Changes in cholinergic responses of sweat glands during denervation and reinnervation

Methods for in vivo studies in rodents of chemotherapy induced peripheral neuropathy

Peripheral neuropathy is one of the most common, dose limiting, and long-lasting disabling adverse events of chemotherapy treatment. Unfortunately, no treatment has proven efficacy to prevent this adverse effect in patients or improve the nerve regeneration, once it is established. Experimental models, particularly using rats and mice, are useful to investigate the mechanisms related to axonal or neuronal degeneration and target loss of function induced by neurotoxic drugs, as well as to test new strategies to prevent the development of neuropathy and to improve functional restitution. Therefore, objective and reliable methods should be applied for the assessment of function and innervation in adequately designed in vivo studies of CIPN, taking into account the impact of age, sex and species/strains features. This review gives an overview of the most useful methods to assess sensory, motor and autonomic functions, electrophysiological and morphological tests in rodent models of peripheral neuropathy, focused on CIPN. We include as well a proposal of protocols that may improve the quality and comparability of studies undertaken in different laboratories. It is recommended to apply more than one functional method for each type of function, and to perform parallel morphological studies in the same targets and models.

Sweating disorders in mice with and without nerve lesions

BACKGROUND

Hypersensitivity and altered sweating are often present in neuropathy patients. Nerve lesions are known to produce sudomotor dysfunctions but also patients suffering from complex regional pain syndrome, CRPS1-a condition without a nerve lesion-present with sweating disorders.

METHODS

Using proton nuclear magnetic resonance of sweat water, we quantified sweat output of mice suffering from a nerve lesion or a bone fracture without nerve lesion and correlated their sweating with behavioural paw hypersensitivity accessed in von Frey testings, water applications and weight-bearing measured with an incapacitance metre.

RESULTS

Lesioned animals sweat less and are hypersensitive compared to healthy controls, as expected. Fractured animals on the injured side sweat less acutely after the injury but more in the chronic phase. They are hypersensitive acutely as well as chronically after the fracture. These findings resemble human bone trauma patients in the acute phase and CRPS patients in the chronic phase.

CONCLUSIONS

Sweating disorders are present both in neuropathic animals and in those with a bone fracture without nerve lesions, and autonomic dysfunctions might be considered as an important component in the aetiology of neuropathies.

SIGNIFICANCE

Sweat output changes in mice after bone trauma, potentially indicative of posttraumatic processes leading to CRPS in humans.

Is active sweating during heat acclimation required for improvements in peripheral sweat gland function?

We investigated whether the eccrine sweat glands must actively produce sweat during heat acclimation if they are to adapt and increase their capacity to sweat. Eight volunteers received intradermal injections of BOTOX, to prevent neural stimulation and sweat production of the sweat glands during heat acclimation, and saline injections as a control in the contralateral forearm. Subjects performed 90 min of moderate-intensity exercise in the heat (35 degrees C, 40% relative humidity) on 10 consecutive days. Heat acclimation decreased end-exercise heart rate (156 +/- 22 vs. 138 +/- 17 beats/min; P = 0.0001) and rectal temperature (38.2 +/- 0.3 vs. 37.9 +/- 0.3 degrees C; P = 0.0003) and increased whole body sweat rate (0.70 +/- 0.29 vs. 1.06 +/- 0.50 l/h; P = 0.030). During heat acclimation, there was no measurable sweating in the BOTOX-treated forearm, but the control forearm sweat rate during exercise increased 40% over the 10 days (P = 0.040). Peripheral sweat gland function was assessed using pilocarpine iontophoresis before and after heat acclimation. Before heat acclimation, the pilocarpine-induced sweat rate of the control and BOTOX-injected forearms did not differ (0.65 +/- 0.20 vs. 0.66 +/- 0.22 mg x cm(-2) x min(-1)). However, following heat acclimation, the pilocarpine-induced sweat rate in the control arm increased 18% to 0.77 +/- 0.21 mg x cm(-2) x min(-1) (P = 0.021) but decreased 52% to 0.32 +/- 0.18 mg x cm(-2) x min(-1) (P < 0.001) in the BOTOX-treated arm. Using complete chemodenervation of the sweat glands, coupled with direct cholinergic stimulation via pilocarpine iontophoresis, we demonstrated that sweat glands must be active during heat acclimation if they are to adapt and increase their capacity to sweat.

Localization of aquaporin-5 in sweat glands and functional analysis using knockout mice

Sweat secretion involves the transport of salt and water into the lumen of the secretory coil of the sweat gland. By analogy to salivary and submucosal glands, where fluid secretion is aquaporin-5 (AQP5) dependent, we postulated that aquaporin water channels might facilitate sweat secretion. Immunolocalization with specific antibodies revealed strong expression of AQP5 at the luminal membrane of secretory epithelial cells in sweat glands in mouse paw skin. Novel quantitative methods were developed to compare sweat secretion in wild-type mice and mice lacking AQP5. Total hindpaw sweat secretion was measured by proton nuclear magnetic resonance of sweat-derived (1)H(2)O in (2)H(2)O solvent, and sweat secretion from individual glands was measured by real-time video imaging of sweat droplet formation under oil. Sweat secretion rates after pilocarpine stimulation did not differ in wild-type mice (0.21 +/- 0.03 nl min(-1) gland(-1)) vs. mice lacking AQP5 (0.19 +/- 0.04 nl min(-1) gland(-1)). The lack of effect of AQP5 on sweat secretion rate was confirmed by microcapillary collections of sweat from defined regions of mouse paws. Also, as by direct counting of droplets, the number of functional sweat glands was not affected by AQP5 deletion. Sweat gland morphology was similar in wild-type and AQP5 null mice. From sweat coil geometry and gland secretion rate, the rate of fluid secretion was estimated to be 130 nl min(-1) cm(-2) of secretory epithelium, substantially lower than that of > 500 nl min(-1) cm(-2) in kidney proximal tubules and salivary glands, where active fluid absorption or secretion is aquaporin dependent. These results indicate the expression of AQP5 in sweat gland secretory epithelium, but provide direct evidence against its physiological involvement in sweat fluid secretion in mice.

Changes in mouse sudomotor function and sweat gland innervation with ageing

Age-related changes in sudomotor neuroeffector function have been evaluated in mice aged 2 (young), 6, 12 (adult) and 18 (old) months. We evaluated sudomotor function by determining the number of sweat glands reactive to pilocarpine and the sweat output per gland on the plantar surface of the hindpaws with the impression mould technique. Protein gene product 9.5 (PGP) and vasoactive intestinal polypeptide (VIP) were immunohistochemically localised in footpads. A marked decrease (44%) in sweat output per gland was observed in old mice as well as a slight (17%), not significant decline in the number of secreting sweat glands. The sudomotor innervation, expressed as the area of sweat gland occupied by VIP and PGP immunoreactive nerve profiles, showed an initial increase from 2 to 6 months and a significant decline (35%) in 18- vs. 6-month-old mice. These results indicate that, in contrast to the number of secreting sweat glands, sweat output per gland does not reach the maximum in adult mouse until 6 months old and that sweating decreases in aged mice mainly due to a decline of sweat output per gland and to a lesser extent to a decrease in number of secreting glands. A reduction of sweat glands size in aged mice was also found, suggesting that the diminished sweat gland responsiveness with ageing may be attributed to sweat gland atrophy as well as to loss of innervation.

Evaluation of direct and axon reflex sweating in the mouse

The nicotinic axon reflex-mediated sudomotor response was studied in mice and rats by recording the impressions of sweat droplets made in silicone molds after local injection of nicotine, and compared with sweating induced by acetylcholine and pilocarpine. Nicotine failed to activate mouse plantar sweat glands at any of the concentrations used (from 3 x 10(-6) to 3 x 10(-1) M). On the contrary, both acetylcholine and pilocarpine produced a dose-dependent increase in the number of secreting sweat glands. The location of sweat glands reactive to pilocarpine and acetylcholine was similar and restricted to the pads near the site of injection. We conclude that the sudomotor axon reflex response mediated by nicotinic receptors is not present in the mouse and the rat.