal ball into every aspect of human health, we expect sweat measurements to continue making inroads into niche applications involving active sweating, such as hydration monitoring for athletes and physical laborers and later for medical and casual health monitoring of relevant drugs and hormones.
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Affiliation(s)
- Noelle Davis
- Electrical Engineering and Computer Sciences, University of California at Berkeley, Berkeley, CA, USA
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jason Heikenfeld
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
- Department of Electrical and Computer Engineering, University of Cincinnati, Cincinnati, OH, USA.
| | - Carlos Milla
- The Stanford Cystic Fibrosis Center, Center for Excellence in Pulmonary Biology, Stanford School of Medicine, Palo Alto, CA, USA.
| | - Ali Javey
- Electrical Engineering and Computer Sciences, University of California at Berkeley, Berkeley, CA, USA.
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
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2
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Peltier AC. Autonomic Dysfunction from Diagnosis to Treatment. Prim Care 2024; 51:359-373. [PMID: 38692780 DOI: 10.1016/j.pop.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Autonomic disorders can present with hypotension, gastrointestinal, genitourinary symptoms, and heat intolerance. Diabetes is the most common causes of autonomic failure, and management should focus on glucose control to prevent developing autonomic symptoms. The most prevalent cause of dysautonomia, or autonomic dysfunction, is Postural Orthostatic Tachycardia Syndrome (POTS). Autonomic testing characterizes causes for nonspecific symptoms but is not necessary in patients with classic presentations. Treatment for autonomic dysfunction and failure focus on discontinuing offending medications, behavioral modification, and pharmacologic therapy to decrease symptom severity. Autonomic failure has no cure; therefore, the focus remains on improving quality of life.
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Affiliation(s)
- Amanda C Peltier
- Department of Neurology, Vanderbilt University Medical Center, 1611 21st Avenue South, Nashville, TN 37232, USA; Department of Medicine, Vanderbilt University Medical Center, 1611 21st Avenue South, Nashville, TN 37232, USA.
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3
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Roche F, Pichot V, Mouhli-Gasmi L, Monier M, Barthélémy JC, Berger M, Celle S, Chouchou F. Anatomy and physiology of the autonomic nervous system: Implication on the choice of diagnostic/monitoring tools in 2023. Rev Neurol (Paris) 2024; 180:42-52. [PMID: 38176987 DOI: 10.1016/j.neurol.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The autonomic nervous system (ANS) harmoniously regulates all internal organic functions (heart rate, blood pressure, vasomotion, digestive tract motility, endocrinal secretions) and adapts them to the needs. It's the control of so-called vegetative functions, which allows homeostasis but also allostasis of our body. ANS is divided into two systems often understood as antagonistic and complementary: the sympathetic and the parasympathetic systems. However, we currently know of many situations of co-activation of the two systems. Long seen as acting through "reflex" control loops passing through the integration of peripheral information and the efferent response to the peripheral organ, more recent electrophysiological and brain functional imaging knowledge has been able to identify the essential role of the central autonomic network. This element complicates the understanding of the responses of the reflex loops classically used to identify and quantify dysautonomia. Finding the "ANS" tools best suited for the clinician in their daily practice is a challenge that we will attempt to address in this work.
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Affiliation(s)
- F Roche
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France.
| | - V Pichot
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - L Mouhli-Gasmi
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - M Monier
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - J-C Barthélémy
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - M Berger
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - S Celle
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - F Chouchou
- IRISSE EA4075, STAPS Department, La Reunion University, Le Tampon, France
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4
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Romanchuk O. Cardiorespiratory dynamics during respiratory maneuver in athletes. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3. [DOI: https:/doi.org/10.3389/fnetp.2023.1276899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction: The modern practice of sports medicine and medical rehabilitation requires the search for subtle criteria for the development of conditions and recovery of the body after diseases, which would have a prognostic value for the prevention of negative effects of training and rehabilitation tools, and also testify to the development and course of mechanisms for counteracting pathogenetic processes in the body. The purpose of this study was to determine the informative directions of the cardiorespiratory system parameters dynamics during the performing a maneuver with a change in breathing rate, which may indicate the body functional state violation.Methods: The results of the study of 183 healthy men aged 21.2 ± 2.3 years who regularly engaged in various sports were analyzed. The procedure for studying the cardiorespiratory system included conducting combined measurements of indicators of activity of the respiratory and cardiovascular systems in a sitting position using a spiroarteriocardiograph device. The duration of the study was 6 min and involved the sequential registration of three measurements with a change in breathing rate (spontaneous breathing, breathing at 0.1 Hz and 0.25 Hz).Results: Performing a breathing maneuver at breathing 0.1 Hz and breathing 0.25 Hz in comparison with spontaneous breathing leads to multidirectional significant changes in heart rate variability indicators–TP (ms2), LF (ms2), LFHF (ms2/ms2); of blood pressure variability indicators–TPDBP (mmHg2), LFSBP (mmHg2), LFDBP (mmHg2), HFSBP (mmHg2); of volume respiration variability indicators - LFR, (L×min-1)2; HFR, (L×min-1)2; LFHFR, (L×min-1)2/(L×min-1)2; of arterial baroreflex sensitivity indicators - BRLF (ms×mmHg-1), BRHF (ms×mmHg-1). Differences in indicators of systemic hemodynamics and indicators of cardiovascular and respiratory systems synchronization were also informative.Conclusion: According to the results of the study, it is shown that during performing a breathing maneuver with a change in the rate of breathing, there are significant changes in cardiorespiratory parameters, the analysis of which the increments made it possible to determine of the changes directions dynamics, their absolute values and informative limits regarding the possible occurrence of the cardiorespiratory interactions dysregulation.
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5
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Romanchuk O. Cardiorespiratory dynamics during respiratory maneuver in athletes. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1276899. [PMID: 38020241 PMCID: PMC10643240 DOI: 10.3389/fnetp.2023.1276899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023]
Abstract
Introduction: The modern practice of sports medicine and medical rehabilitation requires the search for subtle criteria for the development of conditions and recovery of the body after diseases, which would have a prognostic value for the prevention of negative effects of training and rehabilitation tools, and also testify to the development and course of mechanisms for counteracting pathogenetic processes in the body. The purpose of this study was to determine the informative directions of the cardiorespiratory system parameters dynamics during the performing a maneuver with a change in breathing rate, which may indicate the body functional state violation. Methods: The results of the study of 183 healthy men aged 21.2 ± 2.3 years who regularly engaged in various sports were analyzed. The procedure for studying the cardiorespiratory system included conducting combined measurements of indicators of activity of the respiratory and cardiovascular systems in a sitting position using a spiroarteriocardiograph device. The duration of the study was 6 min and involved the sequential registration of three measurements with a change in breathing rate (spontaneous breathing, breathing at 0.1 Hz and 0.25 Hz). Results: Performing a breathing maneuver at breathing 0.1 Hz and breathing 0.25 Hz in comparison with spontaneous breathing leads to multidirectional significant changes in heart rate variability indicators-TP (ms2), LF (ms2), LFHF (ms2/ms2); of blood pressure variability indicators-TPDBP (mmHg2), LFSBP (mmHg2), LFDBP (mmHg2), HFSBP (mmHg2); of volume respiration variability indicators - LFR, (L×min-1)2; HFR, (L×min-1)2; LFHFR, (L×min-1)2/(L×min-1)2; of arterial baroreflex sensitivity indicators - BRLF (ms×mmHg-1), BRHF (ms×mmHg-1). Differences in indicators of systemic hemodynamics and indicators of cardiovascular and respiratory systems synchronization were also informative. Conclusion: According to the results of the study, it is shown that during performing a breathing maneuver with a change in the rate of breathing, there are significant changes in cardiorespiratory parameters, the analysis of which the increments made it possible to determine of the changes directions dynamics, their absolute values and informative limits regarding the possible occurrence of the cardiorespiratory interactions dysregulation.
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Affiliation(s)
- Oleksandr Romanchuk
- Department of Medical Rehabilitation, Ukrainian Research Institute of Medical Rehabilitation and Resort Therapy of the Ministry of Health of Ukraine, Odesa, Ukraine
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6
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Faitatzidou D, Karagiannidis AG, Theodorakopoulou MP, Xanthopoulos A, Triposkiadis F, Sarafidis PA. Autonomic Nervous System Dysfunction in Peritoneal Dialysis Patients: An Underrecognized Cardiovascular Risk Factor? Am J Nephrol 2023; 55:37-55. [PMID: 37788657 DOI: 10.1159/000534318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND In patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD), cardiovascular events represent the predominant cause of morbidity and mortality, with cardiac arrhythmias and sudden death being the leading causes of death in this population. Autonomic nervous system (ANS) dysfunction is listed among the non-traditional risk factors accounting for the observed high cardiovascular burden, with a plethora of complex and not yet fully understood pathophysiologic mechanisms being involved. SUMMARY In recent years, preliminary studies have investigated and confirmed the presence of ANS dysfunction in PD patients, while relevant results from cohort studies have linked ANS dysfunction with adverse clinical outcomes in these patients. In light of these findings, ANS dysfunction has been recently receiving wider consideration as an independent cardiovascular risk factor in PD patients. The aim of this review was to describe the mechanisms involved in the pathogenesis of ANS dysfunction in ESKD and particularly PD patients and to summarize the existing studies evaluating ANS dysfunction in PD patients. KEY MESSAGES ANS dysfunction in PD patients is related to multiple complex mechanisms that impair the balance between SNS/PNS, and this disruption represents a crucial intermediator of cardiovascular morbidity and mortality in this population.
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Affiliation(s)
- Danai Faitatzidou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Artemios G Karagiannidis
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marieta P Theodorakopoulou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Filippos Triposkiadis
- Department of Cardiology, University Hospital of Larissa, Larissa, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Pantelis A Sarafidis
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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7
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Lefaucheur JP. Assessment of autonomic nervous system dysfunction associated with peripheral neuropathies in the context of clinical neurophysiology practice. Neurophysiol Clin 2023; 53:102858. [PMID: 36966708 DOI: 10.1016/j.neucli.2023.102858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
Peripheral neuropathies may involve the small diameter nerve fibers of the autonomic nervous system. In the presence of clinical signs compatible with dysautonomia, it is very difficult to affirm that these signs are really linked to an alteration in postganglionic autonomic innervation, and not to a lesion of the central nervous system or to a direct damage to the tissues and innervated organs. Also, in the context of the investigation of peripheral neuropathies, there is an interest in performing objective and quantitative assessment of distal autonomic innervation. The corresponding autonomic tests are mainly based on the exploration of sudomotor or vasomotor disorders of the limb extremities. In this article, we provide an overview of the various tests available for the study of the autonomic nervous system in clinical practice, including vasomotor reactivity tests, in particular based on laser Doppler techniques, and sudomotor tests, based on axon-reflexes produced by iontophoresis of cholinergic drugs or on the simpler measurement of electrochemical skin conductance by the Sudoscan® device.
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8
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Hovaguimian A. Dysautonomia. Neurol Clin 2022; 41:193-213. [DOI: 10.1016/j.ncl.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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9
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Prokhorov MD, Karavaev AS, Ishbulatov YM, Ponomarenko VI, Kiselev AR, Kurths J. Interbeat interval variability versus frequency modulation of heart rate. Phys Rev E 2021; 103:042404. [PMID: 34005986 DOI: 10.1103/physreve.103.042404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/23/2021] [Indexed: 01/15/2023]
Abstract
The heart rate in humans is regulated by the autonomic nervous system, which modulates the frequency of heart contractions, resulting in heart rate variability (HRV). Therefore, to assess the activity of the autonomic nervous system, which contains important information for medical diagnostics, methods based on the analysis of interbeat interval variability are often used. This approach does not require the use of invasive methods for measuring the signals of the autonomic nervous system, but its accuracy is an open question. Using mathematical modeling, we investigate the possibility of extracting the signal of frequency modulation of the heartbeats from the electrocardiogram (ECG) signal and conduct a detailed comparison of the extracted signal with the real modulating signal. Since the quality of extraction of the signal of frequency modulation from the ECG depends on the method of demodulation, we compare two different approaches. One is based on the detection of the main oscillation rhythm and its bandpass filtering, and the other on the heterodyning technique. It is shown that low-frequency (LF) and high-frequency (HF) oscillations in HRV associated, respectively, with sympathetic and parasympathetic modulation by the autonomic nervous system, in the general case, significantly differ from the signals of frequency modulation of the heart rate in shape, but have close similarity with them in the frequency domain. We find that in model systems, the similarity of the LF component of HRV with sympathetic modulation of the heart rate is higher than the similarity of the HF component of HRV with parasympathetic modulation.
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Affiliation(s)
- M D Prokhorov
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Zelyonaya Street 38, Saratov 410019, Russia
| | - A S Karavaev
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Zelyonaya Street 38, Saratov 410019, Russia
- Saratov State University, Astrakhanskaya Street 83, Saratov 410012, Russia
- Institute of Cardiological Research, Saratov State Medical University, Saratov, B. Kazachaya Street, 112, Saratov 410012, Russia
| | - Y M Ishbulatov
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Zelyonaya Street 38, Saratov 410019, Russia
- Saratov State University, Astrakhanskaya Street 83, Saratov 410012, Russia
- Institute of Cardiological Research, Saratov State Medical University, Saratov, B. Kazachaya Street, 112, Saratov 410012, Russia
| | - V I Ponomarenko
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Zelyonaya Street 38, Saratov 410019, Russia
- Saratov State University, Astrakhanskaya Street 83, Saratov 410012, Russia
| | - A R Kiselev
- Saratov State University, Astrakhanskaya Street 83, Saratov 410012, Russia
- Institute of Cardiological Research, Saratov State Medical University, Saratov, B. Kazachaya Street, 112, Saratov 410012, Russia
| | - J Kurths
- Saratov State University, Astrakhanskaya Street 83, Saratov 410012, Russia
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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10
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Williams ML. Global warming, heat-related illnesses, and the dermatologist. Int J Womens Dermatol 2020; 7:70-84. [PMID: 33537396 PMCID: PMC7838243 DOI: 10.1016/j.ijwd.2020.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/23/2022] Open
Abstract
Global warming, provoked by the greenhouse effect of high levels of atmospheric gases (most notably carbon dioxide and methane), directly threatens human health and survival. Individuals vary in their capacity to tolerate episodes of extreme heat. Because skin is the organ tasked with heat dissipation, it is important for dermatologists to be versed in the physiology of cutaneous heat dissipation and cognizant of clinical settings in which the skin’s thermoregulatory responses may be impaired. When the external temperature is lower than that of the skin, the skin releases internal heat through direct thermal exchange with the environment, a process that is aided by an expansion of cutaneous blood flow and eccrine sweating. Cooling through the evaporation of sweat is effective even when the external temperature exceeds that of skin. Many factors, including environmental and physiological (e.g., age and sex), and pathological (e.g., preexisting illnesses, disorders of eccrine function, and medications) considerations, affect the skin’s capacity to thermoregulate. Identification of individuals at increased risk for heat-related morbidity and mortality will become increasingly important in the care of patients.
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Affiliation(s)
- Mary L Williams
- Departments of Dermatology and Pediatrics, University of California San Francisco, San Francisco, CA, United States
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Abstract
Neuropathy is the most prevalent microvascular complication of diabetes mellitus; it encompasses distal symmetric polyneuropathy, autonomic neuropathy, radiculoplexus neuropathy, mononeuropathy, and treatment-induced neuropathy. The prevalence rate of diabetic neuropathy in Korea was reported to be approximately 43%, which is similar to rates in other countries. However, the precise pathogenic mechanism underlying diabetic neuropathy is still obscure, and many clinical trials have failed to develop methods to prevent or reduce the progression of diabetic neuropathy. Nevertheless, early diagnosis and proper management of diabetic neuropathy are essential to alleviate disabling symptoms and to improve the quality of life of patients. This review discusses clinical manifestations and classification of diabetic neuropathies, bedside neurological examination, and electrophysiological tests.
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Affiliation(s)
- Jeeyoung Oh
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
- Correspondence to Jeeyoung Oh, M.D. Department of Neurology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-7564 Fax: +82-2-2030-5169 E-mail:
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12
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Sanchez JMS, McNally JS, Cortez MM, Hemp J, Pace LA, Clardy SL. Neuroimmunogastroenterology: At the Interface of Neuroimmunology and Gastroenterology. Front Neurol 2020; 11:787. [PMID: 32849234 PMCID: PMC7412790 DOI: 10.3389/fneur.2020.00787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
The central nervous system (CNS) is an important regulator of the gastrointestinal tract, and CNS dysfunction can result in significant and disabling gastrointestinal symptom manifestation. For patients with neuroimmunologic and neuroinflammatory conditions, the recognition of gastrointestinal symptoms is under-appreciated, yet the gastrointestinal manifestations have a dramatic impact on quality of life. The current treatment strategies, often employed independently by the neurologist and gastroenterologist, raise the question of whether such patients are being treated optimally when siloed in one specialty. Neuroimmunogastroenterology lies at the borderlands of medical specialties, and there are few resources to guide neurologists in this area. Here, we provide an overview highlighting the potential mechanisms of crosstalk between immune-mediated neurological disorders and gastrointestinal dysfunction.
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Affiliation(s)
- John Michael S. Sanchez
- Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, UT, United States
| | - J. Scott McNally
- Department of Radiology, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, United States
| | - Melissa M. Cortez
- Department of Neurology, Imaging and Neurosciences Center, University of Utah, Salt Lake City, UT, United States
| | - James Hemp
- Division of Gastroenterology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Laura A. Pace
- Division of Gastroenterology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - Stacey L. Clardy
- Department of Neurology, Imaging and Neurosciences Center, University of Utah, Salt Lake City, UT, United States
- George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, United States
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