1
|
Metzler-Wilson K, Fang MM, Alibegovic K, Daggett JW, Narra SC, Dazé RP, Miller OG, Wilson TE. Effect of reflex and mechanical decreases in skin perfusion on thermal- and agonist-induced eccrine sweating in humans. Am J Physiol Regul Integr Comp Physiol 2023; 324:R271-R280. [PMID: 36622082 PMCID: PMC9970189 DOI: 10.1152/ajpregu.00066.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/07/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
In humans, skin blood flux (SkBF) and eccrine sweating are tightly coupled, suggesting common neural control and regulation. This study was designed to separate these two sympathetic nervous system end-organ responses via nonadrenergic SkBF-decreasing mechanical perturbations during heightened sudomotor drive. We induced sweating physiologically via whole body heat stress using a high-density tube-lined suit (protocol 1; 2 women, 4 men), and pharmacologically via forearm intradermal microdialysis of two steady-state doses of a cholinergic agonist, pilocarpine (protocol 2; 4 women, 3 men). During sweating induction, we decreased SkBF via three mechanical perturbations: arm and leg dependency to engage the cutaneous venoarteriolar response (CVAR), limb venous occlusion to engage the CVAR and decrease perfusion pressure, and limb arterial occlusion to cause ischemia. In protocol 1, heat stress increased arm cutaneous vascular conductance and forearm sweat rate (capacitance hygrometry). During heat stress, despite decreases in SkBF during each of the acute (3 min) mechanical perturbations, eccrine sweat rate was unaffected. During heat stress with extended (10 min) ischemia, sweat rate decreased. In protocol 2, both pilocarpine doses (ED50 and EMAX) increased SkBF and sweat rate. Each mechanical perturbation resulted in decreased SkBF but minimal changes in eccrine sweat rate. Taken together, these data indicate that a wide range of acute decreases in SkBF do not appear to proportionally decrease either physiologically- or pharmacologically induced eccrine sweating in peripheral skin. This preservation of evaporative cooling despite acutely decreased SkBF could have consequential impacts for heat storage and balance during changes in body posture, limb position, or blood flow restrictive conditions.
Collapse
Affiliation(s)
- Kristen Metzler-Wilson
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, Indiana
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Milie M Fang
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Kenan Alibegovic
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - James W Daggett
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Seetharam C Narra
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Robert P Dazé
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Olivia G Miller
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, Indiana
| | - Thad E Wilson
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
- Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky
- Saha Cardiovascular Research Center, University of Kentucky College of Medicine, Lexington, Kentucky
| |
Collapse
|
2
|
Zampoli M, Verstraete J, Nguyen-Khoa T, Sermet-Gaudelus I, Zar HJ, Gonska T, Morrow BM. β-adrenergic sweat test in children with inconclusive cystic fibrosis diagnosis: Do we need new reference ranges? Pediatr Pulmonol 2023; 58:187-196. [PMID: 36193559 PMCID: PMC10092537 DOI: 10.1002/ppul.26179] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/18/2022] [Accepted: 10/02/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Investigating inconclusive cystic fibrosis (CF) diagnosis in children is difficult without advanced cystic fibrosis transmembrane conductance regulator (CFTR) function tests. This study investigated the utility of beta (β)-adrenergic sweat test to exclude CF in participants with inconclusive diagnosis (CF suspects) in South Africa. METHODS β-adrenergic sweat test and sweat chloride tests (SCT) were performed simultaneously in CF suspects and adult controls (healthy, CFTR heterozygotes and CF). Cholinergic and β-adrenergic induced sweat rate was measured by evaporimetry (transepithelial water loss [TEWL]: g H2 O/m2 /h) following intradermal injections. Next-generation sequencing of CFTR was performed in CF suspects. CF diagnosis was defined by genotype. RESULTS Thirty-seven controls (10 healthy, 14 CF, 13 CFTR heterozygotes) and 32 CF suspects (26 children; 6 adults) were enrolled. Six were excluded from formal analyses due to β-adrenergic sweat test failure. In adults, evaporimetry was superior to SCT for diagnosis of CF with β-adrenergic:cholinergic ratio TEWL ≤ 0.05 achieving 100% sensitivity and specificity. Twenty-two CF suspect children (age range: 3.4-15.6 years) completed β-adrenergic sweat testing of which none had CF confirmed by genotyping: β-adrenergic:cholinergic ratio > 0.05 successfully excluded CF in all but one child who was CFTR heterozygous. Median peak β-adrenergic TEWL and β-adrenergic:cholinergic ratio in CFTR negative and CFTR heterozygous children was significantly lower than adult controls. CONCLUSION β-adrenergic sweat test is more accurate than SCT for excluding CF in children with inconclusive diagnosis. Established reference ranges for β-adrenergic sweat test may not be suitable for children due to lower β-adrenergic sweat secretion compared to adults.
Collapse
Affiliation(s)
- Marco Zampoli
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,South African MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Janine Verstraete
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Thao Nguyen-Khoa
- Laboratories of Biochemistry and Newborn screening, Necker-Enfants Malades Hospital Assistance Publique-Hôpitaux de Paris, Paris, France.,Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées. Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.,Institut National de la Santé et de la Recherche Médicale U1151, Institut Necker Enfants Malades, Paris, France
| | - Isabelle Sermet-Gaudelus
- Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées. Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.,Institut National de la Santé et de la Recherche Médicale U1151, Institut Necker Enfants Malades, Paris, France.,European Respiratory Network for Rare Diseases of the Lung
| | - Heather J Zar
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,South African MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Tanja Gonska
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Toronto, and The Program of Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda M Morrow
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
3
|
Nguyen-Khoa T, Hatton A, Drummond D, Aoust L, Schlatter J, Martin C, Ramel S, Kiefer S, Gachelin E, Stremler N, Cosson L, Gabsi A, Remus N, Benhamida M, Hadchouel A, Fajac I, Munck A, Girodon E, Sermet-Gaudelus I. Reclassifying inconclusive diagnosis for Cystic Fibrosis with new generation sweat test. Eur Respir J 2022; 60:13993003.00209-2022. [PMID: 35777769 DOI: 10.1183/13993003.00209-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Thao Nguyen-Khoa
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France.,Laboratoires de Biochimie & du Centre Régional de Dépistage Néonatal- Ile-de-France, Hôpital Necker-Enfants Malades, Paris, France.,Centre de Référence Maladies Rares, Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France
| | - Aurélie Hatton
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France
| | - David Drummond
- Centre de Référence Maladies Rares, Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France.,Service de Pneumo-Allergologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
| | - Laura Aoust
- Centre de Référence Maladies Rares, Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France.,Service de Pneumo-Allergologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
| | - Joël Schlatter
- Pharmacie Clinique, Hôpital Necker-Enfants Malades, Paris, France
| | - Clémence Martin
- Centre de Ressource et de Compétence de la Mucoviscidose (CRCM), Explorations-Fonctionnelles, Hôpital Cochin, Paris, France
| | - Sophie Ramel
- CRCM, Hôpital Hélio Marin, Fondation Ildys, Roscoff, France
| | - Sébastien Kiefer
- CRCM Pédiatrique, Hôpital de Mercy, Centre Hospitalier Régional Universitaire, Nancy, France
| | - Elsa Gachelin
- Service de Pédiatrie, Hôpital Félix-Guyon, Centre Hospitalier Universitaire, Saint Denis, France
| | | | | | - Asma Gabsi
- CRCM, Hôpital André Mignot, Le Chesnay, France
| | - Natascha Remus
- CRCM, Hôpital Inter-Communal de Créteil, Créteil, France
| | - Myriam Benhamida
- CRCM, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Alice Hadchouel
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France.,Centre de Référence Maladies Rares, Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France.,Service de Pneumo-Allergologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
| | - Isabelle Fajac
- Université de Paris, Paris, France.,Centre de Ressource et de Compétence de la Mucoviscidose (CRCM), Explorations-Fonctionnelles, Hôpital Cochin, Paris, France
| | - Anne Munck
- Laboratoires de Biochimie & du Centre Régional de Dépistage Néonatal- Ile-de-France, Hôpital Necker-Enfants Malades, Paris, France
| | - Emmanuelle Girodon
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France.,Université de Paris, Paris, France.,Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, Paris, France
| | - Isabelle Sermet-Gaudelus
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France .,Université de Paris, Paris, France.,Centre de Référence Maladies Rares, Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France.,Service de Pneumo-Allergologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
| |
Collapse
|
4
|
Phadke MY, Sellers ZM. Current clinical opinion on CFTR dysfunction and patient risk of pancreatitis: diagnostic and therapeutic considerations. Expert Rev Gastroenterol Hepatol 2022; 16:499-509. [PMID: 35623009 PMCID: PMC9256802 DOI: 10.1080/17474124.2022.2084072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Cystic fibrosis transmembrane conductance regulator (CFTR)-mediated chloride and bicarbonate secretion is integral to the pancreas' ability to produce the alkaline pancreatic juice required for proper activation of enzymes for digestion. Disruption in this process increases the risk for pancreatitis. AREAS COVERED Using original basic and clinical research, as well as clinical case reports and recent reviews indexed in PubMed, we discuss why patients with CFTR dysfunction are at risk for pancreatitis. We also discuss diagnostic modalities for assessing CFTR function, as well as new therapeutic advancements and the impact these are having on pancreatic function, pancreatitis in particular. EXPERT OPINION CFTR-related pancreatitis occurs in the presence of monallelic or biallelic mutations and/or from toxin-mediated channel disruption. Research-based CFTR diagnostics have been expanded, yet all current methods rely on measuring CFTR chloride transport in non-pancreatic cells/tissue. Newer CFTR-directed therapies ('CFTR modulators') are both improving pancreatitis (pancreatic-sufficient CF patients) and increasing the risk for pancreatitis (previously pancreatic-insufficient CF patients). Our experiences with these drugs are enlightening us on how CFTR modulation can affect pancreatitis risk across a wide spectrum of pancreatic disease, and represents an opportunity for therapeutic relief from pancreatitis in those without CF, but who suffer from CFTR-related pancreatitis.
Collapse
Affiliation(s)
- Madhura Y. Phadke
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, 750 Welch Road, Suite 116, Palo Alto, CA
| | - Zachary M. Sellers
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, 750 Welch Road, Suite 116, Palo Alto, CA
| |
Collapse
|
5
|
Ramalho AS, Boon M, Proesmans M, Vermeulen F, Carlon MS, De Boeck K. Assays of CFTR Function In Vitro, Ex Vivo and In Vivo. Int J Mol Sci 2022; 23:1437. [PMID: 35163362 PMCID: PMC8836180 DOI: 10.3390/ijms23031437] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 12/22/2022] Open
Abstract
Cystic fibrosis, a multi-organ genetic disease, is characterized by abnormal function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein, a chloride channel at the apical membrane of several epithelia. In recent years, therapeutic strategies have been developed to correct the CFTR defect. To evaluate CFTR function at baseline for diagnosis, or the efficacy of CFTR-restoring therapy, reliable tests are needed to measure CFTR function, in vitro, ex vivo and in vivo. In vitro techniques either directly or indirectly measure ion fluxes; direct measurement of ion fluxes and quenching of fluorescence in cell-based assays, change in transmembrane voltage or current in patch clamp or Ussing chamber, swelling of CFTR-containing organoids by secondary water influx upon CFTR activation. Several cell or tissue types can be used. Ex vivo and in vivo assays similarly evaluate current (intestinal current measurement) and membrane potential differences (nasal potential difference), on tissues from individual patients. In the sweat test, the most frequently used in vivo evaluation of CFTR function, chloride concentration or stimulated sweat rate can be directly measured. Here, we will describe the currently available bio-assays for quantitative evaluation of CFTR function, their indications, advantages and disadvantages, and correlation with clinical outcome measures.
Collapse
Affiliation(s)
- Anabela S. Ramalho
- CF Research Lab, Woman and Child Unit, Department of Development and Regeneration, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium; (M.B.); (M.P.); (F.V.); (K.D.B.)
| | - Mieke Boon
- CF Research Lab, Woman and Child Unit, Department of Development and Regeneration, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium; (M.B.); (M.P.); (F.V.); (K.D.B.)
- Department of Pediatrics, Pediatric Pulmonology, University Hospital of Leuven, B-3000 Leuven, Belgium
| | - Marijke Proesmans
- CF Research Lab, Woman and Child Unit, Department of Development and Regeneration, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium; (M.B.); (M.P.); (F.V.); (K.D.B.)
- Department of Pediatrics, Pediatric Pulmonology, University Hospital of Leuven, B-3000 Leuven, Belgium
| | - François Vermeulen
- CF Research Lab, Woman and Child Unit, Department of Development and Regeneration, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium; (M.B.); (M.P.); (F.V.); (K.D.B.)
- Department of Pediatrics, Pediatric Pulmonology, University Hospital of Leuven, B-3000 Leuven, Belgium
| | - Marianne S. Carlon
- Molecular Virology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium;
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium
| | - Kris De Boeck
- CF Research Lab, Woman and Child Unit, Department of Development and Regeneration, KU Leuven (Catholic University of Leuven), B-3000 Leuven, Belgium; (M.B.); (M.P.); (F.V.); (K.D.B.)
- Department of Pediatrics, Pediatric Pulmonology, University Hospital of Leuven, B-3000 Leuven, Belgium
| |
Collapse
|
6
|
Zhang L, Zhang X, Du L, Zhang C, Li H. Cholinergic- rather than adrenergic-induced sweating play a role in developing and developed rat eccrine sweat glands. Exp Anim 2020; 70:218-224. [PMID: 33298631 PMCID: PMC8150243 DOI: 10.1538/expanim.20-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Both cholinergic and adrenergic stimulation can induce sweat secretion in human eccrine sweat glands, but whether cholinergic and adrenergic stimulation play same roles in rat eccrine sweat glands is still controversial. To explore the innervations, and adrenergic- and cholinergic-induced secretory response in developing and developed rat eccrine sweat glands, rat hind footpads from embryonic day (E) 15.5-20.5, postanal day (P) 1-14, P21 and adult were fixed, embedded, sectioned and subjected to immunofluorescence staining for general fiber marker protein gene product 9.5 (PGP 9.5), adrenergic fiber marker tyrosine hydroxylase (TH) and cholinergic fiber marker vasoactive intestinal peptide (VIP), and cholinergic- and adrenergic-induced sweat secretion was detected at P1-P21 and adult rats by starch-iodine test. The results showed that eccrine sweat gland placodes of SD rats were first appeared at E19.5, and the expression of PGP 9.5 was detected surrounding the sweat gland placodes at E19.5, TH at P7, and VIP at P11. Pilocarpine-induced sweat secretion was first detected at P16 in hind footpads by starch-iodine test. There was no measurable sweating when stimulated by alpha- or beta-adrenergic agonists at all the examined time points. We conclude that rat eccrine sweat glands, just as human eccrine sweat glands, co-express adrenergic and cholinergic fibers, but different from human eccrine sweat glands, cholinergic- rather than adrenergic-induced sweating plays a role in the developing and developed rat eccrine sweat glands.
Collapse
Affiliation(s)
- Lei Zhang
- Mental Health Center, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, P.R. China
| | - Xiang Zhang
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, P.R. China
| | - Lijie Du
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, P.R. China
| | - Cuiping Zhang
- Research Center for Tissue Repair and Regeneration affiliated to the Medical Innovation Research Department and Fourth Medical Center of PLA General Hospital, Beijing 100048, P.R. China
| | - Haihong Li
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, P.R. China
| |
Collapse
|
7
|
Amano T, Fujii N, Kenny GP, Nishiyasu T, Inoue Y, Kondo N. The relative contribution of α- and β-adrenergic sweating during heat exposure and the influence of sex and training status. Exp Dermatol 2020; 29:1216-1224. [PMID: 33015872 DOI: 10.1111/exd.14208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/14/2020] [Accepted: 09/27/2020] [Indexed: 02/04/2023]
Abstract
While human eccrine sweat glands respond to adrenergic agonists, there remains a paucity of information on the factors modulating this response. Thus, we assessed the relative contribution of α- and β-adrenergic sweating during a heat exposure and as a function of individual factors of sex and training status. α- and β-adrenergic sweating was assessed in forty-eight healthy young men (n = 35) and women (n = 13) including endurance-trained (n = 12) and untrained men (n = 12) under non-heat exposure (temperate, 25°C; n = 17) and heat exposure (hot, 35°C; n = 48) conditions using transdermal iontophoresis of phenylephrine (α-adrenergic agonist) and salbutamol (β-adrenergic agonist) on the ventral forearm, respectively. Adrenergic sweating was also measured after iontophoretic administration of atropine (muscarinic receptor antagonist) or saline (control) to evaluate how changes in muscarinic receptor activity modulate the adrenergic response to a heat exposure (n = 12). α- and β-adrenergic sweating was augmented in hot compared with temperate conditions (both P ≤ .014), albeit the relative increase was greater in β (~5.4-fold)- as compared to α (~1.5-fold)-adrenergic-mediated sweating response. However, both α- and β-adrenergic sweating was abolished by atropinization (P = .001). Endurance-trained men showed an augmentation in α- (P = .043) but not β (P = .960)-adrenergic sweating as compared to untrained men. Finally, a greater α- and β-adrenergic sweating response (both P ≤ .001) was measured in habitually active men than in women. We show that heat exposure augments α-and β-adrenergic sweating differently via mechanisms associated with altered muscarinic receptor activity. Sex and training status modulate this response.
Collapse
Affiliation(s)
- Tatsuro Amano
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Yoshimitsu Inoue
- Laboratory for Human Performance Research, Osaka International University, Osaka, Japan
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| |
Collapse
|
8
|
Image-based β-adrenergic sweat rate assay captures minimal cystic fibrosis transmembrane conductance regulator function. Pediatr Res 2020; 87:137-145. [PMID: 31344706 PMCID: PMC6962560 DOI: 10.1038/s41390-019-0503-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/14/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is a need to prognosticate the severity of cystic fibrosis (CF) detected by newborn screening (NBS) by early assessment of CF transmembrane conductance regulator (CFTR) protein function. We introduce novel instrumentation and protocol for evaluating CFTR activity as reflected by β-adrenergically stimulated sweat secretion. METHODS A pixilated image sensor detects sweat rates. Compounds necessary for maximum sweat gland stimulation are applied by iontophoresis, replacing ID injections. Results are compared to a validated β-adrenergic assay that measures sweat secretion by evaporation (evaporimetry). RESULTS Ten healthy controls (HC), 6 heterozygous (carriers), 5 with CFTR-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID), and 12 CF individuals completed testing. All individuals with minimal and residual function CFTR mutations had low ratios of β-adrenergically stimulated sweat rate to cholinergically stimulated sweat rate (β/chol) as measured by either assay. CONCLUSIONS β-Adrenergic assays quantitate CFTR dysfunction in the secretory pathway of sweat glands in CF and CRMS/CFSPID populations. This novel image-sensor and iontophoresis protocol detect CFTR function with minimal and residual function and is a feasible test for young children because it is insensible to movement and it decreases the number of injections. It may also assist to distinguish between CF and CRMS/CFSPID diagnosis.
Collapse
|