Detection of G protein-coupled receptor autoantibodies in postural orthostatic tachycardia syndrome using standard methodology
Open accessAbstract
Background: Postural orthostatic tachycardia syndrome (POTS) is a disorder of orthostatic intolerance that primarily affects women of childbearing age. The underlying pathophysiology of POTS is not fully understood, but it has been suggested that autoimmunity may play a role. The aim of this study was to compare concentrations of autoantibodies to cardiovascular G protein–coupled receptors between patients with POTS and healthy controls. Methods: Sera were collected from 116 patients with POTS (91% female; medium age, 29 years) and 81 healthy controls (84% female; medium age, 27 years) from Calgary, Canada, and Malmö, Sweden. Samples were evaluated for autoantibodies to 11 receptors (adrenergic, muscarinic, angiotensin II, and endothelin) using a commercially available enzyme-linked immunosorbent assay. Results: Autoantibody concentrations against all of the receptors tested were not significantly different between controls and patients with POTS. The majority of patients with POTS (98.3%) and all controls (100%) had α1 adrenergic receptor autoantibody concentrations above the seropositive threshold provided by the manufacturer (7 units/mL). The proportion of patients with POTS versus healthy controls who fell above the diagnostic thresholds was not different for any tested autoantibodies. Receiver operating characteristic curves showed a poor ability to discriminate between patients with POTS and controls. Conclusions: Patients with POTS and healthy controls do not differ in their enzyme-linked immunosorbent assay–derived autoantibody concentrations to cardiovascular G protein–coupled receptors. These findings suggest that these tests are not useful for establishing the role of autoimmunity in POTS.
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From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Hall et al., 2022
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Knoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21 · see citing works
- Authors
- Hall, J., Bourne, K. M., Vernino, S., Hamrefors, V., Kharraziha, I., Nilsson, J., Sheldon, R. S., Fedorowski, A., & Raj, S. R.
- Affiliations
- University of Calgary (CA)
- The University of Texas Southwestern Medical Center (US)
- Skåne University Hospital (SE)
- Lund University (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Raj, Satish R.
- ORCID
- Venue
- Circulation
- Published
- 2022-08-23
- Volume
- 146
- Issue
- 8
- Pages
- 613-622
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC9390234
- OpenAlex
- W4283732853
- Cited by
- 35
- References
- 7
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 13 · 2022: 3
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Circulation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000445)
- Canadian Institutes of Health Research (42426_1)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Autoimmune Neurological Disorders and Treatments
- Keywords
- postural orthostatic tachycardia syndrome, autoantibodies, G protein-coupled receptors, autoimmunity, alpha1-adrenoceptors, muscarinic receptors, angiotensin II receptor, endothelin receptors, orthostatic intolerance, diagnostic biomarkers, enzyme-linked immunosorbent assay
- MeSH terms
- Adult, Autoantibodies, Female, Heart Rate, Humans, Male, Autoimmunity, Receptors, G-Protein-Coupled, Orthostatic Intolerance, Postural Orthostatic Tachycardia Syndrome
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