In search of novel therapeutics for osteoarthritis (OA), we detected an omega-6 fatty acid in synovial fluid of knee OA patients with a yet unknown function. In this study, we investigated the function of omega-6 fatty acid adrenic acid (AdA) in inflammation, in order to obtain first insight into its possible role in inflammatory OA.
What is postural orthostatic tachycardia syndrome (POTS)?
Postural orthostatic tachycardia syndrome (POTS) is a condition that affects circulation (blood flow). It involves the autonomic nervous system (which automatically controls and regulates vital bodily functions) and sympathetic nervous system (which activates the fight or flight response).
POTS is a form of orthostatic intolerance, the development of symptoms that come on when standing up from a reclining position, and that may be relieved by sitting or lying back down. The primary symptom of an orthostatic intolerance is lightheadedness, fainting, and an uncomfortable, rapid increase in heartbeat.
Heart rate and blood pressure work together to keep the blood flowing at a healthy pace, no matter what position the body is in. People with POTS cannot coordinate the balancing act of blood vessel squeeze and heart rate response. This means the blood pressure cannot be kept steady and stable.
Each case of POTS is different. POTS patients may see symptoms come and go over a period of years. In most cases, with proper adjustments in diet, medications and physical activity, a person with POTS will see an improvement in quality of life. Also, if an underlying cause is found and is treated, POTS symptoms may subside.
There are various forms of POTS. The most common are:
- Neuropathic POTS: Peripheral denervation (loss of nerve supply) leads to poor blood vessel muscles, especially in the legs and core body.
- Hyperadrenergic POTS: Overactivity of the sympathetic nervous system
- Low blood volume POTS: Reduced blood volume can lead to POTS. Low blood volume can cause similar symptoms that may overlap in neuropathic and hyperadrenergic POTS
Who is at risk for POTS?
The majority of POTS patients are women ages 13-50 years old. About 450,000 people suffer from POTS in the United States.
- Patients may develop POTS after a viral illness, serious infections, medical illness, pregnancy, and trauma such as head injury. The condition may develop as aftermath of a significant illness (especially associated with hospitalization and prolonged immobilization).
- POTS may develop in those who have had a recent history of mononucleosis.
- People with certain autoimmune conditions such as Sjogren’s syndrome and celiac disease can be at higher risk. Sjogren’s can be evaluated by blood testing, dry eye test, lip biopsy, and rheumatology consult. Celiac disease can be tested through blood work, gastroenterology consult, and if needed biopsies of the small intestines
What are the symptoms of postural orthostatic tachycardia syndrome (POTS)?
POTS symptoms can be uncomfortable and frightening experiences. Patients with POTS usually suffer from two or more of the many symptoms listed below. Not all patients with POTS will have all these symptoms.
- High/low blood pressure
- High/low heart rate; racing heart rate
- Chest pain
- Dizziness/lightheadedness especially in standing up, prolonged standing in one position, or long walks
- Fainting or near-fainting
- Exhaustion/fatigue
- Abdominal pain and bloating, nausea
- Temperature deregulation (hot or cold)
- Nervous, jittery feeling
- Forgetfulness and trouble focusing (brain fog)
- Blurred vision
- Headaches and body pain/aches (may feel flu-like); neck pain
- Insomnia and frequent awakenings from sleep, chest pain and racing heart rate during sleep, excessive sweating
- Shakiness/tremors especially with adrenaline surges
- Discoloration of feet and hands
- Exercise intolerance
- Excessive or lack of sweating
- Diarrhea and/or constipation
Except where otherwise noted, data are given for materials in their (at 25 °C 77 °F, 100 kPa).N ( Y N?)Docosatetraenoic acid designates any straight chain 22:4. ( See for nomenclature.)One isomer is of particular interest:.
all- cis-7,10,13,16-docosatetraenoic acid is an with the adrenic acid (AdA). This is a naturally occurring formed through a 2-carbon chain elongation of. It is one of the most abundant fatty acids in the early human brain. This unsaturated fatty acid is also metabolized by cells to biologically active products viz., dihomoprostaglandins, dihomo-epoxyeicosatrienoic acids, and dihomo.See also.References. Martinez M (1992).
'Tissue levels of polyunsaturated fatty acids during early human development'. 120 (4 Pt 2): S129–38.
Campbell WB, Falck JR, Okita JR, Johnson AR, Callahan KS (1985). 'Synthesis of dihomoprostaglandins from adrenic acid (7,10,13,16-docosatetraenoic acid) by human endothelial cells'. 837 (1): 67–76. Kopf PG, Zhang DX, Gauthier KM, Nithipatikom K, Yi XY, Falck JR, Campbell WB (2010). 55 (2): 547–54. Yi XY, Gauthier KM, Cui L, Nithipatikom K, Falck JR, Campbell WB (May 2007). 'Metabolism of adrenic acid to vasodilatory 1alpha,1beta-dihomo-epoxyeicosatrienoic acids by bovine coronary arteries'.
Am J Physiol Heart Circ Physiol. 292 (5): H2265–74.Further reading. Ferretti, A., Flanagan, V.P. Mass spectrometric evidence for the conversion of exogenous adrenate to dihomo-prostaglandins by seminal vesicle cyclo-oxygenase. A comparative study of two animal species. J Chromatogr 383 241-250 (1986). Sprecher, H., VanRollins, M., Sun, F., et al.
Dihomo-prostaglandins and -thromboxane. A prostaglandin family from adrenic acid that may be preferentially synthesized in the kidney. J Biol Chem 257 3912-3918 (1982).