Science of Hyperhidrosis

  • Sympathetic innervation of the sweat glands is “unique”
    • Sweat glands are expressed throughout the body and are innervated only through the sympathetic “cholinergic” system
  • Nicotinic receptors, α3β4, play a central role in sympathetic innervation of the sweat glands
    • Fast activation of acetylcholine (ACh) from fibers
    • Postganglionic ACh targets on the sweat glands through the nicotinic α3β4 and muscarinic receptors M3 and M4
  • Potency increases as sympathetic nerve firing increases in frequency (10-fold increase in sympathetic nerve firings in primary hyperhidrosis versus healthy individuals)
  • AT-5214 inhibits the overactive sympathetic system without inhibiting the parasympathetic system or causing common side-effects such as, dry mouth, blurred vision, and constipation