If POTS does turn out to be caused by autoantibodies would that mean in theory that b cell depletion ( via RTX) could work for POTS ?
Yes, but within reason and within context.
POTS patients range from conditions such as Diabetes to Lyme disease. Generally, Diabetes doesn't render you bedridden unable to move (unless you're in a flare up). Lyme disease and ME in severe cases, does. So we have to think what 'POTS' means to different 'POTS' patients and how ill they are to begin with (their base line health level) when dreaming of an effective treatment.
Naturally someone 'just' with Diabetes who has their autonomic problems helped considerably with b cell depletion may be helped very significantly indeed. Conversely someone crippled with Lyme disease or ME, who has a prolonged disease state with multiple other bad effects of their body, not so much.
Here is why:
Examples of damage found in ME CFS EDS (Many who have POTS), other than 'just' immune mediated autonomic dysfunction:
Asthma.
Allergies including hyper drug sensitivity (makes taking medications very hard).
Accelerated ageing (oxidative stress damage) and brain shrinkage.
Atherosclerotic plaques in arteries that increase risk of premature death.
Osteoporosis.
Cancer.
Destructive arthritis.
Eczema.
Heart Failure and venous insufficiency.
Immune suppression (Dreadful NK function, RN-aseL gene defect - no defence against viruses).
Pituitary disease/hormonal deficiencies, pituitary cysts/adenomas, adult growth hormone deficiency.
Lax, floppy skin and risk of internal rupture from collagen defects (EDS)
So with POTS, as with 'ME' and 'CFS', it would seem likely that
the less severely ill you are, and (in my view)
+ the less time you have been ill, would all lead to more favourable outcome from trying b cell depletion (if you're proven to be a 'responder' by using a biomarker before the therapy).
I'd love to be proven wrong, but as someone with a lot more than just my POTS diagnosis, I need to be realistic. This doesn't mean other younger people couldn't be made completely better, so it is positive news, someone is trying to find out the cause of POTS.
Whilst we're wating years for more autoimmune research, the next step would be for the CDC and British to make a TILT table test (to diagnose POTS) mandatory for all new diagnosese of ME CFS. Currently they still refuse, as then ME CFS are demonstrated (not proposed) as neurological if many with ME CFS are then diagnosed as having POTS.
This doesn't fit in with the CBT GE ruse of 'beliefs' perpetuating ME CFS, when it is autoimmunity and lack of drug therapy.