Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID

Kell, Douglas B.; Khan, Muhammed Asad; Kane, Binita; Lip, Gregory Y. H.; Pretorius, Etheresia

doi:10.3390/jpm14020170

Open AccessOpinion

Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID

by

Douglas B. Kell

^1,2,3,*

,

Muhammed Asad Khan

⁴

,

Binita Kane

^1,5,

Gregory Y. H. Lip

^6,7

and

Etheresia Pretorius

^1,3,*

¹

Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Crown St, Liverpool L69 7ZB, UK

²

The Novo Nordisk Foundation Centre for Biosustainability, Building 220, Chemitorvet 200, Technical University of Denmark, 2800 Kongens Lyngby, Denmark

³

Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch Private Bag X1, Matieland 7602, South Africa

⁴

Directorate of Respiratory Medicine, Manchester University Hospitals, Wythenshawe Hospital, Manchester M23 9LT, UK

⁵

Manchester University Foundation Trust and School of Biological Sciences, University of Manchester, Manchester M13 9PL, UK

⁶

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK

⁷

Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark

^*

Authors to whom correspondence should be addressed.

J. Pers. Med. 2024, 14(2), 170; https://doi.org/10.3390/jpm14020170

Submission received: 11 December 2023 / Revised: 16 January 2024 / Accepted: 27 January 2024 / Published: 31 January 2024

(This article belongs to the Special Issue New Challenges and Perspectives in Neurology and Autonomic Disorders)

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Abstract

Postural orthostatic tachycardia syndrome (POTS) is a common accompaniment of a variety of chronic, inflammatory diseases, including long COVID, as are small, insoluble, ‘fibrinaloid’ microclots. We here develop the argument, with accompanying evidence, that fibrinaloid microclots, through their ability to block the flow of blood through microcapillaries and thus cause tissue hypoxia, are not simply correlated with but in fact, by preceding it, may be a chief intermediary cause of POTS, in which tachycardia is simply the body’s exaggerated ‘physiological’ response to hypoxia. Similar reasoning accounts for the symptoms bundled under the term ‘fatigue’. Amyloids are known to be membrane disruptors, and when their targets are nerve membranes, this can explain neurotoxicity and hence the autonomic nervous system dysfunction that contributes to POTS. Taken together as a system view, we indicate that fibrinaloid microclots can serve to link POTS and fatigue in long COVID in a manner that is at once both mechanistic and explanatory. This has clear implications for the treatment of such diseases.

Keywords: fibrinaloid microclots; postural orthostatic tachycardia syndrome (POTS); Long COVID; TeamClots

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MDPI and ACS Style

Kell, D.B.; Khan, M.A.; Kane, B.; Lip, G.Y.H.; Pretorius, E. Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID. J. Pers. Med. 2024, 14, 170. https://doi.org/10.3390/jpm14020170

AMA Style

Kell DB, Khan MA, Kane B, Lip GYH, Pretorius E. Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID. Journal of Personalized Medicine. 2024; 14(2):170. https://doi.org/10.3390/jpm14020170

Chicago/Turabian Style

Kell, Douglas B., Muhammed Asad Khan, Binita Kane, Gregory Y. H. Lip, and Etheresia Pretorius. 2024. "Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID" Journal of Personalized Medicine 14, no. 2: 170. https://doi.org/10.3390/jpm14020170

APA Style

Kell, D. B., Khan, M. A., Kane, B., Lip, G. Y. H., & Pretorius, E. (2024). Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID. Journal of Personalized Medicine, 14(2), 170. https://doi.org/10.3390/jpm14020170

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Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID

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