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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Retrospective analysis of microorganisms isolated from cystic fibrosis patients in Southern Italy, 2002-2010
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Background
Uncertainty of sweat chloride testing: does the right hand know what the left hand is doing?
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Sweat testing: can the conductivity analysis take the place of the classic Gibson and Cooke technique?
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Comparison of conductivity with sodium determination in the same sweat sample
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Therapie der Mukoviszidose mit CFTR-Modulatoren
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EXPERIENCE OF EVALUATING FUNCTIONALITY OF ANIONIC CFTR CHANNEL METHODS APPLICATION IN PATIENTS WITH CYSTIC FIBROSIS DIAGNOSED AND SUPPOSED
Kondratyeva, E., Melyanovskaya, Y. L., Efremova, A. S., Bulatenko, N., Bukharova, T. B., Goldshtein, D. V., Zodbinova, A., Nikonova, V., Zhekaite, E. K., Kashirskaya, N. Y., et al. (2019) · Siberian medical review · doi:10.20333/2500136-2019-2-60-69 · Cited by 10
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Cystic Fibrosis Diagnosed Using Indigenously Wrapped Sweating Technique: First Large-Scale Study Reporting Socio-Demographic, Clinical, and Laboratory Features among the Children in Bangladesh A Lower Middle Income Country
Kabir, A. L., Roy, S. S., Habib, R., Anwar, K. S., Mollah, M. A. H., Amin, R., Mridha, A. A., Majumder, J. U., Hossain, D., Haque, N., et al. (2020) · Global Pediatric Health · doi:10.1177/2333794x20967585 · Cited by 11
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Cystic fibrosis and art therapy
Farrell Fenton, J. (2000) · The Arts in Psychotherapy · doi:10.1016/s0197-4556(99)00015-5 · Cited by 10
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“Escore de Shwachman-Kulczyckic 80 (32,5) 75 (20,0) 70 (31,3) 0,748”
BackgroundInfluential
Cystic fibrosis, Duchenne muscular dystrophy and preimplantation genetic disorders
Liu, J. (1996) · Human Reproduction Update · doi:10.1093/humupd/2.6.531 · Cited by 10
“The patients also show increased sweat electrolyte concentrations which, although of little clinical consequence, have long been and still are a very reliable diagnostic test for the disease (sweat test; Gibson and Cooke, 1959; Hodson et al., 1983).”
Background
Time Point to Perform Lung Function Tests Evaluating the Effects of an Airway Clearance Therapy Session in Cystic Fibrosis
Hortal, M. C. R., & Hjelte, L. (2014) · Respiratory Care · doi:10.4187/respcare.02823 · Cited by 10
Nasal endoscopic evaluation of children and adolescents with cystic fibrosis
Franco, L. P., Camargos, P. A. M., Becker, H. M. G., et al. (2009) · Brazilian Journal of Otorhinolaryngology · doi:10.1016/s1808-8694(15)30541-3 · Cited by 10
Fentanyl in der Schmerztherapie von Kindern jenseits des Neugeborenenalters
Friedrichsdorf, S. J., & Zernikow, B. (2004) · Kinder- und Jugendmedizin · doi:10.1055/s-0037-1617831 · Cited by 10
VARIANT CYSTIC FIBROSIS PHENOTYPES IN THE ABSENCE OF CFTR MUTATIONS
Oshua, J., Roman, D., Eyer, M. I. E. M., et al. (2002) · Cited by 10
Cystic fibrosis in adults: the unsuspected pulmonary diagnosis.
Nolan, A. J. (1976) · PubMed · Cited by 10
Cyclic Fluctuation of Sweat Electrolytes in Women
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“As a comparison method, we used the Gibson-Cooke titration technique (3).”
MethodInfluential
IMMUNOGLOBULINS AND ALBUMIN IN SPUTUM FROM PATIENTS WITH CYSTIC FIBROSIS
Schiøtz, P. O., Clemmensen, I. H., & Høiby, N. (1980) · Acta Pathologica Microbiologica Scandinavica Section C Immunology · doi:10.1111/j.1699-0463.1980.tb00106.x · Cited by 10
High- Versus Low-Lipase Acid-Resistant Enzyme Preparations in Cystic Fibrosis: A Crossover Randomized Clinical Trial
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Reliability of sweat‐testing by the Macroduct® collection method combined with conductivity analysis in comparison with the classic Gibson and Cooke technique
Mastella, G., Cesare, G. D., Borruso, A., et al. (2000) · Acta Paediatrica · doi:10.1111/j.1651-2227.2000.tb00411.x · Cited by 10
Aldosteronwirkung auf die Natriumchlorid- und Kaliumausscheidung im Schwei� von Pankreasfibrose-Patienten und Gesunden
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An overview of the management of cystic fibrosis.
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Progress in screening for inborn errors of metabolism
Watts, R. W. E. (1978) · Cellular and Molecular Life Sciences · doi:10.1007/bf01944644 · Cited by 10
Activator-associated Ca2+-ATPase in erythrocyte membranes from cystic fibrosis patients
Foder, B., Scharff, O., & Tønnesen, P. (1980) · Clinica Chimica Acta · doi:10.1016/0009-8981(80)90195-3 · Cited by 10
Cystic fibrosis
Shwachman, H. (1978) · Current Problems in Pediatrics · doi:10.1016/s0045-9380(78)80018-8 · Cited by 10
Accelerating Scientific Advancement for Pediatric Rare Lung Disease Research. Report from a National Institutes of Health–NHLBI Workshop, September 3 and 4, 2015
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Translational Research in Cystic Fibrosis: From Bench to Beside
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“Over 20 years later, during an intense summer in New York, excessive loss of salt in sweat was discovered in patients with CF, which later culminated in the development of the sweat test, an exam that is now gold standard in the diagnosis of the disease (5, 6).”
Background
Dyslipidemia in racially admixtured children with cystic fibrosis
Alves, C., Lima, D. O. D., Cardeal, M., et al. (2012) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.98016 · Cited by 9
“Diagnosis of CF was based on clinical criteria and by analyzing twice the concentration of chloride in sweat, in accordance with the technique described by Gibson and Cooke.[9] Search for the ΔF508 mutation was conducted by analyzing the nucleotide sequence as previously described.”
Method
Fibrose quística: Revisão
Damas, C., Amorim, A. A., & Gomes, I. (2008) · Revista Portuguesa de Pneumologia · doi:10.1016/s0873-2159(15)30220-8 · Cited by 9
The first five-year evaluation of cystic fibrosis neonatal screening program in São Paulo State, Brazil
Maciel, L. M. Z., Magalhães, P. K. R., Ciampo, I. R. L. D., et al. (2020) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00049719 · Cited by 9
Implication of the Cystic Fibrosis Transmembrane Conductance Regulator Gene in Infertile Family Members of Indian CF Patients
Sharma, N., Singh, M., Acharya, N., Singh, S. K., Thapa, B. R., Kaur, G., & Prasad, R. (2008) · Biochemical Genetics · doi:10.1007/s10528-008-9199-x · Cited by 9
“Sweat Chloride Sweat was collected using the pilocarpine iontophoresis method (Gibson and Cooke 1959).”
Method
Diagnostic de la mucoviscidose
Storni, V., Claustres, M., Chinet, T., & RAVILLY, S. (2001) · Archives de Pédiatrie · doi:10.1016/s0929-693x(01)80003-8 · Cited by 8
Diagnosing cystic fibrosis: what are we sweating about?
Simmonds, N. J., & Bush, A. (2012) · Thorax · doi:10.1136/thoraxjnl-2012-201758 · Cited by 9
Laboratory performance of sweat conductivity for the screening of cystic fibrosis
Greaves, R. F., Jolly, L., Massie, J., Scott, S., Wiley, V. C., Metz, M. P., & Mackay, R. J. (2017) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2017-0530 · Cited by 9
Detection of Cystic Fibrosis Serological Biomarkers Using a T7 Phage Display Library
Talwar, H. S., Hanoudi, S. N., Geamanu, A., Kissner, D. G., Drăghici, S., & Samavati, L. (2017) · Scientific Reports · doi:10.1038/s41598-017-18041-2 · Cited by 9
Newborn Screening Saves Lives but Cannot Replace the Need for Clinical Vigilance
Neemuchwala, F., Taki, M., Secord, E. A., et al. (2018) · Case Reports in Pediatrics · doi:10.1155/2018/7217326 · Cited by 9
“Sweat chloride testing is considered the gold standard for diagnosis of CF [19].”
Background
Prevalência de bactérias potencialmente patogênicas em espécimes respiratórios de fibrocísticos do Recife
Magalhães, M., de Britto, M. C. A., Bezerra, P. G. D. M., et al. (2004) · Jornal Brasileiro de Patologia e Medicina Laboratorial · doi:10.1590/s1676-24442004000400003 · Cited by 9
A simplified cyclic adenosine monophosphate–mediated sweat rate test for quantitative measure of cystic fibrosis transmembrane regulator (CFTR) function
Callen, A., Diener‐West, M., Zeitlin, P. L., & Rubenstein, R. C. (2000) · The Journal of Pediatrics · doi:10.1067/mpd.2000.109198 · Cited by 9
Complement in cystic fibrosis
G�tz, M., & Lübec, G. (1978) · European Journal of Pediatrics · doi:10.1007/bf00445769 · Cited by 9
Trypsin binding activity of alpha 2-macroglobulin in cystic fibrosis and other lung diseases.
Schidlow, D. V., & Kueppers, F. (1980) · PubMed · doi:10.1164/arrd.1980.121.1.31 · Cited by 9
Laboratory Diagnosis
Ferguson, B. J., & MABRY, R. (1997) · Otolaryngology · doi:10.1016/s0194-5998(97)70003-2 · Cited by 9
Biochemical Observations on Leucine Aminopeptidase II of Human Skin**From the Mayo Clinic and Mayo Foundation, Section of Biochemistry, and the Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota.
Decker, R. H., & Dicken, C. H. (1967) · Journal of Investigative Dermatology · doi:10.1038/jid.1967.20 · Cited by 9
Technique of sweat collection in localised sweating by pilocarpine iontophoresis
Jirka, M. (1965) · Clinica Chimica Acta · doi:10.1016/0009-8981(65)90092-6 · Cited by 9
Heterozygote advantage in cystic fibrosis: mosquito tests
Super, M., & van Schalkwyk, D. (1979) · Clinical Genetics · doi:10.1111/j.1399-0004.1979.tb00853.x · Cited by 9
“Sweat sodium and chloride levels after pilocarpine iontophoresis (using the method of Gibson & Cooke 1959) were measured, as were blood groups, blood glucose (using an Ames Reflectance meter) and, in the Cape Town patients, red cell thiamine levels.”
Method
Measurement of Osmolality and Sodium Concentration in Heated-Cup Sweat Collections for the Investigation of Cystic Fibrosis
Kirk, J. M., Adams, A., Westwood, A., et al. (1983) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456328302000608 · Cited by 9
Cardiac potentials in pulmonary disease
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Marker haplotype association with growth in German cystic fibrosis patients
T�mmler, B., Aschendorff, A., Darnedde, T., et al. (1990) · Human Genetics · doi:10.1007/bf00200573 · Cited by 9
“Diagnosis of CF was based on typical clinical features and at least two positive sweat tests (Gibson and Cooke 1959).”
Method
Targeting of drugs: Possibilities in viral chemotherapy and prophylaxis
Gregoriadis, G. C. (1980) · Pharmacology & Therapeutics · doi:10.1016/0163-7258(80)90010-8 · Cited by 9
Development and Evaluation of the Simultaneous Determination of Sweat Sodium and Chloride by Ion-Selective Electrodes
Barbour, H. M. (1991) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456329102800205 · Cited by 9
Comparison between Gibson–Cooke and Macroduct Methods in the Cystic Fibrosis Neonatal Screening Program and in Subjects Who Are Cystic Fibrosis Screen-Positive with an Inconclusive Diagnosis
Dolce, D., Fevola, C., Camera, E., Orioli, T., Lucenteforte, E., Malanima, M. A., Taccetti, G., & Terlizzi, V. (2023) · International Journal of Neonatal Screening · doi:10.3390/ijns9030041 · Cited by 8
“Although several methods have been proposed for collecting and measuring electrolytes from sweat, the method described by Gibson and Cooke [7] in 1959 is a reference method recommended by national and international guidelines [6,8,9].”
Method
Redox Flow Iontophoresis for Continuous Drug Delivery
Naegele, T. E., Gurke, J., Rognin, E., Willis‐Fox, N., Dennis, A. R., Tao, X., Daly, R., Keyser, U. F., & Malliaras, G. G. (2024) · Advanced Materials Technologies · doi:10.1002/admt.202301641 · Cited by 8
Synthesis and Characteristics of Cu/N-Codoped Ti 3 C 2 T x MXene Using Copper-Aniline Solid Complex and Application to Simultaneous Electrochemical Sensing of Adenine and Guanine in Artificial Sweat
Avan, A. A., & Fılık, H. (2024) · Analytical Letters · doi:10.1080/00032719.2024.2307457 · Cited by 8
“Human sweat is known to contain at least 61 different chemical constituents at varying concentrations (Gibson and Cooke 1959; Harvey, LeBouf, and Stefaniak 2010; Shirreffs and Maughan 1997).”
Incidence of cystic fibrosis in the Albanian population
Festini, F., Taccetti, G., Repetto, T., et al. (2008) · Pediatric Pulmonology · doi:10.1002/ppul.20920 · Cited by 8
Descubrimientos y técnicas que han contribuido a mejorar el tratamiento de las enfermedades pancreáticas
Navarro, S. (2014) · Gastroenterología y Hepatología · doi:10.1016/j.gastrohep.2014.11.005 · Cited by 8
Prática fisioterapêutica no tratamento da fibrose cística
Conto, C. L. D., Vieira, C., Fernandes, K. N., et al. (2014) · ABCS Health Sciences · doi:10.7322/abcshs.v39i2.629 · Cited by 8
Going the Extra Mile: Why Clinical Research in Cystic Fibrosis Must Include Children
Dobra, R., Bentley, S., Edmondson, C. L., Ovens, M., Saunders, C. J., Short, C., Wilson, G., Davies, J. C., & Bush, A. (2022) · Children · doi:10.3390/children9071080 · Cited by 8
“The high concentration of CFTR channels lining sweat ducts makes measuring sweat chloride a feasible way of assessing CFTR function [10], and the diagnostic hallmark of CF is raised sweat chloride due to the failure of CFTR-mediated chloride reabsorption.”
Background
Biochemical and genetic tools to predict the progression to Cystic Fibrosis in CRMS/CFSPID subjects: A systematic review
Terlizzi, V., Manti, S., D’Amico, F., et al. (2024) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2024.01.001 · Cited by 8
Pharmaceutical and medical applications of polymer electrolytes
Latham, R. J., Linford, R. G., & Schlindwein, W. S. (2003) · Ionics · doi:10.1007/bf02376535 · Cited by 8
Electrochemical molecular beacon DNA biosensor for the detection and discrimination of the DF508 cystic fibrosis mutation
Nasef, H. A., Beni, V., & O’Sullivan, C. K. (2011) · Journal of Electroanalytical Chemistry · doi:10.1016/j.jelechem.2011.09.001 · Cited by 8
Sweat Chloride Concentration
Gharib, R. (1965) · American journal of diseases of children · doi:10.1001/archpedi.1965.02090020068007 · Cited by 8
A novel device for quantitative measurement of chloride concentration by fluorescence indicator
Wang, J., Wu, X., Chon, C. H., et al. (2012) · Measurement Science and Technology · doi:10.1088/0957-0233/23/2/025701 · Cited by 8
Implementation of a Quality Improvement Program to Improve Sweat Test Performance in a Pediatric Hospital
Aqil, B., West, A., Dowlin, M. D., et al. (2014) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2013-0041-oa · Cited by 8
Developmental and Inherited Liver Disease
Quaglia, A., Roberts, E. A., & Torbenson, M. S. (2017) · Elsevier eBooks · doi:10.1016/b978-0-7020-6697-9.00003-0 · Cited by 14
Oral ibuprofen differentially affects plasma and sweat lipid mediator profiles in healthy adult males
Agrawal, K., Bosviel, R., Piccolo, B. D., & Newman, J. W. I. (2018) · Prostaglandins & Other Lipid Mediators · doi:10.1016/j.prostaglandins.2018.05.009 · Cited by 7
Sweat rate analysis of ivacaftor potentiation of CFTR in non-CF adults
Kim, J., Farahmand, M., Dunn, C. E., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-34308-8 · Cited by 8
LOCALIZED SCLERODERMA (MORPHOEA)
Serup, J. V. (1984) · The Journal of Dermatology · doi:10.1111/j.1346-8138.1984.tb01476.x · Cited by 8
Neurophysiologie und -Pathophysiologie der Schweißsekretion
Schliack, H., & Schiffter, R. (1979) · Springer eBooks · doi:10.1007/978-3-642-46393-8_5 · Cited by 8
Leukocyte alkaline phosphatase activity in the diagnosis of neonatal bacterial infections
Donato, H., Gebara, E., de Cosen, R. H., et al. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80833-1 · Cited by 8
HLA Frequencies in Patients with Cystic Fibrosis
Säfwenberg, J., Kollberg, H., & Lindblom, J. B. (1977) · Tissue Antigens · doi:10.1111/j.1399-0039.1977.tb00759.x · Cited by 8
El diagnóstico de la fibrosis quística en el adulto
Moreno, R. M. G., & Ancochea, J. (2000) · Archivos de Bronconeumología · doi:10.1016/s0300-2896(15)30225-8 · Cited by 8
Abnormal Sweat Chloride in Auto-immune Hypothyroidism
Squires, L. A., & Dolan, T. F. (1989) · Clinical Pediatrics · doi:10.1177/000992288902801110 · Cited by 8
Síndrome de discinesia ciliar primaria. Una patología frecuente
Barranco, M. J., Císcar, M. A., Peris, R. A., et al. (1994) · Archivos de Bronconeumología · doi:10.1016/s0300-2896(15)31145-5 · Cited by 8
Neonatal screening for cystic fibrosis using blood trypsin with complementary meconium lactase: an advisable strategy for the population of southern Europe
Pederzini, F., Cabrini, G., Faraguna, D., et al. (1995) · Screening · doi:10.1016/0925-6164(94)00021-y · Cited by 8
Electrolyte Excretion by Sweat Glands and Kidneys
May, C. D. (1965) · American journal of diseases of children · doi:10.1001/archpedi.1965.02090020004002 · Cited by 8
Problems Associated with Measuring Sweat Chloride Concentration with an Ion-Specific Electrode
Price, C. P., & Spencer, K. (1977) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456327701400138 · Cited by 8
“Stimulation techniques have included the intradermal injection of a cholinergic drug (Anderson and Freeman, 1958) and iontophoresis of pilocarpine (Gibson and Cooke, 1959).”
Method
Un test de la sueur normal n'exclut pas le diagnostic de mucoviscidose
Sermet‐Gaudelus, I., Bonnefont, J., Khoa, A. T. N., & Lenoir, G. (2000) · Archives de Pédiatrie · doi:10.1016/s0929-693x(00)80125-6 · Cited by 8

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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