ArticleJournal of the American Heart Association2014
Autoimmune basis for postural tachycardia syndrome.
Article in Journal of the American Heart Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 140 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
140 citing papers in PubMed, 1 synthesis or guideline pooled it, 245 citations in OpenAlex.
- Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2018Pooled it
- Noninvasive Vagus Nerve Stimulation in Postural Tachycardia Syndrome: A Randomized Clinical Trial.JACC. Clinical electrophysiology · 2024Trial
- Serum neurofilament light chain as a severity marker for spinocerebellar ataxia.Scientific reports · 2021Trial
- Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients.Immunologic research · 2021Trial
- Splanchnic Venous Compression Enhances the Effects of ß-Blockade in the Treatment of Postural Tachycardia Syndrome.Journal of the American Heart Association · 2020Trial
- Efficacy of Propranolol, Bisoprolol, and Pyridostigmine for Postural Tachycardia Syndrome: a Randomized Clinical Trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Trial
- Trial
- Trial
- Are we treating the wrong POTS in RECOVER-AUTONOMIC? A call for phenotype subtyping.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Observational
- Tissue-specific autoantibody signatures reveal immune alterations undetected by routine serology in long COVID.GeroScience · 2026Article
- Postural Orthostatic Tachycardia Syndrome, Menopause and Hormone Replacement Therapy: Clinical Decisions in Times of Uncertainty.Journal of clinical medicine · 2026Review
- Analysis of adenylate cyclase activity in Japanese children with orthostatic dysregulation.PloS one · 2026Article
- Postural Orthostatic Tachycardia Syndrome, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID as Neuroimmune Disorders.ImmunoTargets and therapy · 2026Review
- Baroreflex sensitivity impairment in Long-COVID patients: a diagnostic tool for classifying the autonomic dysfunction spectrum.Frontiers in cardiovascular medicine · 2026Article
- Article
- Neuroimmune pathophysiology of long COVID.Psychiatry and clinical neurosciences · 2025Review
- Increased Diagnosis Rates and Clinical Characteristics of Pediatric Postural Orthostatic Tachycardia Syndrome During the Coronavirus Disease 2019 Pandemic.Anatolian journal of cardiology · 2025Article
- Functional Autoantibodies Targeting G-Protein-Coupled Receptors and Their Clinical Phenotype in Patients with Long-COVID.International journal of molecular sciences · 2025Article
- Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation.JACC. CardioOncology · 2025Article
80 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPatients with postural tachycardia syndrome (POTS) have exaggerated orthostatic tachycardia often following a viral illness, suggesting autoimmunity may play a pathophysiological role in POTS. We tested the hypothesis that they harbor functional autoantibodies to adrenergic receptors (AR). METHODS AND
resultsFourteen POTS patients (7 each from 2 institutions) and 10 healthy subjects were examined for α1AR autoantibody-mediated contractility using a perfused rat cremaster arteriole assay. A receptor-transfected cell-based assay was used to detect the presence of β1AR and β2AR autoantibodies. Data were normalized and expressed as a percentage of baseline. The sera of all 14 POTS patients demonstrated significant arteriolar contractile activity (69±3% compared to 91±1% of baseline for healthy controls, P<0.001) when coexisting β2AR dilative activity was blocked; and this was suppressed by α1AR blockade with prazosin. POTS sera acted as a partial α1AR antagonist significantly shifting phenylephrine contractility curves to the right. All POTS sera increased β1AR activation (130±3% of baseline, P<0.01) and a subset had increased β2AR activity versus healthy subjects. POTS sera shifted isoproterenol cAMP response curves to the left, consistent with enhanced β1AR and β2AR agonist activity. Autoantibody-positive POTS sera demonstrated specific binding to β1AR, β2AR, and α1AR in transfected cells.
conclusionsPOTS patients have elevated α1AR autoantibodies exerting a partial peripheral antagonist effect resulting in a compensatory sympathoneural activation of α1AR for vasoconstriction and concurrent βAR-mediated tachycardia. Coexisting β1AR and β2AR agonistic autoantibodies facilitate this tachycardia. These findings may explain the increased standing plasma norepinephrine and excessive tachycardia observed in many POTS patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.