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Current Biology , 27 (2), 210223

Rankouhi, J.W

It triggers extreme tachycardia, palpitations, tremors, dizziness, and profound anxietysymptoms that many patients recognize as a "post-meal crash" or POTS flare

This is followed by multiple immune abnormalities: marked impairment of the immunosuppressive function of myeloid-derived suppressor cells (MDSCs), pro-inflammatory polarization of Kupffer cells, T-cell differentiation imbalance, and B-cell hyperactivation that induces antimitochondrial antibody (AMA)-mediated cytotoxicity