Abstract
Under normothermic, resting conditions, humans dissipate heat from the body at a rate
approximately equal to heat production. Small discrepancies between heat production
and heat elimination would, over time, lead to significant changes in heat storage
and body temperature. When heat production or environmental temperature is high the
challenge of maintaining heat balance is much greater. This matching of heat elimination
with heat production is a function of the skin circulation facilitating heat transport
to the body surface and sweating, enabling evaporative heat loss.
These processes are manifestations of the autonomic control of cutaneous vasomotor
and sudomotor functions and form the basis of this review. We focus on these systems
in the responses to hyperthermia. In particular, the cutaneous vascular responses
to heat stress and the current understanding of the neurovascular mechanisms involved.
The available research regarding cutaneous active vasodilation and vasoconstriction
is highlighted, with emphasis on active vasodilation as a major responder to heat
stress. Involvement of the vasoconstrictor and active vasodilator controls of the
skin circulation in the context of heat stress and nonthermoregulatory reflexes (blood
pressure, exercise) are also considered. Autonomic involvement in the cutaneous vascular
responses to direct heating and cooling of the skin are also discussed. We examine
the autonomic control of sweating, including cholinergic and noncholinergic mechanisms,
the local control of sweating, thermoregulatory and nonthermoregulatory reflex control
and the possible relationship between sudomotor and cutaneous vasodilator function.
Finally, we comment on the clinical relevance of these control schemes in conditions
of autonomic dysfunction.
Keywords
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Article info
Publication history
Published online: January 20, 2016
Accepted:
January 19,
2016
Received in revised form:
January 14,
2016
Received:
September 16,
2015
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© 2016 Elsevier B.V. All rights reserved.
