Sweating Disorders

Nature-Inspired Superhydrophilic Biosponge as Structural Beneficial Platform for Sweating Analysis Patch

Perspiration plays a pivotal role not only in thermoregulation but also in reflecting the body's internal state and its response to external stimuli. The up-to-date skin-based wearable platforms have facilitated the monitoring and simultaneous analysis of sweat, offering valuable physiological insights. Unlike conventional passive sweating, dynamic normal perspiration, which occurs during various activities and rest periods, necessitates a more reliable method of collection to accurately capture its real-time fluctuations. An innovative microfluidic patch incorporating a hierarchical superhydrophilic biosponge, poise to significantly improve the efficiency capture of dynamic sweat is introduced. The seamlessly integrated biosponge microchannel showcases exceptional absorption capabilities, efficiently capturing non-sensitive sweat exuding from the skin surface, mitigating sample loss and minimizing sweat volatilization. Furthermore, the incorporation of sweat-rate sensors alongside a suite of functional electrochemical sensors endows the patch of uninterrupted monitoring and analysis of dynamic sweat during various activities, stress events, high-energy intake, and other scenarios.

Computational Prediction of Drug Phenotypic Effects Based on Substructure-Phenotype Associations

Identifying drug phenotypic effects, including therapeutic effects and adverse drug reactions (ADRs), is an inseparable part for evaluating the potentiality of new drug candidates (NDCs). However, current computational methods for predicting phenotypic effects of NDCs are mainly based on the overall structure of an NDC or a related target. These approaches often lead to inconsistencies between the structures and functions and limit the prediction space of NDCs. In this study, first, we constructed quantitative associations of substructure-domain, domain-ADR, and domain-ATC (Anatomical Therapeutic Chemical Classification System code) through L1LOG and L1SVM machine learning models. These associations represent relationships between phenotypes (ADRs and ATCs) and local structures of drugs and proteins. Then, based on these established associations, substructure-phenotype relationships were constructed which were utilized to quantify drug-phenotype relationships. Thus, this approach could achieve high-throughput and effective evaluations of the druggability of NDCs by referring to the established substructure-phenotype relationships and structural information of NDCs without additional prior knowledge. Using this computational pipeline, 83,205 drug-ATC relationships (including 1,479 drugs and 178 ATCs) and 306,421 drug-ADR relationships (including 1,752 drugs and 454 ADRs) were predicted in total. The prediction results were validated at four levels: five-fold cross validation, public databases, literature, and molecular docking. Furthermore, three case studies demonstrated the feasibility of our method. 79 ATCs and 269 ADRs were predicted to be related to Maraviroc, an approved drug, including the existing antiviral effect in clinical use. Additionally, we also found risk substructures of severe ADRs, for example, SUB215 (>= 1, saturated or only aromatic carbon ring size 7) can result in shock. And we analyzed the mechanism of action (MOA) of interested drugs based on the established drug-substructure-domain-protein associations. In a word, this approach through establishing drug-substructure-phenotype relationships can achieve quantitative prediction of phenotypes for a given NDC or drug without any prior knowledge except its structure information. Using that way, we can directly obtain the relationships between substructure and phenotype of a compound, which is more convenient to analyze the phenotypic mechanism of drugs and accelerate the process of rational drug design.

Case Report: Acquired Generalized Anhidrosis Caused by Brain Tumor: Review of the Literature

PURPOSE

There has been limited focus on sweating failure in patients with brain tumor. We report two patients with generalized anhidrosis caused by germinoma. We also review previous reports of generalized anhidrosis due to brain tumor.

CASE REPORTS

Patient 1 was a 12-year-old boy with repetitive heat shock-like episodes even in winter. Based on Minor's test, he was diagnosed with generalized anhidrosis. Magnetic resonance imaging (MRI) revealed the absence of high signal intensity of the posterior pituitary. He was initially diagnosed with central diabetes insipidus. However, an MRI scan performed after 3 months revealed an enlarged pituitary stalk. He was finally diagnosed with germinoma by pituitary biopsy. After chemotherapy and radiation, sweating was partially resolved. Patient 2 was a 12-year-old girl with growth hormone deficiency and generalized anhidrosis. She was diagnosed with germinoma based on MRI and pituitary biopsy findings. After chemotherapy and radiation, the sweating resolved completely.

DISCUSSION

In our literature search, we identified four patients with anhidrosis due to brain tumor, including our cases. All patients had germinoma and continued to require hormone replacement therapy after treatment of germinoma. Two patients with incomplete recovery of sweating had the involvement in the hypothalamus, whereas one patient with complete recovery showed a lack of evident hypothalamic involvement. Improvement in sweating in one patient was not described.

CONCLUSION

Germinoma can cause anhidrosis, and involvement in the hypothalamus may be relevant to incomplete recovery of sweating.

Selective T3-T4 sympathicotomy versus gray ramicotomy on outcome and quality of life in hyperhidrosis patients: a randomized clinical trial

Compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy. The study aimed to reduce compensatory hyperhidrosis to increase patients’ satisfaction. A prospective randomized study on palmar hyperhidrosis, May 2016–September 2019. Twenty-one patients T₃–T₄ sympathicotomy and 21 T₃–T₄ gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and recommend it. No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50–63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75–27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was. T₃–T₄ gray ramicotomy had better results than T₃–T₄ sympathicotomy, with less compensatory sweating and higher patients' satisfaction.

Increased Incidence of Premenstrual Syndrome in Females with Palmar Hyperhidrosis

Background: Premenstrual syndrome (PMS) is a common disorder affecting the quality of life of women of reproductive age. In a previous study, sex hormone imbalances and alterations in autonomic function were present in PMS, with parasympathetic dysfunction and sympathetic overactivity during the late luteal phase. Palmar hyperhidrosis (PH) presents with oversweating, heat and emotional stimulation, sympathetic hyperactivity and parasympathetic hypofunction. We hypothesized that the incidence of PMS is increased in females with PH. Methods: Data were retrieved from the Taiwanese National Health Insurance Database. The patients with PH were identified by the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) disease code 780.8. Female patients matched by age and index day were used as the control group. The incidence of PMS was considered an outcome by the ICD-9-CM disease code 625.4. The factors related to PMS were analyzed by Cox regression. Results: The adjusted hazard ratio for the incidence of PMS was 1.276 (95% confidence interval: 1.05–1.488) in females with PH. Conclusions: This study found a positive correlation between PMS and female PH patients. Patients and physicians must understand the relationship of PMS with autonomic function alterations and other risk factors to prevent this problematic disorder.

Local Passive Heat for the Treatment of Hypertension in Autonomic Failure

Background

Supine hypertension affects a majority of patients with autonomic failure; it is associated with end‐organ damage and can worsen daytime orthostatic hypotension by inducing pressure diuresis and volume loss during the night. Because sympathetic activation prevents blood pressure (BP) from falling in healthy subjects exposed to heat, we hypothesized that passive heat had a BP‐lowering effect in patients with autonomic failure and could be used to treat their supine hypertension.

Methods and Results

In Protocol 1 (n=22), the acute effects of local heat (40–42°C applied with a heating pad placed over the abdomen for 2 hours) versus sham control were assessed in a randomized crossover fashion. Heat acutely decreased systolic BP by −19±4 mm Hg (versus 3±4 with sham, P<0.001) owing to decreases in stroke volume (−18±5% versus −4±4%, P=0.013 ) and cardiac output (−15±5% versus −2±4%, P=0.013). In Protocol 2 (proof‐of‐concept overnight study; n=12), we compared the effects of local heat (38°C applied with a water‐perfused heating pad placed under the torso from 10 pm to 6 am) versus placebo pill. Heat decreased nighttime systolic BP (maximal change −28±6 versus −2±6 mm Hg, P<0.001). BP returned to baseline by 8 am. The nocturnal systolic BP decrease correlated with a decrease in urinary volume (r=0.57, P=0.072) and an improvement in the morning upright systolic BP (r=−0.76, P=0.007).

Conclusions

Local heat therapy effectively lowered overnight BP in patients with autonomic failure and supine hypertension and offers a novel approach to treat this condition. Future studies are needed to assess the long‐term safety and efficacy in improving nighttime fluid loss and daytime orthostatic hypotension.

Registration

URL: https://www.clinicaltrials.gov; Unique identifiers: NCT02417415 and NCT03042988.