“I think that we have identified a biomarker. We now might have the ability to diagnosis this, or at least have an inkling. Like other autoimmune disease, we can take a blood sample and detect if there are increased levels of autoantibodies present. According to our results, autoantibodies against this particular receptor should be present in about 90 percent of patients with POTS,”
Dr. William Gunning: professor of pathology in the UToledo College of Medicine and Life Sciences
New research from The University of Toledo College of Medicine and Life Sciences strongly suggests that postural orthostatic tachycardia syndrome (POTS) is an autoimmune disorder and this new breakthrough might help pave the way to new diagnostic tests and future treatments.
In addition to fainting, POTS patients also regularly suffer with a litany of symptoms, such as anxiety, pain, gastrointestinal issues, bleeding disorders, fatigue and brain fog (just to name a few).
Approximately 3 million Americans are believed to be affected, but as a result of its apparently unrelated and wide-ranging symptoms, POTS is difficult to recognize by health professionals.
Diagnosing POTS
When diagnosing POTS, the trouble is the fact that it is currently an illness with a lack of knowledge from your average physician and possibly a symptom of something larger. It’s based on background, the lack of illness as well as the finding of increase in heart rate when standing. There’s no blood test currently to aid in the diagnosis. It may be an incredibly frustrating process for patients.
Dr. Blair Grubb, Distinguished University Professor of Medicine and Pediatrics in the UToledo College of Medicine and Life Sciences and director of services at The University of Toledo Medical Center suggests:
“People have suspected an autoimmune connection for years, and other small-scale studies have suggested it,” said Grubb, one of the world’s foremost experts in syncope and disorders of the autonomic nervous system. “We did a much larger cross-section of patients than has ever been done before, and found that almost all of them tested positive for autoimmune antibodies. That’s a significant finding.”
In the biggest analysis of POTS patients to date, published Sept. 9 in the Journal of the American Heart Association, Grubb and UToledo study collaborators discovered 89 percent of patients they examined had elevated levels of autoantibodies from the adrenergic alpha 1 receptor.
Not one of the 55 patients who participated in the analysis had another autoimmune disorder. Fifty-two were female, with a mean age of 30.
Gunning and Grubb say more study is needed. However, this study adds that POTS is an autoimmune disorder — and it reveals it may be possible to provide a simple way to physicians with the condition.
“What this does is prove the concept,” Grubb said. “Other studies had used very expensive research tests. What we used are the same kind of testing methods that would be used by regular hospitals. We wanted to do something that would potentially be a test applicable to the general population, not just a research test.”
Even though Grubb and Gunning caution they’re still investigating the precise methods by which POTS is based, their study does raise the risk that immune modulating drugs could be a technique for a number of patients.
Source:
Journal reference:
GunningIII, W.T. et al. (2019) Postural Orthostatic Tachycardia Syndrome Is Associated With Elevated G‐Protein Coupled Receptor Autoantibodies. JAHA: Journal of the American Heart Association. doi.org/10.1161/JAHA.119.013602.
