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Solving the Medical Mystery of Cold Feet
Date:8/17/2012

e] set-point or something in the regulation mechanism goes wrong. Now we know for certain that two molecules called Epac and Rap1 play an important role in the process."

The study identified new players that influence adrenergic receptor function in small blood vessels, said senior study author Maqsood Chotani, a principal investigator at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio.

"The alpha-2C receptors had been identified many years ago, but the exact function of this alpha-2C subtype in blood vessels was very intriguing to me," Chotani said. "Early observations showed the alpha2C to be inside the cell and not on the cell surface like other receptors in the same family. The general belief [had been] that the receptor doesn't do anything in blood vessels -- it was like a vestigial, or like a silent receptor."

Not so, the study found.

"The alpha-2C receptor has a specialized role; in fact, we believe it is a stress-responsive receptor and in this case it's actually conserving body heat," he said. "So we know how the receptor is regulated in health. In disease -- like Raynaud's -- there could be a dysfunction, there could be overactivity of the new players we have identified in this study."

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases describes two levels of Raynaud's.

Primary Raynaud's, which usually starts between the ages of 15 and 25, is seen most often in women and people living in cold places. Preventive measures include keeping hands and feet warm and dry, avoiding air conditioning and wearing gloves to touch frozen or cold food.

Secondary Raynaud's starts later in life and is seen with connective tissue diseases like scleroderma, Sjorgen's syndrome and lupus, according to the NIAMS. Severe cases can lead to tissue death in the fingers and toes.

In secondary Raynaud's, Chotani said, "the underlying cause could be an immune response, and it coul
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