Abstract：
Postural orthostatic tachycardia syndrome (POTS) is characterized by exaggerated orthostatic tachycardia in the absence of orthostatic hypotension. The pathophysiology of POTS may involve hypovolemia, autonomic neuropathy, a hyperadrenergic state, and cardiovascular deconditioning, any of which can co-occur in the same patient. Furthermore, there is growing evidence of the role of autoimmunity in a subset of POTS cases. In recent years, investigators have described an increased rate of autoimmune comorbidities as evidenced by the finding of several types of neural receptor autoantibody and non-specific autoimmune marker in patients with POTS. In particular, the association of the disease with several types of anti-G protein-coupled receptor (GPCR) antibodies and POTS has frequently been noted. A previous study reported that autoantibodies to muscarinic AChRs may play an important role in POTS with persistent, gastrointestinal symptoms. To date, POTS is recognized as one of the sequelae of coronavirus disease 2019 (COVID-19) and its frequency and pathogenesis are still largely unknown. Multiple autoantibody types occur in COVID-related, autonomic disorders, suggesting the presence of autoimmune pathology in these disorders. Herein, we review the association of anti-GPCR autoantibodies with disorders of the autonomic nervous system, in particular POTS, and provide a new perspective for understanding POTS-related autoimmunity.
摘要：
体位性心动过速综合征（POTS）的特征是在没有体位性低血压的情况下，体位性心动过速加剧。POTS的病理生理学可能涉及低血容量，自主神经病变,高肾上腺素能状态,和心血管疾病，其中任何一种都可以在同一患者中共同发生。此外，越来越多的证据表明自身免疫在一部分POTS病例中的作用.近年来,研究者已经描述了自身免疫合并症的发生率增加,这在POTS患者中发现了几种类型的神经受体自身抗体和非特异性自身免疫标志物就证明了这一点.特别是,人们经常注意到该疾病与几种类型的抗G蛋白偶联受体(GPCR)抗体和POTS相关.先前的研究报道，毒蕈碱AChRs的自身抗体可能在POTS中发挥重要作用，胃肠道症状。迄今为止,POTS被认为是2019年冠状病毒病(COVID-19)的后遗症之一，其频率和发病机制在很大程度上仍不清楚。多种自身抗体类型出现在与COVID相关的人群中，自主神经紊乱,提示在这些疾病中存在自身免疫病理学。在这里，我们回顾了抗GPCR自身抗体与自主神经系统疾病的关系，特别是锅，为理解POTS相关自身免疫提供了新的视角。
