Autoimmunity in Syndromes of Orthostatic Intolerance: An Updated Review.

This review article discusses the emerging evidence linking autoimmunity to syndromes of orthostatic intolerance, specifically focusing on postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (OH). The authors explore various pathogenic mechanisms, including the role of adrenergic, cholinergic, and angiotensin II type I autoantibodies in these conditions. It is suggested that autoimmune processes may contribute to the development of orthostatic intolerance via multiple pathways such as peripheral neuropathy and altered blood volume regulation. The review cites studies where immunomodulation therapies have shown positive outcomes in treating autonomic symptoms in patients with POTS and OH, indicating a potential therapeutic avenue worth further exploration.