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Postural orthostatic tachycardia syndrome
(section)
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== Potential mechanisms == Autoimmunity is thought to play a role in many cases of POTS: adrenergic<ref>{{Cite journal | last = Kem | first = David C. | last2 = Melander | first2 = Olle | last3 = Sutton | first3 = Richard | last4 = Scofield | first4 = Robert Hal | last5 = Quadri | first5 = Syed M.S. | last6 = Murphy | first6 = Taylor A. | last7 = Liles | first7 = Campbell | last8 = Harris | first8 = Valerie M. | last9 = Koelsch | first9 = Kristi A. | date = 2017-07-01 | title = Antiadrenergic autoimmunity in postural tachycardia syndrome|url=https://academic.oup.com/europace/article/19/7/1211/2952372|journal=EP Europace|language=en|volume=19|issue=7|pages=1211–1219|doi=10.1093/europace/euw154|issn=1099-5129}}</ref>, muscarinic<ref>{{Cite journal | last = Yu | first = Xichun | last2 = Stavrakis | first2 = Stavros | last3 = Hill | first3 = Michael A. | last4 = Huang | first4 = Shijun | last5 = Reim | first5 = Sean | last6 = Li | first6 = Hongliang | last7 = Khan | first7 = Muneer | last8 = Hamlett | first8 = Sean | last9 = Cunningham | first9 = Madeleine W. | date = 2012-01-01 | title = Autoantibody activation of beta-adrenergic and muscarinic receptors contributes to an “autoimmune” orthostatic hypotension|url=http://www.sciencedirect.com/science/article/pii/S1933171111002452|journal=Journal of the American Society of Hypertension|volume=6|issue=1 | pages = 40–47|doi=10.1016/j.jash.2011.10.003|issn=1933-1711}}</ref> and other autoantibodies<ref>{{Cite journal | last = Thieben | first = Mark J. | last2 = Sandroni | first2 = Paola | last3 = Sletten | first3 = David M. | last4 = Benrud-Larson | first4 = Lisa M. | last5 = Fealey | first5 = Robert D. | last6 = Vernino | first6 = Steven | last7 = Low | first7 = Phillip A. | last8 = Lennon | first8 = Vanda A. | last9 = Shen | first9 = Win-Kuang | date = 2007-03-01 | title = Postural Orthostatic Tachycardia Syndrome: The Mayo Clinic Experience|url=http://www.sciencedirect.com/science/article/pii/S0025619611610276|journal=Mayo Clinic Proceedings|volume=82|issue=3|pages=308–313|doi=10.4065/82.3.308|issn=0025-6196}}</ref><ref>{{Cite journal | last = Li Hongliang | last2 = Yu Xichun | last3 = Liles Campbell | last4 = Khan Muneer | last5 = Vanderlinde‐Wood Megan | last6 = Galloway Allison | last7 = Zillner Caitlin | last8 = Benbrook Alexandria | last9 = Reim Sean | title = Autoimmune Basis for Postural Tachycardia Syndrome|url=https://www.ahajournals.org/doi/full/10.1161/JAHA.113.000755|journal=Journal of the American Heart Association|volume=3|issue=1| pages = e000755|doi=10.1161/JAHA.113.000755|pmc = 3959717|pmid=24572257}}</ref><ref>{{Cite journal | last = Lennon | first = Vanda | last2 = Low | first2 = Phillip | last3 = Klein | first3 = Christopher | last4 = Singer | first4 = Wolfgang | date = 2015-04-06 | title = Autoantibodies in the Postural Tachycardia Syndrome (P1.272)|url=https://n.neurology.org/content/84/14_Supplement/P1.272|journal=Neurology|language=en|volume=84|issue=14 Supplement|pages=P1.272|issn=0028-3878}}</ref> have been found. A small study of POTS in children found that 24.39% of patients had [[acetylcholine]] receptor autoantibodies.<ref>{{Cite journal | last = Li | first = Jiawei | last2 = Zhang | first2 = Qingyou | last3 = Liao | first3 = Ying | last4 = Zhang | first4 = Chunyu | last5 = Hao | first5 = Hongjun | last6 = Du | first6 = Junbao | date = 2014-08-03 | title = The Value of Acetylcholine Receptor Antibody in Children with Postural Tachycardia Syndrome|url=https://link.springer.com/article/10.1007/s00246-014-0981-8|journal=Pediatric Cardiology|language=en|volume=36|issue=1|pages=165–170|doi=10.1007/s00246-014-0981-8|issn=0172-0643}}</ref>A small study of adult patients found elevated α1, β1 and β2 adrenergic receptor autoantibodies.<ref>{{Cite journal | last = Li | first = Hongliang | last2 = Yu | first2 = Xichun | last3 = Liles | first3 = Campbell | last4 = Khan | first4 = Muneer | last5 = Vanderlinde‐Wood | first5 = Megan | last6 = Galloway | first6 = Allison | last7 = Zillner | first7 = Caitlin | last8 = Benbrook | first8 = Alexandria | last9 = Reim | first9 = Sean | date = 2014-01-27 | title = Autoimmune Basis for Postural Tachycardia Syndrome|url=https://www.ahajournals.org/doi/abs/10.1161/JAHA.113.000755|journal=Journal of the American Heart Association|language=EN|volume=3|issue=1|doi=10.1161/jaha.113.000755|issn=2047-9980|pmc=3959717|pmid=24572257}}</ref> Lax vasculature has been though to play a role in the development of POTS in people with Ehlers-Danlos Syndrome, a connective tissue disorder.<ref>{{Cite journal | last = Hakim | first = Alan | last2 = O'Callaghan | first2 = Chris | last3 = Wandele | first3 = Inge De | last4 = Stiles | first4 = Lauren | last5 = Pocinki | first5 = Alan | last6 = Rowe | first6 = Peter | date = 2017 | title=Cardiovascular autonomic dysfunction in Ehlers–Danlos syndrome—Hypermobile type|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.c.31543|journal=American Journal of Medical Genetics Part C: Seminars in Medical Genetics|language=en|volume=175|issue=1|pages=168–174|doi=10.1002/ajmg.c.31543|issn=1552-4876}}</ref>
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