Thoracoscopic Sympathectomy at the T2 or T3 Level Facilitates Bradykinin-Induced Protein Extravasation in Human Forearm Skin

Leis, Stefan; Meyer, Nicola; Bickel, Andreas; Schick, Christoph; Krüger, Sophie; Schmelz, Martin; Birklein, Frank

doi:10.1111/j.1526-4637.2010.00820.x

Cited by 9 publications

(4 citation statements)

References 35 publications

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“…This is due to the interruption of the sympathetic chain that induces the release of vasomotor control and hyperactive tone of the small arteries and arterioles, thus improving the circulation to the skin, the soft tissue and the bone of the peripheral extremities [6]. Also, the role of a bradykinin-induced inflammation after thoracic sympathectomy was investigated [8]. Patient satisfaction one year after surgery was excellent.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

et al. 2020

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Despite the development of vascular reconstruction techniques, thoracic sympathectomy still represents a valid therapeutic option for certain ischemic disorders. In selected patients for which direct revascularization is not feasible because of the very peripheral localization of vascular lesions, sympathectomy maximizes tissue preservation thus preventing or delaying major amputation and it permits optimal pain control. Also, thoracic sympathectomy can be safely performed with a minimally invasive technique, reducing operative time and morbidity. We report the case of a patient with peripheral ischemic disease of his right hand that was successfully treated by endoscopic thoracic sympathectomy. Surgery was safe and effective in controlling pain and maximizing tissue preservation, preventing major amputation.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

et al. 2020

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“…1d). Increases in skin flux (vasodilation) and dialyzate protein concentration (greater capillary permeability) have previously been identified during bradykinin administration in the skin [25, 26].…”

Section: Methodsmentioning

confidence: 99%

Role of Bradykinin Type 2 Receptors in Human Sweat Secretion: Translational Evidence Does Not Support a Functional Relationship

Wilson

Narra

Metzler-Wilson

et al. 2021

Skin Pharmacol Physiol

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Bradykinin increases skin blood flow via a cGMP mechanism but its role in sweating in vivo is unclear. There is a current need to translate cell culture and nonhuman paw pad studies into in vivo human preparations to test for therapeutic viability for disorders affecting sweat glands. Protocol 1: physiological sweating was induced in 10 healthy subjects via perfusing warm (46–48°C) water through a tube-lined suit while bradykinin type 2 receptor (B2R) antagonist (HOE-140; 40 μM) and only the vehicle (lactated Ringer’s) were perfused intradermally via microdialysis. Heat stress increased sweat rate (HOE-140 = +0.79 ± 0.12 and vehicle = +0.64 ± 0.10 mg/cm<sup>2</sup>/min), but no differences were noted with B2R antagonism. Protocol 2: pharmacological sweating was induced in 6 healthy subjects via intradermally perfusing pilocarpine (1.67 mg/mL) followed by the same B2R antagonist approach. Pilocarpine increased sweating (HOE-140 = +0.38 ± 0.16 and vehicle = +0.32 ± 0.12 mg/cm<sup>2</sup>/min); again no differences were observed with B2R antagonism. Last, 5 additional subjects were recruited for various control experiments which identified that a functional dose of HOE-140 was utilized and it was not sudorific during normothermic conditions. These data indicate B2R antagonists do not modulate physiologically or pharmacologically induced eccrine secretion volumes. Thus, B2R agonist/antagonist development as a potential therapeutic target for hypo- and hyperhidrosis appears unwarranted.

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“…Some patients with ischemia of the hand (thromboangiitis obliterans and distal arterial obstructions, ulcers in the fingers, or ischemic pain) may benefit from sympathectomy (16,17).…”

Section: Ischemia Of the Handmentioning

confidence: 99%

“…Almost the same experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral G3 sympathectomy in pediatric patients, published by Lage et al with the mean age of 14 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] years. All patients had previously tried at least one form of medical therapy with no success.…”

Section: Palmar Hyperhidrosismentioning

confidence: 99%

Upper extremity sympathectomy

Campos¹,

Kauffman²,

Faustino³

et al. 2018

J. Vis. Surg.

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Hyperhidrosis is a condition in which there is excessive production of sweat that is disproportional to thermoregulation needs and that profoundly hampers the quality of life (QOL) of the population that is affected by it. The disorder is typically limited to the palms, the plantar and craniofacial regions, armpits, and manifests itself in a symmetrical fashion in addition to being associated to family history. At present, sympathectomy is considered the golden standard treatment and there are a number of approaches a surgeon may elect to adopt in its care. The clinical treatment with oxybutynin also improves screening of the group of patients that will benefit the most with this indication. However, the efficacy of the surgical method, what most counts for a successful outcome is the occurrence or not of compensatory hyperhidrosis whose intensity may impact the results. All patients are and must be thoroughly informed of this possibility prior to surgery. For the others indications, is also one of the final approaches necessary for a fruitful treatment.

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Thoracoscopic Sympathectomy at the T2 or T3 Level Facilitates Bradykinin-Induced Protein Extravasation in Human Forearm Skin

Cited by 9 publications

References 35 publications

Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

Role of Bradykinin Type 2 Receptors in Human Sweat Secretion: Translational Evidence Does Not Support a Functional Relationship

Upper extremity sympathectomy

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