Cited by 1,434Cystic Fibrosis Research AdvancesPancreatitis Pathology and TreatmentSalivary Gland Disorders and Functions

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A TEST FOR CONCENTRATION OF ELECTROLYTES IN SWEAT IN CYSTIC FIBROSIS OF THE PANCREAS UTILIZING PILOCARPINE BY IONTOPHORESIS

Gibson, Lewis E., Cooke, Robert E.·1959·Pediatrics

DOI 10.1542/peds.23.3.545

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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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Crossref · 10.1542/peds.23.3.545

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Naehrlich, L. (2020) · International Journal of Neonatal Screening · doi:10.3390/ijns6030054 · Cited by 15
“In 1959, Gibson and Cooke published a method for sweat induction by pilocarpine iontophoresis on a small body surface area [6], and it remains the diagnostic gold standard for CF even today.”
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“«Золотым стандартом» в диагностике заболевания является потовая проба: аномально высокие концентрации хлорида (выше 60 ммоль/л) в сочетании с клиническими признаками свидетельствуют о недостаточной функции канала [2].”
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“Sweat was obtained by the pilocarpine iontophoretic method of Gibson & Cooke [13].”
Method
The response of normal men and women to changes in their environmental temparatures and ways of life
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“The standard method of using pilocarpine iontophoresis to produce sweat (Gibson and Cooke, 1959), and estimating the sodium present by conductivity or flame photometry, is a workable technique but has some drawbacks.”
Method
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“Diagnosis was based upon typical history and abnormal sweat electrolytes using the pilocarpine iontophoresis technique [12].”
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“factor prior to the identification of the CF gene [3].”
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“Since 1959, CF diagnosis has been obtained using the Gibson and Cooke test, that is, the sweat test [16].”
Method
Pulsed direct and constant direct currents in the pilocarpine iontophoresis sweat chloride test
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“In classical Gibson and Cooke test, the 75 mg sweat criteria was considered, being 1 g (sweat)/m2 (sweat collection area)/min (collection time) in a area of 5.5 cm diameter filter paper.”
BackgroundMethodInfluential
Can continuous glucose monitoring predict cystic fibrosis-related diabetes and worse clinical outcome?
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“Pilocarpine hydrochloride solution (5mL, 0.5%, Galena Quı́mica e Farmacêutica, Campinas, SP, Brazil) was applied through the skin using an electrical current of 1.5mA (60 mAcm 2) for 5min, as described by Gibson and Cooke (1959) and Buono and Sjoholm, 1988; Buono et al. (1991).”
MethodInfluential
Incidência e evolução da polipose nasal em crianças e adolescentes com fibrose cística
Weber, S. A. T., & Ferrari, G. F. (2008) · Revista Brasileira de Otorrinolaringologia · doi:10.1590/s0034-72992008000100003 · Cited by 13
The novel complex allele [A238V;F508del] of the CFTR gene: clinical phenotype and possible implications for cystic fibrosis etiological therapies
Diana, A., Polizzi, A. M., Santostasi, T., et al. (2016) · Journal of Human Genetics · doi:10.1038/jhg.2016.15 · Cited by 13
Biological Variation of Chloride and Sodium in Sweat Obtained by Pilocarpine Iontophoresis in Adults: How Sure are You About Sweat Test Results?
Willems, P., Weekx, S., Meskal, A., & Schouwers, S. (2017) · Lung · doi:10.1007/s00408-017-9984-6 · Cited by 13
“The sweat test using pilocarpine iontophoresis, as described by Gibson and Cooke in 1959 [6], remains the Abstract Introduction The measurement of chloride and sodium concentrations in sweat is an important test for the diagnosis of cystic fibrosis (CF).”
Method
Newborn screening for cystic fibrosis: Is there benefit for everyone?
Course, C. W., & Hanks, R. (2019) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2019.02.003 · Cited by 13
Research advances in molecular mechanisms underlying the pathogenesis of cystic fibrosis: From technical improvement to clinical applications (Review)
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Protracted neonatal hypertrypsinogenaemia, normal sweat chloride, and cystic fibrosis
Castellani, C. (2000) · Archives of Disease in Childhood · doi:10.1136/adc.82.6.481 · Cited by 13
Autoimmune thyroiditis. Spontaneous autoimmune thyroiditis in praomys (Mastomys) coucha.
Solleveld, H. A., Coolen, J., Haaijman, J. J., et al. (1985) · PubMed · Cited by 13
Reliability of sweat tests in diagnosis of cystic fibrosis
Gibson, L. E. (1972) · The Journal of Pediatrics · doi:10.1016/s0022-3476(72)80435-9 · Cited by 13
Self-citation
Cystic fibrosis
Hodson, M. E. (1984) · Postgraduate Medical Journal · doi:10.1136/pgmj.60.701.225 · Cited by 13
Increased Monocyte Chemiluminescence in Cystic Fibrosis Patients and in their Parents
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RELIABLE DIAGNOSIS OF THE MAJOR TYPE OF CYSTIC FIBROSIS WITH FIBROBLAST CULTURES A Double Blind Study
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Newborn Screening for Cystic Fibrosis: Infant and Laboratory Factors Affecting Successful Sweat Test Completion
Shenoy, A., Spyropoulos, D., Peeke, K. L., et al. (2020) · International Journal of Neonatal Screening · doi:10.3390/ijns7010001 · Cited by 12
“All infants with an abnormal or inconclusive CF NBS require diagnostic sweat chloride testing (ST), the gold standard test for diagnosing CF [14].”
Background
Anchoring PQQ-Glucose Dehydrogenase with Electropolymerized Azines for the Most Efficient Bioelectrocatalysis
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Cystic Fibrosis: A Journey through Time and Hope
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Lung Clearance Index Improves in People with Cystic Fibrosis not Achieving a Clinical Important Difference in Forced Expiratory Volume in One Second After Elexacaftor/Tezacaftor/Ivacaftor Therapy
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Final results of the southwest German pilot study on cystic fibrosis newborn screening – Evaluation of an IRT/PAP protocol with IRT-dependent safety net
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“The comparison between the quality and results of ST for CF diagnosis showed a higher number of incorrect tests in the chloride concentration range of 40 to 60 mEq/L, known as borderline range for the ST, as determined by Gibson and Cooke [14].”
MethodInfluential
Iontophoresis in ophthalmology: A review of the literature
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“However, this case and published reports from well-established screening programs12,14,15 emphasize that screening does not provide definitive diagnosis of CF. Sweat chloride testing is always warranted given clinical suspicion, despite negative screening results.”
MethodInfluential
Lack of harmonization in sweat testing for cystic fibrosis – a national survey
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“[154] The quantitative assessment of sweat Cl − continues to be the primary confirmatory diagnostic approach for CF, especially in newborns.”
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“It can be collected noninvasively after activation of the sweat glands by heating [14] or electrophoresis of pilocarpine [15,16].”
Background
Demographic characteristics, clinical and laboratory features, and the distribution of pathogenic variants in the CFTR gene in the Cypriot cystic fibrosis (CF) population demonstrate the utility of a national CF patient registry
Yiallouros, P. K., Matthaiou, A. Μ., Anagnostopoulou, P., Κouis, P., Libik, M., Adamidi, T., Eleftheriou, A., Demetriou, A., Ioannou, P., Tanteles, G. A., et al. (2021) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-021-02049-z · Cited by 11
“Genotyping was performed in all of our patients, whereas most of them underwent quantitative measurement of sweat chloride with the pilocarpine iontophoresis stimulation of a localized skin area (Gibson & Cooke, 1959) method.”
Method
Quantitative Ultrasound in Spanish Children and Young Adults With Cystic Fibrosis
López‐Rodriguez, M. J., García, J. M. L., Canal-Macías, M. L., et al. (2012) · Biological Research For Nursing · doi:10.1177/1099800412441500 · Cited by 11
“We confirmed the disease by a history of chronic bronchitis, intestinal malabsorption, and two positive sweat tests with values above 60 mEq of chloride (Cl ), according to the Gibson and Cook method (Gibson & Cooke, 1959), and/or two cystic fibrosis transmembrane conductance regulator mutations.”
Method
Comparative Variability of Nasal Potential Difference Measurements in Human and Mice
Leonard, A., Lubamba, B., Dhooghe, B., Noël, S., Wallemacq, P. E., Lebecque, P., & Leal, T. (2012) · Open Journal of Respiratory Diseases · doi:10.4236/ojrd.2012.22007 · Cited by 10
“Sweat test was carried out by pilocarpine iontophoresis according to Gibson and Cooke [23].”
Method
Topical Iontophoretic Delivery
Hirvonen, J. J. (2005) · American Journal of Drug Delivery · doi:10.2165/00137696-200503020-00001 · Cited by 11
Sodium, Calcium, and Magnesium Levels in Nails of Children with Cystic Fibrosis of the Pancreas
Leonard, P., & Morris, W. P. (1972) · Archives of Disease in Childhood · doi:10.1136/adc.47.254.495 · Cited by 11
Mutational spectrum of cystic fibrosis patients from Córdoba province and its zone of influence: Implications of molecular diagnosis in Argentina
Ramírez, A. M. O., Ramos, M. D. B., Jiménez, J., et al. (2006) · Molecular Genetics and Metabolism · doi:10.1016/j.ymgme.2005.12.001 · Cited by 11
The Cystic Fibrosis Gene is Not Likely to be Involved in Chronic Obstructive Pulmonary Disease
Gasparini, P., Savoia, A., Luisetti, M., et al. (1990) · American Journal of Respiratory Cell and Molecular Biology · doi:10.1165/ajrcmb/2.3.297 · Cited by 11
Cystic fibrosis newborn screening does not delay the identification of cystic fibrosis in children with negative results
MacLean, J. E., Solomon, M. P., Corey, M. L., & Selvadurai, H. C. (2011) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2011.04.002 · Cited by 11
“Sweat testing was completed at both centers using pilocarpine iontophoresis [25].”
Method
Iontophoretic drug delivery using the IOMED Phoresor®system
Fischer, G. A. (2005) · Expert Opinion on Drug Delivery · doi:10.1517/17425247.2.2.391 · Cited by 11
“Pilocarpine + Sweat test (cystic fibrosis) [43,44]”
Method
Coagulopathy with piperacillin administration in cystic fibrosis: Two case reports
RYE, P. J., Roberts, G. W., STAUGAS, R., et al. (1994) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.1994.tb00635.x · Cited by 11
Clinical presentation of cystic fibrosis at the time of diagnosis: a multicenter study in a region without newborn screening
FARAHMAND, F., Khalili, M., Shahbaznejad, L., et al. (2013) · The Turkish Journal of Gastroenterology · doi:10.4318/tjg.2013.0653 · Cited by 11
“The sweat chloride concentration was measured by a quantitative pilocarpine iontophoresis sweat test as Gibson-Cooke procedure (14).”
Method

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
DOI: 10.1542/peds.23.3.545
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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A TEST FOR CONCENTRATION OF ELECTROLYTES IN SWEAT IN CYSTIC FIBROSIS OF THE PANCREAS UTILIZING PILOCARPINE BY IONTOPHORESIS

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