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Rasmussen VF, Schmeichel A, Thrysøe M, Nyengaard JR, Christensen AMR, Vestergaard ET, Kristensen K, Terkelsen AJ, Karlsson P, Singer W. Sweat gland nerve fiber density and association with sudomotor function, symptoms, and risk factors in adolescents with type 1 diabetes. Clin Auton Res 2023; 33:691-703. [PMID: 37682387 PMCID: PMC10751258 DOI: 10.1007/s10286-023-00973-7] [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: 05/24/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To quantify sweat gland nerve fiber density in adolescents with diabetes. Additionally, to investigate associations between sudomotor innervation, sweat responses, and possible risk factors for sudomotor neuropathy. METHODS Cross-sectional study where 60 adolescents with type 1 diabetes (duration > 5 years) and 23 control subjects were included. Clinical data, quantitative sudomotor axon reflex test, and skin biopsies were obtained. Skin tissue was immunostained and imaged by confocal microscopy. Quantification of the sweat gland volume and three-dimensional reconstruction of the nerve fibers was performed using a design-unbiased technique. RESULTS Adolescents with diabetes had a significant reduction of maximum and mean values of nerve fiber length and nerve fiber density in sweat glands compared to controls (p values < 0.05). No association between nerve fiber density and sweat responses was found (p = 0.21). In cases with reduced sweat gland nerve fiber length, nerve fiber density, and volume, the sweat response was reduced or absent. Height, systolic blood pressure, time in hypoglycemia, and total daily and basal/total insulin dose were positively correlated to sweat response, while low-density lipoprotein, and HbA1c were negatively correlated with sweat response (p values < 0.05). Other microvascular complications and high cholesterol levels increased the relative risk for reduced sweat gland nerve fiber density. CONCLUSION Our findings of reduced sweat gland innervation in a selected group of adolescents add new knowledge about the structural changes that occur in autonomic nerves due to diabetes. Evaluating both the sweat gland innervation and sweat gland volume was important for understanding the association with sweat responses. Further research is needed to understand its clinical relevance.
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Affiliation(s)
- Vinni Faber Rasmussen
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Pediatrics and Adolescents, Randers Regional Hospital, Randers, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
| | - Ann Schmeichel
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Mathilde Thrysøe
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Randel Nyengaard
- Core Center for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Ann-Margrethe Rønholt Christensen
- Steno Diabetes Center North Denmark, Aalborg, Denmark
- Department of Pediatrics and Adolescents, Aalborg University Hospital, Aalborg, Denmark
| | - Esben Thyssen Vestergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics and Adolescents, Aarhus University Hospital, Aarhus, Denmark
| | - Kurt Kristensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics and Adolescents, Aarhus University Hospital, Aarhus, Denmark
| | - Astrid Juhl Terkelsen
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Páll Karlsson
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Core Center for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Kwon RW, Park JS, Lee HG, Park JI, Choo EA, Lee SJ, Lee JB. Coffee intake may promote sudomotor function activation via the contribution of caffeine. Front Nutr 2022; 9:1051828. [PMID: 36570158 PMCID: PMC9774485 DOI: 10.3389/fnut.2022.1051828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Ryeo-Won Kwon
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea,Department of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Jin-Sun Park
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ha-Gyoung Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Jong-In Park
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Eon-Ah Choo
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Seung-Jea Lee
- Department of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Jeong-Beom Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea,Department of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea,*Correspondence: Jeong-Beom Lee,
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Hayakawa T, Fujita F, Okada F, Sekiguchi K. Establishment and characterization of immortalized sweat gland myoepithelial cells. Sci Rep 2022; 12:7. [PMID: 34997030 PMCID: PMC8741770 DOI: 10.1038/s41598-021-03991-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
Sweat glands play an important role in thermoregulation via sweating, and protect human vitals. The reduction in sweating may increase the incidence of hyperthermia. Myoepithelial cells in sweat glands exhibit stemness characteristics and play a major role in sweat gland homeostasis and sweating processes. Previously, we successfully passaged primary myoepithelial cells in spheroid culture systems; however, they could not be maintained for long under in vitro conditions. No myoepithelial cell line has been established to date. In this study, we transduced two immortalizing genes into primary myoepithelial cells and developed a myoepithelial cell line. When compared with primary sweat gland cells, the immortalized myoepithelial cells (designated "iEM") continued to form spheroids after the 4th passage and expressed α-smooth muscle actin and other proteins that characterize myoepithelial cells. Furthermore, treatment with small compounds targeting the Wnt signaling pathways induced differentiation of iEM cells into luminal cells. Thus, we successfully developed an immortalized myoepithelial cell line having differentiation potential. As animal models are not useful for studying human sweat glands, our cell line will be helpful for studying the mechanisms underlying the pathophysiology of sweating disorders.
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Affiliation(s)
- Tomohisa Hayakawa
- Laboratory of Advanced Cosmetic Science, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Fumitaka Fujita
- Laboratory of Advanced Cosmetic Science, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Fundamental Research Institute, Mandom Corporation, Osaka, Japan.
| | - Fumihiro Okada
- Laboratory of Advanced Cosmetic Science, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Fundamental Research Institute, Mandom Corporation, Osaka, Japan
| | - Kiyotoshi Sekiguchi
- Division of Matrixome Research and Application, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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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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Park TH, Lee JB, Lee HJ, Yun B. Sex-related differences in sudomotor function in healthy early twenties focused on activated sweat gland density. CHINESE J PHYSIOL 2020; 63:1-6. [PMID: 32056980 DOI: 10.4103/cjp.cjp_46_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Tae-Hwan Park
- College of Medicine, Soonchunhyang University, 366-1 Ssangyong-dong, Cheonan 31151, Republic of Korea
| | - Jeong-Beom Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, 366-1 Ssangyong-dong, Cheonan 31151, Republic of Korea
| | - Hye-Jin Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, 366-1 Ssangyong-dong, Cheonan 31151, Republic of Korea
| | - Bahda Yun
- College of Arts and Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
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Tan CCS, Chin LKK, Low ICC. Thermoregulation in the Aging Population and Practical Strategies to Overcome a Warmer Tomorrow. Proteomics 2019; 20:e1800468. [PMID: 31652021 DOI: 10.1002/pmic.201800468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/05/2019] [Indexed: 12/11/2022]
Abstract
As global temperatures continue to rise, improving thermal tolerance in the aged population is crucial to counteract age-associated impairments in thermoregulatory function. Impairments in reflex cutaneous vasodilation and sweating response can augment the vulnerability of older adults to heat-related injuries following exposure to heat stress. Mechanisms underlying a compromised cutaneous vasodilation are suggested to include reduced sympathetic neural drive, diminished cholinergic co-transmitter contribution, and altered second messenger signaling events. On the other hand, impairments in sweating response are ascribed to reduced sweat gland cholinergic sensitivity and altered cyclooxygenase and nitric oxide signaling. Several practical mitigation strategies such as exercise, passive heating, and behavioral adaptations are proposed as means to overcome heat stress and improve thermal tolerance in the aged. Aerobic exercise training is shown to be amongst the most effective ways to enhance thermoregulatory function. However, in elderly with limited exercise capability due to chronic diseases and mobility issues, passive heating can serve as a functional alternative as it has been shown to confer similar benefits to that of exercise training. Supplementary to exercise training and passive heating, behavioral adaptations can be applied to further enhance the heat-preparedness of the aged.
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Affiliation(s)
- Chee Chong Shawn Tan
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
| | - Li Kang Karen Chin
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
| | - Ivan Cherh Chiet Low
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
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Fujii N, McGarr GW, Nishiyasu T, Sigal RJ, Boulay P, Kenny GP. Ageing attenuates muscarinic‐mediated sweating differently in men and women with no effect on nicotinic‐mediated sweating. Exp Dermatol 2019; 28:968-971. [DOI: 10.1111/exd.13878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 11/03/2018] [Accepted: 01/01/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Naoto Fujii
- Faculty of Health and Sport SciencesUniversity of Tsukuba Tsukuba Japan
- Human and Environmental Physiology Research UnitUniversity of Ottawa Ottawa Ontario Canada
| | - Gregory W. McGarr
- Human and Environmental Physiology Research UnitUniversity of Ottawa Ottawa Ontario Canada
| | - Takeshi Nishiyasu
- Faculty of Health and Sport SciencesUniversity of Tsukuba Tsukuba Japan
| | - Ronald J. Sigal
- Human and Environmental Physiology Research UnitUniversity of Ottawa Ottawa Ontario Canada
- Departments of MedicineCardiac Sciences and Community Health SciencesFaculties of Medicine and KinesiologyUniversity of Calgary Calgary Alberta Canada
- Clinical Epidemiology ProgramOttawa Hospital Research Institute Ottawa Ontario Canada
| | - Pierre Boulay
- Faculty of Physical Activity SciencesUniversity of Sherbrooke Sherbrooke Quebec Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research UnitUniversity of Ottawa Ottawa Ontario Canada
- Clinical Epidemiology ProgramOttawa Hospital Research Institute Ottawa Ontario Canada
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Lee J, Shin Y. Comparison of density and output of sweat gland in tropical Africans and temperate Koreans. Auton Neurosci 2017; 205:67-71. [PMID: 28506659 DOI: 10.1016/j.autneu.2017.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/30/2017] [Accepted: 05/04/2017] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- JeongBeom Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, 366-1 Ssangyong-dong, Cheonan, Republic of Korea
| | - YoungOh Shin
- Department of Healthcare, Global Graduate School, Soonchunhyang University, 646 Eumnae-ri Sinchang-myeon, Asan-si, Republic of Korea.
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Shin YO, Lee JB, Kim JH. Seasonal acclimation in sudomotor function evaluated by QSART in healthy humans. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2016; 20:499-505. [PMID: 27610036 PMCID: PMC5014996 DOI: 10.4196/kjpp.2016.20.5.499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Young Oh Shin
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
| | - Jeong-Beom Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
| | - Jeong-Ho Kim
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
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