title: Expression of acetylcholine and its receptor in human sympathetic ganglia in primary hyperhidrosis.
abstract: BACKGROUND
  The pathophysiologic characteristics of primary hyperhidrosis are not well understood and seem to be related to a sympathetic nervous system dysfunction. The resection of thoracic sympathetic chain ganglia is the most effective treatment for hyperhidrosis; however sympathetic ganglia function in normal individuals and in patients with hyperhidrosis is unknown.
  
  
  METHODS
  A cross-sectional study, in which 2 groups of 20 subjects were analyzed: the hyperhidrosis group (HYP), comprised of patients with hyperhidrosis who were eligible for thoracic sympathectomy, and the control group (CON) comprised of brain-dead organ donors without a history of hyperhidrosis. For each subject, the following were performed: resection of the third left sympathetic ganglion, measurement of the ganglion's diameter, and immunohistochemical evaluation by quantification of strong and weak expression areas of primary antibodies against acetylcholine and alpha-7 neuronal nicotinic receptor subunit.
  
  
  RESULTS
  The presence of a strong alpha-7 subunit expression area was 4.85% in patients with primary hyperhidrosis and 2.34% in controls (p < 0.001), whereas the presence of a weak expression area was 11.48% in the HYP group and 4.59% in the CON group (p < 0.001). Strong acetylcholine expression was found in 4.95% of the total area in the HYP group and in 1.19% in the CON group (p < 0.001), whereas weak expression was found in 18.55% and 6.77% of the HYP and CON groups, respectively (p < 0.001). Furthermore, diameter of the ganglia was 0.71 cm in the HYP group and 0.53 cm in the CON group (p < 0.001).
  
  
  CONCLUSIONS
  There is a higher expression of acetylcholine and alpha-7 neuronal nicotinic receptor subunit in the sympathetic ganglia of patients with hyperhidrosis. Furthermore, the diameter of the thoracic sympathetic chain ganglia is larger in such patients.
authors.affiliation: Division of Thoracic Surgery, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. nabor@usp.br
authors.forename: Nabor B
authors.initials: NB
authors.lastname: de Moura Júnior
authors.forename: João C
authors.initials: JC
authors.lastname: das-Neves-Pereira
authors.forename: Flávio R G
authors.initials: FR
authors.lastname: de Oliveira
authors.forename: Fabio B
authors.initials: FB
authors.lastname: Jatene
authors.forename: Edwin R
authors.initials: ER
authors.lastname: Parra
authors.forename: Vera L
authors.initials: VL
authors.lastname: Capelozzi
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: José R M
authors.initials: JR
authors.lastname: de Campos
mesh_terms: D000109:Acetylcholine / Q000096:biosynthesis*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005728:Ganglia, Sympathetic / Q000378:metabolism*; D006801:Humans; D006945:Hyperhidrosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011950:Receptors, Cholinergic / Q000096:biosynthesis*; D055815:Young Adult
chemical_list: D011950:Receptors, Cholinergic; D000109:Acetylcholine