Thank you for posting these links @kangaSue
and I copied a few quotes from the first link below:
Grubb, who has been treating POTS patients and studying the condition for more than three decades, now believes he and his collaborators are increasingly close to proving a long-held theory that POTS is an autoimmune disorder.
I absolutely believe that POTS will ultimately prove to be an autoimmune disorder. This new research is so exciting to me!
In a retrospective study of 34 POTS patients, Gunning, Grubb and a team of UToledo scientists documented a significant elevation of five inflammatory markers characteristic of an innate immune condition.
"This is a tremendous step forward," Grubb said. "Not only does this work give additional credence to the existence of POTS, we have an idea of pathophysiology and would potentially have a very simple diagnostic test. We don't yet have that with POTS, but these studies suggest we are getting close."
It will be amazing when there is one simple diagnostic test (since it is not realistic, or even safe, for all patients to have a tilt table test). Not to mention so many locations in which there is no physical access to a TTT or insurance will not cover it.
The inflammatory markers identified in the research -- a mixture of specific cytokines and chemokines -- are similar to those seen in patients with other autoimmune disorders, including psoriasis, multiple sclerosis and rheumatoid arthritis.
I wish that the article had specifically listed all of the cytokines, chemokines & autoantibodies that they found in the POTS patients in their study. I belong to a private group for people like me w/the N-type Calcium Channel Autoantibody. It is a fairly rare autoantibody and many Neuros are not familiar with it. But almost every single person in the group also has POTS (either actively or in remission).
The paper, published in the journal Clinical Medicine, builds on years of research led by Gunning and Grubb. In 2019, the duo published what was at the time the largest study of POTS patients to date, finding 89% of patients had elevated levels of autoantibodies against the adrenergic alpha 1 receptor.
I tested positive for that autoantibody with Cell Trend (among many others auto-abs) and have no doubt that the anti adrenergic & muscarinic autoantibodies are correlated with POTS.
Grubb and Gunning also have hypothesized that POTS may be initiated by a viral infection.
It was in my case. I know the exact date of my first POTS episode following a virus.
Currently physicians are only able to treat the symptoms of POTS. If POTS is confirmed as an autoimmune disorder, knowing the specific inflammatory markers that are engaged could help to direct treatments for the underlying condition itself.
This was the most exciting part of the article to me and it was treatments for autoimmunity (IVIG & Rituximab) that led to my POTS going into remission. I definitely had some symptomatic relief from beta blocker (and I tried endless POTS meds over the course of several years) but it was the immune treatments that led to remission.
"The pace of POTS research has accelerated exponentially. Part of that is having new technology that allows us to do this research, but it's also a function of the collaboration we have at this institution," he said. "We have been on the forefront of new innovations and research in the POTS field, and we are making real progress."
I also think there is going to be significant future research on POTS in light of it now also being a major symptom in Long COVID patients.