Sweat protein components tested by SDS-polyacrylamide gel electrophoresis followed by immunoblotting.

Sweat samples were collected in a sauna from 74 healthy volunteers (72 men and 2 women) and concentrated. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) of the individual samples revealed, in general, five main proteins and four PAS positive components. In pooled sweat, a method of SDS-PAGE followed by immunoblotting with specific antisera or antibodies against 24 human serum components was applied, and three out of the five main proteins showed the same molecular weights and antigenicities corresponding to serum albumin (67,000 Da), Zn-alpha 2-glycoprotein (42,000 Da) and lysozyme (14,000 Da). Moreover, orosomucoid, transferrin, IgG and IgA were demonstrated in the pooled sweat. Although alpha 1-antitrypsin was probably in the pooled sweat, other serum components could not be detected. On the pooled and individual sweat samples, anti-carcinoembryonic antigen (CEA) formed three bands at 42,000, 19,000 and 18,000 Da, but the antibody did not react with normal serum. It might be considered from these molecular weights that those sweat components are CEA-related antigens.

DNA analysis of cystic fibrosis genotypes in relatives with equivocal sweat test results.

Restriction fragment length polymorphism linkage analysis of cystic fibrosis (CF) is used primarily for pre-pregnancy family studies, prenatal diagnosis, and carrier testing among close relatives of an affected individual. We undertook to clarify the status of six individuals with borderline or elevated sweat chloride concentrations and a relative with CF by testing for haplotype sharing. Their families and physicians expressed concern about management of these generally asymptomatic individuals. We typed DNA from family members with pJ3.11, pXV2C, pKM19, pmetH, pmetD, and p7C22. Each family was fully informative, enabling us to track the CF region of chromosome 7. Our analysis identified five individuals from four families as CF heterozygotes. A sixth individual, whose maternal first cousin died from CF, has the same haplotype as six of his seven healthy siblings, and thus we predict that he is unaffected. These family studies are a novel application of an emerging genetic technology. DNA linkage analysis is useful for elucidation of the CF genotype in families where the clinical features are equivocal and management is an issue.

Assay of a urinary CF-lectin factor as a second diagnostic test for cystic fibrosis.

Analysis of urine samples for a lectin-like factor in patients with a diagnosis of cystic fibrosis (CF) revealed that the low molecular weight (MW) factor is present in urine only from such patients and not from heterozygous carriers of the CF gene or from normal controls. The urine fraction containing the factor must be separated from whole urine by a gel filtration column (TSK-20) for the activity to appear. The assay requires addition of an aliquot of normal serum to provide the necessary IgM to which the CF-factor binds, resulting in the lectin-like activity that causes agglutination of mouse erythrocytes. All 22 CF patients tested, who were not receiving intravenous (IV) antibiotics had positive CF-lectin urinary activity, whereas five others receiving IV aminoglycosides were negative. Four patients with a clinical diagnosis of CF, but with normal sweat tests (35-54 mEq/L), all had positive urinary CF-lectin tests. A blind study in which urine samples were shipped from Miami, FL to Sepulveda, CA was completely successful in correctly identifying 11 samples from CF patients as compared with ten from non-CF patients. It was concluded that an assay for urinary CF-lectin factor is specific and reliable for confirming a diagnosis of CF when the sweat test is indeterminate, and when patients have not received recent IV aminoglycosides.

Resposta das glândulas sudoríparas écrinas à estimulaçäo colinérgica em asmáticos

Avaliamos a funçäo do sistema colinérgico, através da resposta das glândulas sudoríparas à estimulaçäo com pilocarpina, em 56 crianças com asma brônquica. Um grupo de pacientes com mucoviscidose (19) e outro de crianças que näo apresentavam doenças respiratórias (19) serviu de controle e foi pareado em relaçäo à idade e sexo. Näo houve diferenças significativas na quantidade de suor nos três grupos, e também näo houve diferença na concentraçäo de sódio no suor entre o grupo de asmáticos e o grupo de crianças sem doenças respiratórias. Estes resultados opöem-se aos resultados de estudos com indivíduos adultos e poderiam sugerir que a respostas aumentada do sistema colinérgico é exclusiva do aparelho respiratório ou que as anormalidades de ordem sistêmica do parassimpático em asmáticos säo adquiridas após a infância

[The sweat test in cystic fibrosis]. / Schweisstest bei Cystischer Fibrose.

The high concentration of Na and Cl in the sweat of patients with Cystic Fibrosis is directly due to the primary pathogenetic defect, the reduced transport of Cl-Ions through cell membranes of exocrine glands. The most reliable method for the sweat test is by Gibson and Cooke. In good correlation are the results of the Wescor Macroduct System. This method is easier to perform, but needs special instruments.

Does lithium carbonate affect the ion transport abnormality in cystic fibrosis?

Lithium is known to affect several aspects of cellular regulation which may be related to ion channel function in epithelial cells. To determine whether the ion transport abnormality in cystic fibrosis (CF) is affected by lithium with resultant changes in clinical status, 36 CF patients, 12-37 years old, were enrolled in a 14 week, double-blind, placebo-controlled trial. Eighteen patients were randomly assigned to receive lithium carbonate for 10 weeks. At the end of therapy their average serum lithium concentration was 0.56 +/- 0.06 mmol (SEM) per liter. Their sweat chloride concentration fell from 92.1 +/- 4.8 mmol per liter to 87.4 +/- 4.0 mmol per liter after 10 weeks of therapy (P = 0.07) and rose to 94.4 +/- 3.5 mmol per liter 4 weeks after end of therapy (P less than 0.001 compared to results at end of therapy). Their forced vital capacity (FVC) fell from 72 +/- 5.3% of predicted to 66 +/- 5.1% of predicted after 4 weeks of therapy (P less than 0.01), and their forced expiratory volume in one second (FEV1) fell from 56 +/- 5.5% of predicted to 51 +/- 5.5% of predicted after 4 weeks of therapy (P less than 0.01). In a non-blind assessment, performed 19 weeks after the end of therapy, their FVC and FEV1 had risen and were not significantly different from baseline. Sweat chloride, FVC, and FEV1 remained unchanged in the placebo group throughout the period of study.(ABSTRACT TRUNCATED AT 250 WORDS)

Depressive illness and abnormal sweat electrolytes. A case report.

False-positive sweat electrolyte levels are infrequently reported in adolescent psychiatric conditions. A case is reported and the interpretation of elevated sweat electrolytes discussed.

Quantification of chloride in sweat with the Cystic Fibrosis Indicator System.

We examined the relation between chloride concentration and the area of complexed chloride of Medtronic's Cystic Fibrosis Indicator System, using a high-resolution x-y coordinated digitizer to measure the circumference of the chloride precipitation ring. These digitized points were entered directly into an IBM PC computer, where the area of the chloride precipitation was calculated with use of a repetitive rectangular estimation program. Using these data, we determined the relationship between the area of chloride precipitation and the chloride concentration of the standard NaCl solutions. When the area of the ring of chloride precipitation in the system's patch is measured immediately after the sweat test is completed, the concentration of chloride in the sweat can be calculated with a reproducibility equal to that of the Gibson-Cooke sweat test.

Fractional measurements of sweat osmolality in patients with cystic fibrosis.

After pilocarpine iontophoresis the change of sweat concentration during collection was studied by vapour pressure osmometry in 24 patients with cystic fibrosis and 24 healthy controls. There was a continuous but proportionate fall in sweat concentrations during the collection period. Mean (SD) initial sweat concentration in the control group was 154.4 (32.6) mmol/kg falling, after 50 microliters of sweat produced, to 92.9 (15.8) mmol/kg. In the cystic fibrosis group it was 315.9 (35.8) mmol/kg falling to 247.4 (24.9) mmol/kg. Despite different rates of fall in concentrations, separation of the two groups was maintained throughout. We conclude that there are implications for the potential improvement of the predictive value of the sweat test.

ABO and Lewis typing of secretion stains on nitrocellulose membranes using a new dot-blot-ELISA technique.

A new method for ABO and Lewis typing of body fluids is described. It combines the advantages of a good antigen binding to nitrocellulose membranes, the need of only very small amounts of stain material and the high sensitivity of an enzyme-linked immunosorbent assay for antigen detection. This is of special interest because conventional ABO and Lewis typing of secretion stains need relatively large stain dimensions. The method is very easy to handle, does not need any expensive equipment and gives a permanent record. Furthermore the high sensitivity offers the possibility of analyzing even sweat and urine stains without the need of concentrating these extracts.

[Diagnosis of mucoviscidosis by examination of sweat: value of conductometry]. / Mukoviszidose-Diagnostik durch Schweissuntersuchung: Stellenwert der Konduktometrie.

Two methods for the determination of sodium in the sweat after stimulation by pilocarpine-iontophoresis were compared in 227 patients, among them 27 with a known cystic fibrosis. These two methods were 1. the standardized method by flame fotometry (State Pharmacopoeia of the German Democratic Republic) and 2. the determination of the sweat conductance by the new apparatus "CF-Conductognost". Both methods showed a good correlation. We recommend the conductometry for the decentralized screening because it saves time and gives results immediately. But in all patients with a questionable or pathologic value of conductance the sweat test should be repeated with the standardized method. This concerns only about 10 per cent of all patients.

Radioimmunoassay detection limits for 19-OH F1 alpha/F2 alpha prostaglandin in normal, infertile and vasectomized semen stains. Analysis of saliva, sweat and urine for possible non-specific or matrix effects.

The sensitivity of a simple radioimmunoassay (RIA) for the detection of 19-OH prostaglandin F1 alpha/F2 alpha (PG F) has been evaluated on a number of semen samples from vasectomized, infertile and fertile donors. The specificity of the test has been examined by testing saliva, sweat and urine from a number of male and female donors. The assay technique could readily detect the PG in semen stains prepared from 0.2 microliter of semen from normal, infertile and vasectomized donors. The detection limit of the assay system, based on the observed displacement, was calculated to be approximately 0.05 microliter semen. The assay could be conducted over a pH range of 7.5-10.5 even after the PG has been heated to 100 degrees C. The 19-OH series of PG were absent from sweat, saliva and female urine using the normal assay protocol; volumes in excess of 100 microliters of some urines particularly from women in labour and those with acute urinary tract infection showed some displacement. Low levels of PG were detected in 50% of the male urine analysed. However, urine samples from men who had engaged in recent sexual activity contained relatively high concentrations of PG which could be readily detected in 10 microliters of urine. These results emphasise the potential of these compounds as specific and sensitive markers for the presence of human semen.

Relapsing pancreatitis as initial manifestation of cystic fibrosis in a young man without pulmonary disease.

In young adults with acute pancreatitis a wide etiologic spectrum has to be considered. Among the possible causes, cystic fibrosis is rare. Besides the typical clinical triad of pancreatic exocrine insufficiency, chronic obstructive pulmonary disease, and elevated sweat chloride levels, there is a wide spectrum of variants of the cystic fibrosis syndrome. Especially mild manifestations of the disease may, therefore, escape proper identification. Here we describe a young man who presented initially with recurrent acute pancreatitis without pulmonary disease and without a family history of cystic fibrosis, in whom the diagnosis of cystic fibrosis was established by slightly elevated sweat chloride levels and obstructive azoospermia. Five years after the first attack of pancreatitis the patient developed pancreatic exocrine insufficiency.