Sweat glucose and GLUT2 expression in atopic dermatitis: Implication for clinical manifestation and treatment

Abstract

Sweat includes active components and metabolites, which are needed to maintain skin homeostasis. Component changes in sweat derived from atopic dermatitis (AD) have been reported. To investigate the influence of sweat components on the pathogenesis of AD, we performed a multifaceted assessment, including nuclear magnetic resonance spectroscopy-based metabolomic analysis, and linked these features to clinical features of AD. Distinctive properties of AD sweat are the quite-variation in protein, anti-microbial peptides and glucose concentrations. pH, sodium, and other salt levels in sweat of AD were comparable to that of healthy subjects. Sweat from AD patients with acute inflammation had a more prominent increase in glucose concentration than sweat from healthy individuals or those with AD with chronic inflammation. Topical glucose application delayed recovery of transepidermal water loss in barrier-disrupted mice. Furthermore, the glucose transporter GLUT2 was highly expressed in the lumen of sweat glands from AD patients. AD patients with chronic inflammation had significantly increased GLUT2 mRNA expression and near normal sweat glucose levels. Despite the small sample size in our study, we speculate that the increased glucose levels might be affected by AD severity and phenotype. We hope that this report will bring novel insight into the impact of sweat components on the clinical manifestation of AD.

Shaping the diversity of Th2 cell responses in epithelial tissues and its potential for allergy treatment

“…Obesity, which is a high‐risk factor for the development of the hyperglycemia‐associated metabolic syndrome, is associated with the rising prevalence of allergic diseases . Recently, varying concentrations of glucose have been found in the sweat of atopic dermatitis patients . Thus, glucose seems to be a variable microenvironmental tissue factor with a potential impact on Th2 immunity.…”

Why does sweat lead to the development of itch in atopic dermatitis?

“…Thus, the properties of sweat were compared between AD and healthy subjects who were induced to sweat in a sauna. Unexpectedly, findings revealed that the pH and salt concentration of sweat were equal or lower in AD than in healthy subjects . In sweat from subjects with AD, the concentration of LL‐37, an antimicrobial peptide, varied greatly among individuals .…”

“…Unexpectedly, findings revealed that the pH and salt concentration of sweat were equal or lower in AD than in healthy subjects . In sweat from subjects with AD, the concentration of LL‐37, an antimicrobial peptide, varied greatly among individuals . As LL‐37 is cytotoxic, it can be imagined that sweat with high sweat concentrations of LL‐37 may promote inflammation and cause itching in subjects with AD (Figure ).…”

“…Metabolomic analysis of sweat using nuclear magnetic resonance revealed some unique characteristics of sweat in AD . Specifically, glucose concentrations were high during the acute exacerbation phase of AD and were positively correlated with disease severity . Glucose moves from blood to sweat by osmotic pressure, but the mechanism of increased sweat glucose in AD remains obscure.…”

“…Sweat glucose levels increase according to the blood glucose levels. Boysen et al reported that glucose levels in sweat were 0.6‐1.2 mg/dL when A study using barrier disruption model mice revealed that topical glucose interferes with skin barrier recovery at concentrations similar to those in AD sweat . blood glucose increased to 200‐250 mg/dL .…”