Effect of age and gender on sweat lactate and ammonia concentrations during exercise in the heat

Paper-based optical sensor arrays for simultaneous detection of multi-targets in aqueous media: A review

Sensor arrays, which draw inspiration from the mammalian olfactory system, are fundamental concepts in high-throughput analysis based on pattern recognition. Although numerous optical sensor arrays for various targets in aqueous media have demonstrated their diverse applications in a wide range of research fields, practical device platforms for on-site analysis have not been satisfactorily established. The significant limitations of these sensor arrays lie in their solution-based platforms, which require stationary spectrophotometers to record the optical responses in chemical sensing. To address this, this review focuses on paper substrates as device components for solid-state sensor arrays. Paper-based sensor arrays (PSADs) embedded with multiple detection sites having cross-reactivity allow rapid and simultaneous chemical sensing using portable recording apparatuses and powerful data-processing techniques. The applicability of office printing technologies has promoted the realization of PSADs in real-world scenarios, including environmental monitoring, healthcare diagnostics, food safety, and other relevant fields. In this review, we discuss the methodologies of device fabrication and imaging analysis technologies for pattern recognition-driven chemical sensing in aqueous media.

Harvesting and manipulating sweat and interstitial fluid in microfluidic devices

Microfluidic devices began to be used to facilitate sweat and interstitial fluid (ISF) sensing in the mid-2010s. Since then, numerous prototypes involving microfluidics have been developed in different form factors for sensing biomarkers found in these fluids under in vitro, ex vivo, and in vivo (on-body) settings. These devices transport and manipulate biofluids using microfluidic channels composed of silicone, polymer, paper, or fiber. Fluid flow transport and sample management can be achieved by controlling the flow rate, surface morphology of the channel, and rate of fluid evaporation. Although many devices have been developed for estimating sweat rate, electrolyte, and metabolite levels, only a handful have been able to proceed beyond laboratory testing and reach the stage of clinical trials and commercialization. To further this technology, this review reports on the utilization of microfluidics towards sweat and ISF management and transport. The review is distinguished from other recent reviews by focusing on microfluidic principles of sweat and ISF generation, transport, extraction, and management. Challenges and prospects are highlighted, with a discussion on how to transition such prototypes towards personalized healthcare monitoring systems.

Kinetic changes in sweat lactate following fatigue during constant workload exercise

It is useful to investigate various physiological responses induced by fatigue in athletes. Moreover, wearable noninvasive sensors, including sweat sensors, are compatible with fatigue evaluation because of their ease of use, and ability to measure repeatedly and continual data. This cross-sectional study aimed to clarify how sweat lactate elimination curves obtained during constant workload exercise changed following fatigue. Seventeen recreationally trained males (average age, 20.6 ± 0.8 years) completed two consecutive constant workload exercise tests (at 25% peak power) with rest intervals; the participants were encouraged to perform Test 1 until exhaustion and Test 2 only for 10 min. Subjective fatigue (numerical rating scale with face rating scale), sweat lactate, and sweat rate were measured for 10 min in each test. Subjective fatigue was compared using the Wilcoxon signed-rank test and time to each constant value between Tests 1 and 2 was compared using paired t-test. Subjective fatigue significantly increased during Test 2 compared with that during Test 1. After Test 1, the sweat lactate elimination curve demonstrated a leftward shift, as proved by the significantly sooner observation of the peak and constant values of sweat lactate (2, 3, and 4 μA) (p < 0.01). Our preliminary results suggest that the sweat lactate elimination curve is different in the fatigue state. Further research may provide insight in the application of this curve to the evaluation for fatigue.

Osmotically Enabled Wearable Patch for Sweat Harvesting and Lactate Quantification

Lactate is an essential biomarker for determining the health of the muscles and oxidative stress levels in the human body. However, most of the currently available sweat lactate monitoring devices require external power, cannot measure lactate under low sweat rates (such as in humans at rest), and do not provide adequate information about the relationship between sweat and blood lactate levels. Here, we discuss the on-skin operation of our recently developed wearable sweat sampling patch. The patch combines osmosis (using hydrogel discs) and capillary action (using paper microfluidic channel) for long-term sweat withdrawal and management. When subjects are at rest, the hydrogel disc can withdraw fluid from the skin via osmosis and deliver it to the paper. The lactate amount in the fluid is determined using a colorimetric assay. During active sweating (e.g., exercise), the paper can harvest sweat even in the absence of the hydrogel patch. The captured fluid contains lactate, which we quantify using a colorimetric assay. The measurements show the that the total number of moles of lactate in sweat is correlated to sweat rate. Lactate concentrations in sweat and blood correlate well only during high-intensity exercise. Hence, sweat appears to be a suitable biofluid for lactate quantification. Overall, this wearable patch holds the potential of providing a comprehensive analysis of sweat lactate trends in the human body.

Fabrication of a Wearable Flexible Sweat pH Sensor Based on SERS-Active Au/TPU Electrospun Nanofibers

Development of wearable sensing platforms is essential for the advancement of continuous health monitoring and point-of-care testing. Eccrine sweat pH is an analyte that can be noninvasively measured and used to diagnose and aid in monitoring a wide range of physiological conditions. Surface-enhanced Raman scattering (SERS) offers a rapid, optical technique for fingerprinting of biomarkers present in sweat. In this paper, a mechanically flexible, nanofibrous, SERS-active substrate was fabricated by a combination of electrospinning of thermoplastic polyurethane (TPU) and Au sputter coating. This substrate was then investigated for suitability toward wearable sweat pH sensing after functionalization with two commonly used pH-responsive molecules, 4-mercaptobenzoic acid (4-MBA), and 4-mercaptopyridine (4-MPy). The developed SERS pH sensor was found to have good resolution (0.14 pH units for 4-MBA; 0.51 pH units for 4-MPy), with only 1 μL of sweat required for a measurement, and displayed no statistically significant difference in performance after 35 days (p = 0.361). Additionally, the Au/TPU nanofibrous SERS pH sensors showed fast sweat-absorbing ability as well as good repeatability and reversibility. The proposed methodology offers a facile route for the fabrication of SERS substrates which could also be used to measure a wide range of health biomarkers beyond sweat pH.

A Wearable Patch for Prolonged Sweat Lactate Harvesting and Sensing

Operating at low sweat rates, such as those experienced by humans at rest, is still an unmet need for state-of-the-art wearable sweat harvesting and testing devices for lactate. Here, we report the on-skin performance of a non-invasive wearable sweat sampling patch that can harvest sweat at rest, during exercise, and post-exercise. The patch simultaneously uses osmosis and evaporation for long-term (several hours) sampling of sweat. Osmotic sweat withdrawal is achieved by skin-interfacing a hydrogel containing a concentrated solute. The gel interfaces with a paper strip that transports the fluid via wicking and evaporation. Proof of concept results show that the patch was able to sample sweat during resting and post-exercise conditions, where the lactate concentration was successfully quantified. The patch detected the increase in sweat lactate levels during medium level exercise. Blood lactate remained invariant with exercise as expected. We also developed a continuous sensing version of the patch by including enzymatic electrochemical sensors. Such a battery-free, passive, wearable sweat sampling patch can potentially provide useful information about the human metabolic activity.

Monitor for lactate in perspiration

Sweat is a noninvasive biological fluid on the surface of human skin and has attracted increasing attention as a diagnostic specimen for disease and biomarker detection. Sweat metabolite quantification is possible due to progress in sweat analysis techniques; nevertheless, the role of sweat monitoring in energy metabolism, physiological or pathological state assessment, health status assessment, and the development and outcome of metabolism-related diseases remains unclear. This review provides a comprehensive overview of the literature on human sweat lactate concentration. The first, second, and third sections of this review present an introduction of sweat lactate, methods for the collection and storage of sweat lactate samples, and methods of detection and analysis of sweat lactate, respectively. The fourth section elaborates upon the current state of clinical application of sweat lactate monitoring and its prospects for health surveillance. The last section focuses on the challenges and future directions of this novel technology for detecting lactate in sweat.

The Impact of Nutritional Supplementation on Sweat Metabolomic Content: A Proof-of-Concept Study

Sweat is emerging as a prominent biosource for real-time human performance monitoring applications. Although promising, sources of variability must be identified to truly utilize sweat for biomarker applications. In this proof-of-concept study, a targeted metabolomics method was applied to sweat collected from the forearms of participants in a 12-week exercise program who ingested either low or high nutritional supplementation twice daily. The data establish the use of dried powder mass as a method for metabolomic data normalization from sweat samples. Additionally, the results support the hypothesis that ingestion of regular nutritional supplementation semi-quantitatively impact the sweat metabolome. For example, a receiver operating characteristic (ROC) curve of relative normalized metabolite quantities show an area under the curve of 0.82 suggesting the sweat metabolome can moderately predict if an individual is taking nutritional supplementation. Finally, a significant correlation between physical performance and the sweat metabolome are established. For instance, the data illustrate that by utilizing multiple linear regression modeling approaches, sweat metabolite quantities can predict VO₂ max (p = 0.0346), peak lower body Windage (p = 0.0112), and abdominal circumference (p = 0.0425). The results illustrate the need to account for dietary nutrition in biomarker discovery applications involving sweat as a biosource.

The (in)dependency of blood and sweat sodium, chloride, potassium, ammonia, lactate and glucose concentrations during submaximal exercise

Purpose

To reduce the need for invasive and expensive measures of human biomarkers, sweat is becoming increasingly popular in use as an alternative to blood. Therefore, the (in)dependency of blood and sweat composition has to be explored.

Methods

In an environmental chamber (33 °C, 65% relative humidity; RH), 12 participants completed three subsequent 20-min cycling stages to elicit three different local sweat rates (LSR) while aiming to limit changes in blood composition: at 60% of their maximum heart rate (HR_max), 70% HR_max and 80% HR_max, with 5 min of seated-rest in between. Sweat was collected from the arm and back during each stage and post-exercise. Blood was drawn from a superficial antecubital vein in the middle of each stage. Concentrations of sodium, chloride, potassium, ammonia, lactate and glucose were determined in blood plasma and sweat.

Results

With increasing exercise intensity, LSR, sweat sodium, chloride and glucose concentrations increased (P ≤ 0.026), while simultaneously limited changes in blood composition were elicited for these components (P ≥ 0.093). Sweat potassium, lactate and ammonia concentrations decreased (P ≤ 0.006), while blood potassium decreased (P = 0.003), and blood ammonia and lactate concentrations increased with higher exercise intensities (P = 0.005; P = 0.007, respectively). The vast majority of correlations between blood and sweat parameters were non-significant (P > 0.05), with few exceptions.

Conclusion

The data suggest that sweat composition is at least partly independent of blood composition. This has important consequences when targeting sweat as non-invasive alternative for blood measurements.

Electronic supplementary material

The online version of this article (10.1007/s00421-020-04562-8) contains supplementary material, which is available to authorized users.

Rate normalization for sweat metabolomics biomarker discovery

As the demand for real-time exercise performance feedback increases, excreted sweat has become a biosource of interest for continuous human performance assessment. For sweat to truly fulfill this requirement, analyte concentrations must be normalized to adequately assess day-to-day differences within and among individuals. In this manuscript, data are presented highlighting the use of accurate localized sweat rate as a means for ion and global metabolomic data normalization. The results illustrate large sweat rate variability among individuals over the course of two distinct exercises protocols. Furthermore, the data show sweat rate is not symmetrical at similar locations among right and left forearms of individuals (p = 0.0007). Sweat ion conductivity analysis suggest overall sweat rate normalization reduces variability collectively among ion values and participants with principal component analysis showing 77.8% of variation in the data set attributable to sweat rate normalization. Global metabolomic analysis of sweat illustrated overall rate normalization increases the variability among test subjects with 72.7% of the variation explained by sweat rate normalization. Finally, overall rate normalized metabolomic features of sweat significantly correlated (ρ ≥ 0.7, ρ ≤ -0.7) with measured performance metrics of the individual, establishing the potential for sweat to be used as a biosource for performance monitoring. Collectively, these data illustrate the importance of accurate localized sweat rate determination, for analyte data normalization, in support for the use of sweat in biomarker discovery efforts to predict human performance.

Recent Advances in Noninvasive Biosensors for Forensics, Biometrics, and Cybersecurity

Recently, biosensors have been used in an increasing number of different fields and disciplines due to their wide applicability, reproducibility, and selectivity. Three large disciplines in which this has become relevant has been the forensic, biometric, and cybersecurity fields. The call for novel noninvasive biosensors for these three applications has been a focus of research in these fields. Recent advances in these three areas has relied on the use of biosensors based on primarily colorimetric assays based on bioaffinity interactions utilizing enzymatic assays. In forensics, the use of different bodily fluids for metabolite analysis provides an alternative to the use of DNA to avoid the backlog that is currently the main issue with DNA analysis by providing worthwhile information about the originator. In biometrics, the use of sweat-based systems for user authentication has been developed as a proof-of-concept design utilizing the levels of different metabolites found in sweat. Lastly, biosensor assays have been developed as a proof-of-concept for combination with cybersecurity, primarily cryptography, for the encryption and protection of data and messages.

Comparative Study of the Composition of Sweat from Eccrine and Apocrine Sweat Glands during Exercise and in Heat

This preliminarily study was made to examine the differences in sweat excretions from human eccrine and apocrine sweat glands in dynamic exercise and heat conditions. Sweat samples were collected from six young males while they were either running on a treadmill or sitting in a sauna cabinet. Sweat samples of at least 5 mL from the eccrine (upper-back) and apocrine (armpit) sweat glands were collected during a 20-min running (or inactive overheating) period. The samples were then analyzed for urea, uric acid, and electrolyte (Na+, Cl-, and K+) excretions. The results from a two-way repeated-measures analysis of variance (ANOVA) revealed that the secretions of urea and K+ were significantly higher during running than during inactive overheating for both glands, as were Na+ secretions for the apocrine glands (all P < 0.05). Under the same sweating conditions, urea and K+ excretions from the apocrine glands were also higher than those from the eccrine glands (all P < 0.05). Significant differences were observed between the Na+ secretions of the apocrine and eccrine glands under the running condition. The effects of various sweating methods and sweat glands on Cl- secretions were nonsignificant, and little uric acid was excreted. A higher urea excretion level during running rather than in hot conditions could be attributed to an elevated metabolic rate.

Soft, skin-interfaced microfluidic systems with integrated enzymatic assays for measuring the concentration of ammonia and ethanol in sweat

Eccrine sweat is a rich and largely unexplored biofluid that contains a range of important biomarkers, from electrolytes, metabolites, micronutrients and hormones to exogenous agents, each of which can change in concentration with diet, stress level, hydration status and physiologic or metabolic state. Traditionally, clinicians and researchers have used absorbent pads and benchtop analyzers to collect and analyze the biochemical constituents of sweat in controlled, laboratory settings. Recently reported wearable microfluidic and electrochemical sensing devices represent significant advances in this context, with capabilities for rapid, in situ evaluations, in many cases with improved repeatability and accuracy. A limitation is that assays performed in these platforms offer limited control of reaction kinetics and mixing of different reagents and samples. Here, we present a multi-layered microfluidic device platform with designs that eliminate these constraints, to enable integrated enzymatic assays with demonstrations of in situ analysis of the concentrations of ammonia and ethanol in microliter volumes of sweat. Careful characterization of the reaction kinetics and their optimization using statistical techniques yield robust analysis protocols. Human subject studies with sweat initiated by warm-water bathing highlight the operational features of these systems.

Printed, Flexible Lactate Sensors: Design Considerations Before Performing On-Body Measurements

This work reports the process of sensor development, optimization, and characterization before the transition to on-body measurements can be made. Sensors using lactate oxidase as a sensing mechanism and tetrathiafulvalene as a mediator were optimized for sporting applications. Optimized sensors show linear range up to 24 mM lactate and sensitivity of 4.8 μA/mM which normalizes to 68 μA*cm-2/mM when accounting for surface area of the sensor. The optimized sensors were characterized 3 different ways: using commercially available reference and counter electrodes, using printed reference and counter electrodes, and using a printed reference electrode with no counter electrode. Sensors intended for measuring sweat must be selective in the presence of sweat constituents. Thus, in addition to traditional characterization in pH 7.0 buffer, we characterized sensor performance in solutions intended to approximate sweat. Sensor performance in pH 7.0 buffer solution was not reflective of sensor performance in artificial sweat, indicating that further characterization is necessary between sensor measurement in pH 7.0 buffer and on-body measurements. Furthermore, we performed enzyme activity measurements and sensor measurements concurrently in five different salts individually, finding that while NH4Cl and MgCl2 do not affect enzyme activity or sensor performance in physiologically relevant ranges of salt concentration, NaCl concentration or KCl concentration decreases enzyme activity and sensor current. On the other hand, CaCl2 induced a nonlinear change in sensor performance and enzyme activity with increasing salt concentration.

Pediatric Thermoregulation: Considerations in the Face of Global Climate Change

Predicted global climate change, including rising average temperatures, increasing airborne pollution, and ultraviolet radiation exposure, presents multiple environmental stressors contributing to increased morbidity and mortality. Extreme temperatures and more frequent and severe heat events will increase the risk of heat-related illness and associated complications in vulnerable populations, including infants and children. Historically, children have been viewed to possess inferior thermoregulatory capabilities, owing to lower sweat rates and higher core temperature responses compared to adults. Accumulating evidence counters this notion, with limited child-adult differences in thermoregulation evident during mild and moderate heat exposure, with increased risk of heat illness only at environmental extremes. In the context of predicted global climate change, extreme environmental temperatures will be encountered more frequently, placing children at increased risk. Thermoregulatory and overall physiological strain in high temperatures may be further exacerbated by exposure to/presence of physiological and environmental stressors including pollution, ultraviolet radiation, obesity, diabetes, associated comorbidities, and polypharmacy that are more commonly occurring at younger ages. The aim of this review is to revisit fundamental differences in child-adult thermoregulation in the face of these multifaceted climate challenges, address emerging concerns, and emphasize risk reduction strategies for the health and performance of children in the heat.

The proteomic and metabolomic characterization of exercise-induced sweat for human performance monitoring: A pilot investigation

Sweat is a biofluid with several attractive attributes. However, investigation into sweat for biomarker discovery applications is still in its infancy. To add support for the use of sweat as a non-invasive media for human performance monitoring, volunteer participants were subjected to a physical exertion model using a treadmill. Following exercise, sweat was collected, aliquotted, and analyzed for metabolite and protein content via high-resolution mass spectrometry. Overall, the proteomic analysis illustrates significant enrichment steps will be required for proteomic biomarker discovery from single sweat samples as protein abundance is low in this medium. Furthermore, the results indicate a potential for protein degradation, or a large number of low molecular weight protein/peptides, in these samples. Metabolomic analysis shows a strong correlation in the overall abundance among sweat metabolites. Finally, hierarchical clustering of participant metabolite abundances show trends emerging, although no significant trends were observed (alpha = 0.8, lambda = 1 standard error via cross validation). However, these data suggest with a greater number of biological replicates, stronger, statistically significant results, can be obtained. Collectively, this study represents the first to simultaneously use both proteomic and metabolomic analysis to investigate sweat. These data highlight several pitfalls of sweat analysis for biomarker discovery applications.

Maximum rate of sweat ions reabsorption during exercise with regional differences, sex, and exercise training

PURPOSE

It is recently reported that determining sweat rate (SR) threshold for increasing galvanic skin conductance (GSC) would represent a maximum rate of sweat ion reabsorption in sweat glands. We evaluate the maximum rate of sweat ion reabsorption over skin regions, sex, and long-term exercise training by using the threshold analysis in the present study.

METHODS

Ten males (2 untrained, 4 sprinters, and 4 distance runners) and 12 females (5 untrained, 4 sprinters, and 3 distance runners) conducted graded cycling exercise for 45 min at low, middle, and high exercise intensities (heart rate 100-110, 120-130, and 140-150 beats/min, respectively) for 10, 15, and 20 min, respectively, at 30 °C and 50% relative humidity. Comparisons were made between males and females and among untrained individuals, distance runners, and sprinters on the back and forearm.

RESULTS

SR threshold for increasing GSC on back was significantly higher than that of forearm (P < 0.05) without any sex differences (back 0.70 ± 0.08 and 0.61 ± 0.04, forearm 0.40 ± 0.05 and 0.45 ± 0.06 mg/cm²/min for males and females, respectively). Distance runners and sprinters showed higher SR threshold for increasing GSC than that of untrained subjects on back (P < 0.05) but not on forearm (back 0.45 ± 0.06, 0.83 ± 0.06, and 0.70 ± 0.04, forearm 0.33 ± 0.04, 0.49 ± 0.02, and 0.39 ± 0.07 mg/cm²/min for untrained subjects, distance runners, and sprinters, respectively).

CONCLUSION

These results suggest that the maximum sweat ion reabsorption rate on the back is higher than that of forearm without sex differences. Furthermore, exercise training in distance runners and sprinters improves the maximum sweat ion reabsorption rate on the back.

Bioaffinity-based assay for the sensitive detection and discrimination of sweat aimed at forensic applications

Sweat is a well-known piece of biological evidence that is actually used much less than expected. Biological samples are important because their components can often provide some type of information about a person-of-interest. Sweat, in particular, is important because of its DNA content which can be extracted and analyzed to provide information that can be imperative to a criminal investigation. While it is a very important source of forensic information, the methods for detection and discrimination of sweat are limited, causing it to be overlooked during evidence collection. This manuscript presents a biocatalytic method for sweat detection that utilizes an enzyme cascade system that has the capability to detect trace amounts of sweat and distinguish it from saliva, even after the sample has dried. The results show the initial calibration studies performed to insure that the cascade performs well using both mimicked and authentic sweat samples which have components that could negatively affect the enzymes needed for the analysis. The method presented here also has the potential to be adapted for on-site analysis. The initial results of the development of a sweat-sensitive strip are shown here.

Uranium(VI) Binding Forms in Selected Human Body Fluids: Thermodynamic Calculations versus Spectroscopic Measurements

Human exposure to uranium increasingly becomes a subject of interest in many scientific disciplines such as environmental medicine, toxicology, and radiation protection. Knowledge about uranium chemical binding forms(speciation) in human body fluids can be of great importance to understand not only its biokinetics but also its relevance in risk assessment and in designing decorporation therapy in the case of accidental overexposure. In this study, thermodynamic calculations of uranium speciation in relevant simulated and original body fluids were compared with spectroscopic data after ex-situ uranium addition. For the first time, experimental data on U(VI) speciation in body fluids (saliva, sweat, urine) was obtained by means of cryogenic time-resolved laser-induced fluorescence spectroscopy (cryo-TRLFS) at 153 K. By using the time dependency of fluorescence decay and the band positions of the emission spectra, various uranyl complexes were demonstrated in the studied samples. The variations of the body fluids in terms of chemical composition, pH, and ionic strength resulted in different binding forms of U(VI). The speciation of U(VI) in saliva and in urine was affected by the presence of bioorganic ligands, whereas in sweat, the distribution depends mainly on inorganic ligands. We also elucidated the role of biological buffers, i.e., phosphate (H(2)PO(4−)/HPO(4)(2−)) on U(VI) distribution, and the system Ca(2+)/UO(2)(2+)/PO(4)(3−) was discussed in detail in both saliva and urine. The theoretical speciation calculations of the main U(VI) species in the investigated body fluids were significantly consistent with the spectroscopic data. Laser fluorescence spectroscopy showed success and reliability for direct determination of U(VI) in such biological matrices with the possibility for further improvement.

A self-powered amperometric lactate biosensor based on lactate oxidase immobilized in dimethylferrocene-modified LPEI

Lactate is an important biomarker due to its excessive production by the body during anerobic metabolism. Existing methods for electrochemical lactate detection require the use of an external power source to supply a positive potential to the working electrode of a given device. Herein we describe a self-powered amperometric lactate biosensor that utilizes a dimethylferrocene-modified linear poly(ethylenimine) (FcMe2-LPEI) hydrogel to simultaneously immobilize and mediate electron transfer from lactate oxidase (LOx) at the anode and a previously described enzymatic cathode. Operating as a half-cell, the FcMe2-LPEI electrode material generates a jmax of 1.51 ± 0.13 mAcm(-2) with a KM of 1.6 ± 0.1 mM and a sensitivity of 400 ± 20 μAcm(-2)mM(-1) while operating with an applied potential of 0.3 V vs. SCE. When coupled with an enzymatic biocathode, the self-powered biosensor has a detection range between 0mM and 5mM lactate with a sensitivity of 45 ± 6 μAcm(-2)mM(-1). Additionally, the FcMe2-LPEI/LOx-based self-powered sensor is capable of generating a power density of 122 ± 5 μWcm(-2) with a current density of 657 ± 17 μAcm(-2) and an open circuit potential of 0.57 ± 0.01 V, which is sufficient to act as a supplemental power source for additional small electronic devices.

Hydrogel micropatches for sampling and profiling skin metabolites

Metabolites excreted by skin have a huge potential as disease biomarkers. However, due to the shortage of convenient sampling/analysis methods, the analysis of sweat has not become very popular in the clinical setting (pilocarpine iontophoresis being a prominent exception). In this report, a facile method for sampling and rapid chemical profiling of skin metabolites excreted with sweat is proposed. Metabolites released by skin (primarily the constituents of sweat) are collected into hydrogel (agarose) micropatches. Subsequently, they are extracted in an online analytical setup incorporating nanospray desorption electrospray ionization and an ion trap mass spectrometer. In a series of reference measurements, using bulk sampling and electrospray ionization mass spectrometry, various low-molecular-weight metabolites are detected in the micropatches exposed to skin. The sampling time is as short as 10 min, while the desorption time is 2 min. Technical precision of micropatch analysis varies within the range of 3-42%, depending on the sample and the method of data treatment; the best technical precision (≤10%) has been achieved while using an isotopically labeled internal standard. The limits of detection range from 7 to 278 pmol. Differences in the quantities of extracted metabolites are observed for the samples obtained from healthy individuals (intersubject variabilities: 30-89%; n = 9), which suggests that this method may have the potential to become a semiquantitative assay in clinical analysis and forensics.

Respostas termorregulatórias de crianças no exercício em ambiente de calor

OBJETIVO: Revisar as possíveis peculiaridades nos mecanismos biológicos referentes às respostas termorregulatórias e sudorípara específicas no exercício realizado por crianças em ambiente de calor. FONTES DE DADOS: Foi feita uma revisão de 47 artigos publicados entre 1960 e 2011 nas bases de dados eletrônicos MedLine e SciELO Brasil, com a utilização dos seguintes descritores: 'crianças', 'calor', 'sudorese', 'termorregulação', 'glândula sudorípara' e 'exercício', sendo usados isoladamente ou em combinação, além de uma tese de doutorado sobre o assunto. SÍNTESE DOS DADOS: Em pré-púberes, a taxa de sudorese durante o esforço é menor em comparação aos adultos. Crianças possuem características termorregulatórias diferenciadas, apresentando um débito de suor por glândula muito menor. A maior razão entre área de superfície e massa corporal faz com que crianças absorvam mais calor durante o exercício sob estresse térmico, elevando o risco de apresentarem sintomas de hipertermia. O maior fluxo sanguíneo para a pele contribui com um melhor controle da homeostase térmica de crianças. O menor tamanho da glândula, a menor sensibilidade colinérgica, os níveis baixos de catecolaminas circulantes durante o esforço e a falta de hormônio androgênico explicam a ocorrência da baixa eliminação de suor no exercício realizado por crianças. CONCLUSÕES: Crianças exibem glândulas sudoríparas imaturas. Assim, a prática de atividade física combinada a altas temperaturas não é bem tolerada havendo maior vulnerabilidade às lesões térmicas. No calor, deve-se ter um controle rigoroso da ingestão de líquidos e um monitoramento atencioso das condições climáticas para maior segurança na prática de exercícios.

Lactate in human sweat: a critical review of research to the present day

This review provides a critical overview of the literature published in the area of lactate in human sweat between 1934 and the present. The first section summarizes the relevant pieces of literature, the second evaluates the literature across a range of topics and the third presents potential applications for sweat lactate measurements. Key factors that may affect sweat lactate are discussed in detail in the second section of this review. Both acetylcholine and catecholamine hormonal signals can trigger sweating independently of one another; differences in sweat output and lactate concentrations are compared. The primary triggers for sweating, exercise and heat are also compared, with exercise-induced sweating being further examined with respect to the exercise intensity. This review examines the significant variations in sweat lactate between bodily sites as well the relationship to physiological parameters such as gender, age and physical fitness, along with the effect of climate adaptation on sweat lactate concentrations.

Avaliação do estado hidroeletrolítico de crianças praticantes de exercício físico e recomendação de hidratação

Este estudo aborda as características termorregulatórias, recursos de prevenção e de diagnóstico do déficit hidroeletrolítico e danos causados pela prática do exercício no calor em crianças. Exercitar-se no calor pode levar a um aumento da temperatura central, e comprometer o desempenho e a saúde das crianças. O sistema termorregulatório delas está em desenvolvimento; e a eliminação do calor, por evaporação do suor, fica prejudicada, já que as crianças apresentam menores taxa de sudorese e concentração de eletrólitos no suor do que os adultos. A avaliação do estado de hidratação pré-exercício pode ser importante para prevenir que a criança inicie o exercício desidratada. Além disso, considerando que muitas vezes elas não bebem a quantidade de líquido necessária pra evitar a desidratação durante o exercício, as crianças devem ser educadas a se hidratar antes, durante e após o exercício, especialmente no calor.

Hyperammonemia in the pediatric emergency care setting

Hyperammonemia is encountered frequently in acutely ill children presenting for emergency care with altered levels of consciousness (ALOC). Ammonia production, metabolism, and excretion are affected by different variables. Hyperammonemia may be a transient state or may signify more grave etiologies as inborn errors of metabolism. Levels of ammonia are also affected by proper sampling technique, transport, and analysis.

OBJECTIVES

To determine the level of ammonia in acutely ill children with ALOC, identify causes of hyperammonemia, and correlate levels with illness severity and morbidity.

DESIGN

Observational study.

SETTING

Emergency department at Cairo University Specialized Paediatric Hospital.

METHODS

Fifty cases of acutely ill pediatric patients with ALOC who presented to the emergency department were included in the study from 2008 through 2009. Emergency department patients (n = 20) with known diseases that may induce hyperammonemia were excluded. Patients were subjected to detailed history taking with emphasis on factors affecting ammonia levels and thorough clinical examination. A cohort group of age- and sex-matched children acted as a control group.

RESULTS

The measured blood ammonia level ranged between 13 and 265 μmol/L, with a mean level of 95 μmol/L. Sixty percent of the children with ALOC had ammonia levels of greater than 75 μmol/L, with levels greater than 200 μmol/L seen in 6% of the studied sample. The study demonstrated a highly significant statistical difference between children with ALOC and control groups.There was no correlation between blood ammonia level and age. Correlations of ammonia levels were also conducted in comparison with etiological diagnoses and laboratory parameters with no statistical significance.There was no statistical significance between ammonia level and duration of illness, Sequential Organ Failure Assessment score, or Glasgow Coma Scale score/Morray Scale score.

CONCLUSIONS

Clinicians should consider testing children with ALOC for hyperammonemia, provided that a clear understanding of its metabolism and factors controlling it are understood. Proper sampling must be ensured. Mild elevations of ammonia levels are fairly common, but exceedingly high levels should raise concern and may require further evaluation.

The relationship between exercise intensity and the sweat lactate excretion rate

The purpose of this study was to determine the effect of increases in exercise intensity on the sweat lactate concentration and lactate excretion rate. Eight healthy male volunteers complete a 90-min exercise bout of treadmill walking in a 35 degrees C and 40% relative humidity environmental chamber. During the exercise trial, the subjects performed three 30-min ordered exercise bouts at 60, 70, and 80% of their age-predicted maximum heart rate (HR(max)), with 10 min of rest outside the chamber between bouts. Sweat rate was measured volumetrically during each of the three exercise bouts on the flexor surface of the proximal half of the right forearm. Sweat lactate concentration ([lactate](sweat)) was measured in each sample and multiplied by the forearm sweat rate to calculate the lactate excretion rate (LER). There was a significant (P < 0.05) decrease in the [lactate](sweat) at the 70 and 80% HR(max) exercise intensities compared to the 60% HR(max) exercise intensity. Conversely, the LER increased significantly at the highest two exercise intensities compared to the 60% HR(max) exercise intensity. Such data suggest that increases in exercise intensity require an increase in lactate production, as measured by the LER. Furthermore, the decreased [lactate](sweat) at the higher exercise intensities is most likely the result of increased sweat production causing a dilution effect on the [lactate](sweat), thus limiting its ability to accurately indicate the metabolic activity of the sweat gland.

The betaine content of sweat from adolescent females

Background

This study was developed to establish whether betaine was present in the sweat of females and to determine any correlations with other sweat components.

Methods

Sweat patches were placed on eight trained adolescent Highland dancers (age = 13.6 ± 2.3 yr), who then participated in a dance class for 2 hours. Patches were removed, and the sweat recovered via centrifugation. The sweat was subsequently analyzed for betaine, choline, sodium, potassium, chloride, lactate, glucose, urea and ammonia.

Results

Betaine was present in the sweat of all subjects (232 ± 84 μmol·L^-1), which is higher than typically found in plasma. The concentration of several sweat components were correlated, in particular betaine with most other measured components.

Conclusion

Betaine, an osmoprotectant and methyl donor, is a component of sweat that may be lost from the body in significant amounts.