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A TEST FOR CONCENTRATION OF ELECTROLYTES IN SWEAT IN CYSTIC FIBROSIS OF THE PANCREAS UTILIZING PILOCARPINE BY IONTOPHORESIS
Abstract
A method of performing the test for chloride or sodium in the sweat of patients with cystic fibrosis of the pancreas is presented. It utilizes pilocarpine by iontophoresis and has the advantage of being both rapid and painless. Data are presented to show that the method is reliable.
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In the citing paper
“Sweat testing has historically been used in applications ranging from medical diagnosis of cystic fibrosis and autonomic neuropathy to assessment of fluid and electrolyte balance in endurance athletes (6–10).”
From Regional and correlative sweat analysis using high-throughput microfluidic sensing patches toward decoding sweat (2019) · cites this paper as [6]
In the citing paper
“Sweat behaviors of only a few analytes, including ethanol and chloride, have been extensively investigated and related to blood concentrations or health status (6, 8, 27, 35).”
From Regional and correlative sweat analysis using high-throughput microfluidic sensing patches toward decoding sweat (2019) · cites this paper as [6]
In the citing paper
“During the iontophoresis operation, the cationic pilocarpine drug was delivered across the skin at the anode electrode (Figure 1D).32”
From Noninvasive Alcohol Monitoring Using a Wearable Tattoo-Based Iontophoretic-Biosensing System (2016) · cites this paper as [32]
In the citing paper
“Pilocarpine is a large positively charged molecule, and the electron shuttling activity of PB can be influenced by pilocarpine due to the vulnerability of PB against other positive ions in electrolytes.32”
From Noninvasive Alcohol Monitoring Using a Wearable Tattoo-Based Iontophoretic-Biosensing System (2016) · cites this paper as [32]
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“The sweat test was carried out by the method of Gibson and Cooke,8 which consists of three phases: (1) induction of sweating by pilo-carpine iontophoresis for 30 to 60 seconds using 70 cm quantitative No 3 Whatman filter paper containing 0-06% ashes and measuring 3 cm in diameter; (2) elution of…”
MethodRoomans, G. M., Afzelius, B. A., Kollberg, H., et al. (1978) · Acta Paediatrica · doi:10.1111/j.1651-2227.1978.tb16282.x · Cited by 21
Inadequate erythroid response to hypoxia in cystic fibrosis
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In VitroandIn VivoEvaluation of Carboplatin Delivery to the Eye Using Hydrogel-Iontophoresis
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“Abbreviations: P Aldo = plasma aldosterone; U Aldo = urinary aldosterone; PRA = plasma renin activity; A = androstenedione; DHEA = dehydroepiandrosterone; F = cortisol; 17-KS = 17-ketosteroids; 17-OHCS = 17-hydroxycorticosteroids; FF = free cortisol Localised sweating was induced with pilocarpine iontophoresis [5].”
MethodUrinary Bile Acid Excretion in Correlation to Liver Histopathology in Cystic Fibrosis
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Cystic Fibrosis With Acute Hypoelectrolytemia and Metabolic Alkalosis in Infancy
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Clinical presentation of exclusive cystic fibrosis lung disease
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Modified Method to Measure Nasal Potential Difference
Leal, T., Lebacq, J., Lebecque, P., Cumps, J., & Wallemacq, P. E. (2003) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2003.011 · Cited by 19
Sharma, H., Mavuduru, R. S., Singh, S., et al. (2014) · Molecular Human Reproduction · doi:10.1093/molehr/gau047 · Cited by 20
Advances in the Diagnosis and Management of Cystic Fibrosis in the Genomic Era
Wiencek, J. R., & Lo, S. F. (2018) · Clinical Chemistry · doi:10.1373/clinchem.2017.274670 · Cited by 23
Clinical and mutation profile of children with cystic fibrosis in Jammu and Kashmir
Kawoosa, M. S., Bhat, M. A., Ali, S. W., Hafeez, I., & Shastri, S. (2013) · Indian Pediatrics · doi:10.1007/s13312-014-0381-4 · Cited by 21
Neonatal screening for cystic fibrosis in São Paulo State, Brazil: a pilot study
Rodrigues, R., Magalhães, P. K. R., Fernandes, M. I. M., Gabetta, C. S., Ribeiro, A. F., Pedro, K. P., Valdetaro, F., Santos, J. L. F., de Souza, R. M., Filho, A. P. L., et al. (2009) · Brazilian Journal of Medical and Biological Research · doi:10.1590/s0100-879x2009005000017 · Cited by 20
“All infants with positive IRT2 results were referred to Center 1 or Center 2 for clinical evaluation and for the measurements of sweat electrolytes using the Gibson-Cooke pilocarpine iontophoresis sweat-chloride test on the forearms (12).”
MethodEvidence of mild respiratory disease in men with congential absence of the vas deferens
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False positive sweat test, malnutrition, and the Mauriac syndrome
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Cystic fibrosis presenting with recurrent vomiting and metabolic alkalosis
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Mutations of the CFTR Gene in Idiopathic Pancreatic Hyperenzymemia
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“The sweat test, which is based on the quantitative pilocarpine iontophoresis technique described by Gibson and Cooke (1959), is by far the most frequently used diagnostic test for CF in Italy.”
MethodGasparini, P., Marigo, C., Bisceglia, G., et al. (1993) · Human Mutation · doi:10.1002/humu.1380020511 · Cited by 20
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Cystic Fibrosis of the Pancreas
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Pilocarpine iontophoresis test: an index of physiological sweat secretion?
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Diagnosing Cystic Fibrosis in Adults
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Airway ion transport impacts on disease presentation and severity in cystic fibrosis
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Thirty Years of Sweat Chloride Testing at One Referral Center
Faria, A. G., Marson, F. A. L., Gomez, C. C. S., et al. (2017) · Frontiers in Pediatrics · doi:10.3389/fped.2017.00222 · Cited by 19
“One of the ST collection methods approved by the CFF was developed by Gibson and Cooke (2).”
MethodInfluentialCystic Fibrosis in India: Past, Present and Future
Kabra, S. K. (2015) · Pulmonary Medicine & Respiratory Research · doi:10.24966/pmrr-0177/100002 · Cited by 19
Cirilli, N., Raia, V., Rocco, I., Gregorio, F. D., Tosco, A., Salvadori, L., Sepe, A. O., Buzzetti, R., Minicuci, N., & Castaldo, G. (2018) · Pediatric Pulmonology · doi:10.1002/ppul.23992 · Cited by 19
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Marvelli, A., Campi, B., Mergni, G., et al. (2020) · Analytical and Bioanalytical Chemistry · doi:10.1007/s00216-020-02821-3 · Cited by 19
“Sweat samples were collected by the pilocarpine iontophoresis test (QPIT) [12].”
MethodCYFIUC Group, Marson, F. A. L., Hortêncio, T. D. R., Aguiar, K. C. A., & Ribeiro, J. D. (2015) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-15-3 · Cited by 20
“Sweat chloride concentration Measurement of the sweat chloride concentration by the Gibson and Cooke method [35] is the gold standard for a diagnosis of CF.”
MethodChronic idiopathic anhydrosis--a rare cause of heat stroke
Dann, E. J., & Berkman, N. (1992) · Postgraduate Medical Journal · doi:10.1136/pgmj.68.803.750 · Cited by 19
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Biological variation in sweat sodium chloride conductivity
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Iontophoretic Transport of Model Compounds from a Gel Matrix Across a Cellophane Membrane
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In vivo assessments of microneedle arrays and iontophoresis of pilocarpine in human palmar sweating
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Sweat induction using Pilocarpine microneedle patches for sweat testing in healthy adults
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Patho-physiological studies of the sweat gland
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A reference interval for sweat chloride in infants aged between five and six weeks of age
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Sweating and Congestive Heart Failure
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Clinical approach to the diagnosis and treatment of cystic fibrosis and CFTR-related disorders
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Proof of concept for identifying cystic fibrosis from perspiration samples
Zhou, Z., Alvarez, D., Milla, C. E., & Zare, R. N. (2019) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1909630116 · Cited by 18
“The sweat chloride test (8) includes first stimulation of a high rate of sweat secretion in a small area of skin by pilocarpine iontophoresis, collection of sweat, and determination of chloride concentration in the sweat collected (9).”
BackgroundWeidler, S., Stopsack, K. H., Hammermann, J., et al. (2016) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2016.07.002 · Cited by 18
Hauschild, D. B., Rosa, A. F., Ventura, J. C., Barbosa, E., Moreira, E. A. M., Neto, N. L., & Moreno, Y. M. F. (2018) · Revista Paulista de Pediatria · doi:10.1590/1984-0462/;2018;36;1;00006 · Cited by 19
“Delta F508 heterozigoto 17 (44,7) 28,2; 61,3”
Skin Biomarkers for Cystic Fibrosis: A Potential Non-Invasive Approach for Patient Screening
Esteves, C. Z., Dias, L. D. A., Lima, E. D. O., et al. (2018) · Frontiers in Pediatrics · doi:10.3389/fped.2017.00290 · Cited by 18
“After sweat collection, chloride levels are evaluated and concentrations above 60 mmol/L for non-infants and infants are considered positive for CF (12, 13).”
BackgroundMethodReticuloendothelial Clearance in Cystic Fibrosis and Other Inflammatory Lung Diseases
Mantzouranis, E. C., Rosen, F. S., & Colten, H. R. (1988) · New England Journal of Medicine · doi:10.1056/nejm198808113190604 · Cited by 18
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Sweat testing for cystic fibrosis: Characteristics of a combination chloride ion-selective electrode
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Cystic Fibrosis Mistaken for Idiopathic Biliary Atresia
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Mild Cystic Fibrosis in a Consanguineous Family
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Fasting Serum Bile Acid Levels in Relation to Liver Histopathology in Cystic Fibrosis
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Abnormal Sweat Electrolytes in a Case of Celiac Disease and a Case of Psychosocial Failure to Thrive
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Growth dynamics in cystic fibrosis
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Erythrocyte cytosolic free Ca2+ and plasma membrane Ca2+-ATPase activity in cystic fibrosis
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CLARKE, J. T. (1961) · American journal of diseases of children · doi:10.1001/archpedi.1961.04020050080012 · Cited by 18
Diagnostic Testing in Cystic Fibrosis
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A Review of Emerging Tear Proteomics Research on the Ocular Surface in Ocular Allergy
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Diagnosis and Presentation of Cystic Fibrosis
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Collection of the Abstracts of the 2019Sp PMD: Translational Myology and Mobility Medicine
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Should isolated Pseudo‐Bartter syndrome be considered a CFTR‐related disorder of infancy?
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“In the following years, the loss of electrolytes with the sweat was identified as a hallmark of the disease itself and used for the recognition of the same, through the measurement of sweat chloride.(17) Hyponatremic, hypochloremic metabolic alkalosis resembling Bartter syndrome (defined as PBS) is a well‐known manife…”
Adam, K. A. R. (1991) · Annals of Tropical Paediatrics · doi:10.1080/02724936.1991.11747491 · Cited by 17
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Nutritional assessment of infants with cystic fibrosis diagnosed through screening
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Resting energy expenditure and substrate oxidation rates in cystic fibrosis.
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“The laboratory diagnosis of cystic fibrosis is based on analy sis of sweat collected by the quantitative pilocarpine ionto phoresis method of Gibson and Cooke (1959).”
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Progress of personalized medicine of cystic fibrosis in the times of efficient CFTR modulators
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“and found elevated sweat chloride in all patients [12].”
BackgroundRESPONSE OF SWEAT GLANDS TO PILOCARPINE IN THE BANTU OF UGANDA
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Efficacy of iontophoresis in the rat cornea
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“nique has been used in various fields of medicine [5, 8-10, 18].”
MethodFibrose cística em adultos: aspectos clínicos e espirométricos
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Sweat testing for cystic fibrosis: standards of performance in Australasia
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Genetic and Immunologic Aspects of Cystic Fibrosis
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Interpretation of Sweat Sodium Results—The Effect of Patient Age
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Li, Y., Liu, Y., Chen, L., & Xu, J. (2021) · Advanced Healthcare Materials · doi:10.1002/adhm.202100046 · Cited by 15
Diagnosing Cystic Fibrosis in the 21st Century—A Complex and Challenging Task
Anton-Păduraru, D.-T., Azoicai, A. N., Trofin, F., Mîndru, D. E., Murgu, A. M., Bocec, A. S., Halițchi-Iliescu, C.-O., Ciongradi, C. I., Sârbu, I., & Iliescu, M. L. (2024) · Diagnostics · doi:10.3390/diagnostics14070763 · Cited by 18
“In 1959, Gibson and Cooke introduced quantitative iontophoresis with pilocarpine, comprising four stages: local pilocarpine-induced sweat gland stimulation on the forearm, sweat collection, quantitative sweat electrolyte analysis (sodium, chloride), and result interpretation [6,12,40–47].”
BackgroundSommerburg, O., Stahl, M., Hammermann, J., et al. (2017) · Klinische Pädiatrie · doi:10.1055/s-0042-124187 · Cited by 15
“Positiv getestete NG wurden in lokale CF-Zentren zur Chlorid-Messung im Schweiß [nach [5, 6]] und zur klinischen Evaluation überwiesen.”
BackgroundSkin wipe test: A simple, inexpensive, and fast approach in the diagnosis of cystic fibrosis
Ďurč, P., Foret, F., Homola, L., Malá, M., Pokojová, E., Vinohradská, H., Dastych, M., Krausova, D., Nagy, D., Bede, O., et al. (2020) · Pediatric Pulmonology · doi:10.1002/ppul.24758 · Cited by 15
Metadata
- Authors
- Gibson, L. E., & Cooke, R. E.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1959-03-01
- Volume
- 23
- Issue
- 3
- Pages
- 545-549
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1946951765
- Cited by
- 1,434
- References
- 0
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 24 · 2023: 24 · 2022: 15 · 2021: 34 · 2020: 41 · 2019: 37 · 2018: 37 · 2017: 42 · 2016: 37 · 2015: 32 · 2014: 35 · 2013: 30 · 2012: 39
- FWCI
- 27.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Physiology (medical) › Salivary Gland Disorders and Functions
- Keywords
- cystic fibrosis, sweat test, sweat electrolytes, chloride, sodium, pilocarpine, iontophoresis
- MeSH terms
- Chlorides, Cystic Fibrosis, Electrolytes, Humans, Iontophoresis, Pilocarpine, Sodium, Sodium, Dietary, Sweat
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