Discover and read the best of Twitter Threads about #DysConf2022
Most recents (5)
🧵 An absolutely fascinating talk by William Gunning @Dysautonomia conf - Innate Immune system Activation in PoTS. A complex topic made easy to understand by a Prof in pathology & it makes a lot of sense to me, it’s like seeing another puzzle piece! Here’s some interesting
2/points:
Platelets are very important in innate immunity & homeostasis (still being debated)
Platelets have over 400 biochemicals!
Serotonin is produced in the gut & pooled in platelets for delivery around the body (outside of CNS 99% of serotonin is in the platelets)
Platelets are very important in innate immunity & homeostasis (still being debated)
Platelets have over 400 biochemicals!
Serotonin is produced in the gut & pooled in platelets for delivery around the body (outside of CNS 99% of serotonin is in the platelets)
3/Symptoms of low seratonin are commonly seen in PoTS
Platelets secrete a number of pro-inflammatory cytokines & chemokines
All cells secrete chemicals that recruit inflammatory cell response
Dr Gunning has done some studies:
- one showed significant ⬇️ in dense granule number
Platelets secrete a number of pro-inflammatory cytokines & chemokines
All cells secrete chemicals that recruit inflammatory cell response
Dr Gunning has done some studies:
- one showed significant ⬇️ in dense granule number
🧵 Great talk with @BendyBrain at the @Dysautonomia conf. Dr Eccles shared some information from their mechanisms of chronic pain & fatigue programme with people with ME/CFS, Fibro & EDS.
2/In their studies they have found hypermobility factors correlated with pain, fatigue & cognition. Baseline inflammatory markers were raised compared to controls & though not abnormal they were relevant - autonomic induced fatigue was mediated by levels of inflammation that
3/would not meet diagnostic thresholds, autonomic induced pain was explained by differences in connective tissue.
When we know more about biological mechanisms we can tailor treatment better.
Further research is needed to look at mechanisms of pain & fatigue incorporating
When we know more about biological mechanisms we can tailor treatment better.
Further research is needed to look at mechanisms of pain & fatigue incorporating
🧵 Long covid & autonomic dysfunction with Dr Mitchell Miglis & Charlie (has lived long covid experience) @Dysautonomia conf #DysConf2022
PoTS is the most common autonomic dysfunction associated with long covid
67% of the people surveyed in the US had a compass-31 score
PoTS is the most common autonomic dysfunction associated with long covid
67% of the people surveyed in the US had a compass-31 score
2/ suggestive of moderate to severe autonomic dysfunction with no difference between those hospitalised & those not
SFN is common in long covid
Potential mechanisms include: tissue injury, immune mediated, micrclotting, viral persistence, MCAS, baroreflex impairment,
SFN is common in long covid
Potential mechanisms include: tissue injury, immune mediated, micrclotting, viral persistence, MCAS, baroreflex impairment,
3/ deconditioning (does not cause it, deconditioning is secondary consequence), gender physiology.
Lots of Brian fog theories inc: neuroinflammation, cerebral hypoperfusion, tissue damage, product of systemic disease
Autoantibodies mentioned - higher prevelanve in PoTS, not
Lots of Brian fog theories inc: neuroinflammation, cerebral hypoperfusion, tissue damage, product of systemic disease
Autoantibodies mentioned - higher prevelanve in PoTS, not
🧵 Neurovascular dysregulation during exercise in ME/CFS & long covid with David Systrom @Dysautonomia conf. Some key points:
Preload failure contributes to exercise intolerance
Inability to take up oxygen in periphery tends to be either left to right shunting or #DysConf2022
Preload failure contributes to exercise intolerance
Inability to take up oxygen in periphery tends to be either left to right shunting or #DysConf2022
2/dysfunction
- Left to right shunting in periphery in some people with ME/CFS
- Some with have ME/CFS also have small fibre neuropathy
- Poor systemic O2 extraction may also be related to mitochondrial dysfunction in skeletal muscle in ME/CFS
Hyperventilation is common in
- Left to right shunting in periphery in some people with ME/CFS
- Some with have ME/CFS also have small fibre neuropathy
- Poor systemic O2 extraction may also be related to mitochondrial dysfunction in skeletal muscle in ME/CFS
Hyperventilation is common in
3/ME/CFS & long covid
- Study is underway looking at mitochondrial dysfunction in ME/CFS
- On tilt test cerebral blood flow was shown to go down in both people with ME/CFS & PoTS, with PoTS found that the vasoconstriction is related to hypercapnia in upright tilt
- Study is underway looking at mitochondrial dysfunction in ME/CFS
- On tilt test cerebral blood flow was shown to go down in both people with ME/CFS & PoTS, with PoTS found that the vasoconstriction is related to hypercapnia in upright tilt
🧵 Brilliant talk by David Putrino @Dysautonomia Autonomic Rehab Approaches to Long Covid care
We need to:
- Measure subjective symptoms - use outcome measures alongside self reports
- Look for organ pathology, make sure red flags ruled out
#DysConf2022
We need to:
- Measure subjective symptoms - use outcome measures alongside self reports
- Look for organ pathology, make sure red flags ruled out
#DysConf2022
2/Correct deviations from normative physiology - avoid common triggers
Common triggers include stress (it doesn’t cause PoTs or dysautonomia but makes it worse), dehydration, over doing things, weather changes, consuming large meals, premenstrual period, alcohol & caffeine.
Common triggers include stress (it doesn’t cause PoTs or dysautonomia but makes it worse), dehydration, over doing things, weather changes, consuming large meals, premenstrual period, alcohol & caffeine.
3/If have no hyperventilation and low CO2 at end tidal volumes a breath practice with a hold & slow exhale like 4:7:8 can be helpful. If there may be a breathing pattern disorder it needs assessing by a respiratory physician & respiratory physio can treat (I’ve added the latter)
