A model for in vivo analysis of sudomotor sympathetic C-fiber activation and human sweat gland output

Intradermal electrical stimulation of sudomotor nerves and local sweat rate

The local sweat rate (LSR) response to intradermal electrical stimulation generates a sigmodal stimulus-response curve with a peak sweat rate generated during a 30-s period of continuous stimuli at a frequency of 16-32 Hz. However, the in vivo firing pattern of the sudomotor nerve resembles more of a bursting pattern. We tested the hypothesis that a bursting pattern during intradermal electrical stimulation would result in a greater sweating response than the regular continuous stimulus pattern. Fifteen subjects were studied in a temperature-controlled room at 27.6 ± 0.2°C. The LSR was measured with a miniature sweat capsule with guide sleeves for holding the intradermal stimulating electrodes. The nine continuous stimulus frequencies (0.2, 1, 2, 4, 8, 12, 16, 32, and 64 Hz) were compared to a bursting pattern with a similar total number of stimuli. The sweating response was determined as the area under the ∆LSR-time curve. Peak ∆LSR was slightly higher for the continuous stimuli (0.396 ± 0.242 mg·min-1·cm-2, P = 0.023) than for the bursting stimuli (0.356 ± 0.244 mg·min-1·cm-2). The sigmoidal-shaped stimulus-response curves, however, were significantly different (P = 0.0007). The stimulus frequency producing 50% of peak LSR (EC50, P = 0.0029) was higher during continuous stimulation and the Hill slope was lower (P < 0.0001) during bursting stimuli. These data do not support the concept that a bursting stimulus pattern during intradermal electrical stimulation evokes a greater ∆LSR.NEW & NOTEWORTHY Neuron discharge variability can offer some advantages to a downstream physiological response. We examined this possibility with respect to sudomotor nerve activity and local sweat rate. Variable neuron discharge activity, induced by intradermal electrical stimulation, did not have an impact on the peak local sweat rate but did reduce the time to sweating onset and the stimulus intensity required to reach 50% of peak sweating (EC50).

Transdermal iontophoretic application of l-NAME is available in sweating research induced by heat stress in young healthy adults

Iontophoretic transdermal administration of NG-nitro-l-arginine methyl ester hydrochloride [l-NAME, a nitric oxide synthase (NOS) inhibitor] has been used as a non-invasive evaluation of NOS-dependent mechanisms in human skin. However, the availability has yet to be investigated in sweating research. Prior observations using invasive techniques (e.g., intradermal microdialysis technique) to administer l-NAME have implicated that NOS reduces sweating induced by heat stress but rarely influences the response induced by the administration of cholinergic muscarinic receptor agonists. Therefore, we investigated whether the transdermal iontophoretic administration of l-NAME modulates sweating similar to those prior observations. Twenty young healthy adults (10 males, 10 females) participated in two experimental protocols on separate days. Before each protocol, saline (control) and 1% l-NAME were bilaterally administered to the forearm skin via transdermal iontophoresis. In protocol 1, 0.001% and 1% pilocarpine were iontophoretically administered at l-NAME-treated and untreated sites. In protocol 2, passive heating was applied by immersing the lower limbs in hot water (43 °C) until the rectal temperature increased by 0.8 °C above baseline. The sweat rate was continuously measured throughout both protocols. Pilocarpine-induced sweat rate was not significantly different between the control and l-NAME-treated sites in both pilocarpine concentrations (P ≥ 0.316 for the treatment effect and interaction of treatment and pilocarpine concentration). The sweat rate during passive heating was attenuated at the l-NAME-treated site relative to the control (treatment effect, P = 0.020). Notably, these observations are consistent with prior sweating studies administrating l-NAME into human skin using intradermal microdialysis techniques. Based on the similarity of our results with already known observations, we conclude that transdermal iontophoresis of l-NAME is a valid non-invasive technique for the investigation of the mechanisms of sweating related to NOS during heat stress.

Role of nitric oxide synthase in human sweat gland output

The mechanism by which nitric oxide synthase (NOS) inhibition impacts human sweating is unknown. We tested the hypothesis that the activation of NOS and release on nitric oxide acts to open K⁺ channels and enhance sweat gland output. Local sweat rate (LSR) was measured with a small sweat capsule mounted on the skin while sweating was initiated by intradermal electrical stimulation. Sigmoid shape stimulus-response curves were generated by plotting the area under the LSR-time curve (LSR AUC) versus log₁₀ stimulus frequency and normalized to the peak AUC response during control trials. NOS inhibition alone reduced the peak sweat rate response to 81.5 ± 4.5% peak LSR AUC of that seen with lactated Ringer's (P = 0.0004). Fifty mM of tetraethylammonium chloride (TEA) alone reduced peak LSR (0.317 ± 0.060 vs. 0.511 ± 0.104 mg·min^-1·cm^-2, P = 0.03) and the peak LSR AUC response from 0.193 ± 0.170 to 0.158 ± 0.127 mg·cm^-2 (P = 0.004). Delivery of a 20 mM nitro-l-arginine methyl ester (l-NAME) following 50 mM TEA produced a further decrease in the peak LSR AUC response to 0.095 ± 0.064 mg·cm^-2 (≈20% reduction, P = 0.0145). These data support the hypothesis that sudomotor control of sweat gland activity is locally modulated by a functioning NOS system that appears to be additive and independent to the effect of blockade of K⁺ channels with TEA.NEW & NOTEWORTHY The contribution of nitric oxide synthase (NOS) to the process of cholinergic-mediated human eccrine sweat production is unclear. Using a novel model for cholinergic-mediated sweating in humans, I demonstrate that blocking the NOS system led to a reduction in local sweat rate (LSR). This reduction in LSR was maintained in the presence of K⁺ channel blockade with tetraethylammonium.

TEA-sensitive K+ channels and human eccrine sweat gland output

Cholinergic-activated sweating depends on an influx of Ca²⁺ from extracellular fluid. It is thought that the opening of K⁺ channels on secretory epithelial cells facilitates Ca²⁺ entry. We examined the hypothesis that tetraethylammonium (TEA)-sensitive K⁺ channels participate in sweat production. We used a pre-post experimental design and initiated cholinergic-mediated sweating with intradermal electrical stimulation, monitored local sweat rate (SR) with a small sweat capsule mounted on the skin, and delivered 50 mM TEA via intradermal microdialysis. Local SR was activated by intradermal stimulation frequencies of 0.2-64 Hz, and we generated a sigmoid-shaped stimulus-response curve by plotting the area under the SR-time curve versus log₁₀ stimulus frequency. Peak local SR was reduced from 0.372 ± 0.331 to 0.226 ± 0.190 mg·min^-1·cm^-2 (P = 0.0001) during application of 50 mM TEA, whereas the EC₅₀ and Hill slopes were not altered. The global sigmoid-shaped stimulus-response curves for control and 50 mM TEA were significantly different (P < 0.0001), and the plateau region was significantly reduced (P = 0.0023) with the TEA treatment. The effect of TEA on peak local SR was similar in male and female subjects. However, we did note a small effect of sex on the shape of the stimulus-response curves during intradermal electrical stimulation. Overall, these data support the hypothesis that cholinergic control of sweat gland activity is modulated by the presence of TEA-sensitive K⁺ channels in human sweat gland epithelial cells.NEW & NOTEWORTHY The contribution of various potassium channels to the process of cholinergic-mediated human eccrine sweat production is unclear. Using a novel model for cholinergic-mediated sweating in humans, we provide evidence that tetraethylammonium-sensitive K⁺ channels (K_Ca1.1 and K_v channels) contribute to eccrine sweat production.