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