Laura A. Pace, MD, PhD
@LauraAPace
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Physician-scientist | Neurogastroenterology | Microbiota-Neuroimmune Axis | Women's Health. Be a part of the solution. Tweets are my own.
Palo Alto, CA
Joined June 2019
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Today, 50% of people with
#longcovid
meet the diagnostic criteria for
#MECFS
– that’s a 4x increase in people living with this debilitating disorder!
We need to come together to solve
#MECFS
& other
#neuroimmune
conditions 🧵
#millionsmissing
#MECFSAwarenessDay
#WorldMEDay2023
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I am so proud to introduce Metrodora, a national center of excellence designed to close the gap in the diagnosis, care, and cure of women with neuroimmune disorders. Read about the launch of this entirely new patient-centric model of care.
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Delighted to have presented at
#DysConf2022
today!
#Neurogastroenterology
has so much more to offer individuals with
#POTS
#EDS
#MCAS
. Excited to share an example of a new technology that allows us to diagnose non-IgE mediated food allergies in real-time!
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Hello everyone living with
#EDS
#POTS
#MCAS
#ME
#LongCovid
#Gastroparesis
etc please share your story! You are denied life altering care on a regular basis due to insurance coverage denials! We must fight to change this!
@Dysautonomia
@OpenMedF
@TheEDSociety
The good people at
@propublica
are putting together a project about health insurance denials. They are collecting stories. They came to the right corner of twitter for stories. You can tell yours at the link below.
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#Neuroimmune
#IBS
#POTS
#EDS
#sjogrens
#LongCOVID
#MECFS
Have you ever wondered what your autonomic nervous system does?
Well ... it controls everything your body does that you never think about until something goes wrong and then it is all you think about!
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We are excited to announce
@MetrodoraInst
has officially opened its doors!
As the first medical & research center dedicated to advancing care & accelerating cures for people living with
#neuroimmune
axis disorders, we are leading the next frontier of
#medicine
.
#MedTwitter
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Gastrointestinal symptoms are common and often incredibly disabling in
#POTS
,
#Dysautonomia
, and
#EDS
. HAS THE TIME COME FOR GASTROINTESTINAL FUNCTIONAL TESTING TO BE INCLUDED AS PART OF AUTONOMIC NERVOUS SYSTEM TESTING?
@cyan0bacteria
@MCortez_DO
@AASAutonomic
@Dysautonomia
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Neuroimmune disorders are disorders that involve both the nervous and immune systems. These include many conditions you may already know about, such as many cases of
#Dysautonomia
,
#Sjogrens
,
#POTS
, and many autoimmune and gastrointestinal disorders, including
#MotilityDisorders
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What to do next when symptoms are suggestive of
#gastroparesis
but the gastric emptying study is "normal"? Below represents the power of performing the correct diagnostic study.
#SmartPill
, a wireless motility capsule was able to diagnose intestinal failure.
#GITwitter
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#MECFS
#POTS
#LongCovid
@VirusesImmunity
“As a basic scientist, of course I’d like to have all the pieces of the puzzle” before launching trials. “But the patients, they can’t wait.” We couldn't agree more!
@MetrodoraInst
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Metrodora is already conducting research that is going to massively accelerate our understanding of Neuroimmune disorders and we will be open June 2022 to see patients! Can't wait to see you all there!
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On my way to
#DysConf2023
! I am so excited to be in person again w/ the incredible
@Dysautonomia
community & look forward to meeting many new faces!
If you're in DC this weekend, please say hello!
Since we're all hard to recognize w/ a mask, just look for my pink kicks 👟👇
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My research is focused on the pathophysiology and genetics of hEDS and POTS. I also collaborate with a very talented group of microbial ecologists to investigate the role of the gastrointestinal microbiome in health and disease.
#EDS
#
#Dysautonomia
#microbiome
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Next week I will be presenting preliminary results from our multidisciplinary EDS clinic, as well as our whole genome sequencing project to identify genes associated with hEDS and POTS, at the Center for Genomic Medicine Symposium at the University of Utah.
#EDS
#Dysautonomia
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22
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Today is
#WomensEqualityDay
, and what better day than today to call on
@NIH
and
@POTUS
to invest in
#WomensHealth
. Women account for 80% of individuals living with an
#autoimmunedisease
and yet there is no funding priority to discover why!
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Metrodora Institute is a destination medical and research center focused on the care & cure of neuroimmune axis disorders.
@MetrodoraInst
Opening early 2023!
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If you have symptoms impacting multiple body systems and most doctors are telling you that nothing is wrong because you look fine, STOP, and consider getting tested for an autonomic nervous system disorder! Receiving a proper diagnosis matters!
@MetrodoraInst
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The
#COVID19
pandemic increased
#POTS
and other autonomic disorders. Patients need true therapeutic options, not just recommendations for exercise and increased fluid intake!
#Dysautonomia
#Neuroimmune
#LongCovid
#MECFS
#Sjogrens
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Our team is presenting three posters on gastrointestinal disorders associated with
#POTS
,
#EDS
, and
#MCAS
at the 31st International Symposium on the Autonomic Nervous System in November.
#AAS2020
@Dysautonomia
@TheEDSociety
@cyan0bacteria
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#LongCovid
trial with an actual therapeutic! This is not an exercise trial!!
🔥🔥🔥🔥🔥🔥
#POTS
📢
#ClinicalTrial
Update:
@MetrodoraInst
is looking for clinical trial volunteers [18+ years old] who have been diagnosed with post-COVID
#POTS
👇
#LongCovid
#clinicaltrial
#clinicalresearch
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There are many
#Neuroimmune
axis disorders caused by pathological
#autoantibodies
.
#Myasthenia
is one example and the data shows that early intervention with biological therapies improves outcomes.
#Efgartigimod
is now
@US_FDA
approved for
#Myasthenia
!
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We can help our patients most by simply believing them.
@ANMSociety
@Dysautonomia
@TheEDSociety
@OpenMedF
@IFFGD
@AmCollegeGastro
@AASAutonomic
@AANMember
@INMAssociation
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"We find that in nearly 75% of the cases where a disease afflicts primarily one gender, the funding pattern favors males, in that either the disease affects more women and is underfunded or the disease affects more men and is overfunded."
#MECFS
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While I appreciate this sentiment, take a look at the data for non-profit and not for profit healthcare organizations, they are at times even worse! Healthcare is broken at every level. Healthcare is no longer about the care of a person.
I advise friends around the world not to do what the US has done, putting for-profit corporations in charge of health care.
It has been an absolute disaster.
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April is
#IBSAwarenessMonth
...
#IBS
is a diagnosis based on clinical symptoms. It is not a diagnosis based on an understanding of the biological drivers of the symptoms. This means we miss the opportunity to diagnose and effectively treat the actual cause of the symptoms. 🧵
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Excited to be back at
#DysConf2023
w/
@Dysautonomia
!
Today
#Dysautonomia
impacts over 70M people & ~69% of people w
#POTS
have
#GI
symptoms. These numbers are on the rise!
In order to properly diagnose & treat patients, we need to look at how the
#neuroimmune
axis is involved!
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This is a game changer! Say goodbye to complicated and expensive diet elimination trials!
@MetrodoraInst
@maunakeatech
@IFFGD
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#LongCovid
&
#Autoimmunity
#CovidIsNotOver
"The idea that viruses can trigger autoimmunity in those with genetic predisposition through molecular mimicry has been simmering for a while."
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@US_FDA
is hosting a public meeting on Patient-Focused Drug Development for
#LongCovid
!
With the major advances in the
#immunology
space we have so many options to test as a treatments for LongCOVID and other related conditions including autonomic disorders (
#POTS
) &
#MECFS
. 🧵
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📢 Patients: you are your own expert! No one knows your body better than you.
As physicians, we must listen to & partner w/ patients to make progress in identifying the biological mechanisms of
#MECFS
& other complex
#neuroimmune
disorders.
#MECFSAwarenessDay
#MillionsMissing
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This is also leading to significant harm to our patients!
#MoralInjury
When will it stop?
Doctors are sick and tired of having our practice of medicine dictated to us by a bunch of bean counters.
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Millions of people in the United States suffer from an autonomic nervous system disorder and yet most people will wait years for a proper diagnosis!
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#Neurogastroenterology
is the best subspecialty! It combines neurology, immunology, genetics, metabolics, and some really amazing procedures which can truly help people live better lives!
@ANMSociety
@IFFGD
@AASAutonomic
@AANMember
Undecided on
#MEDTwitter
?
Consider GI as a fellowship choice: Gastroenterologists are the most 'in-demand' specialty, report finds
I’d say the coolest specialty!
@AmerGastroAssn
@AmCollegeGastro
@ASGEendoscopy
@AASLDtweets
@MayoClinicGIHep
#GITwitter
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You are completely correct in your thinking. Like many post-infectious neuroimmune conditions (
#POTS
, GI motility disorders, and many autoimmune disorders)
#LongCovid
needs to be thought about and treated as an immunological disorder. We must do better!
#MedTwitter
#NeuroTwitter
Why is no one at least attempting to treat
#LongCovid
as an autoimmune condition? It feels that those with LC in the present have essentially been written off. I've many symptoms that point to autoimmunity yet am just expected to grin & bear it. This continued inaction is immoral
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The
@NIH
&
@NIH_NINDS
NANDS ME/CFS Research Roadmap Working Group has organized a series of lectures to help them define their research priorities to solve
#MECFS
.
#MECFS
#Neuroimmune
axis
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Just wrapped another great
#POTS
and Beyond conference!
#Neurogastroenterology
and
#MicrobiotaGutBrainAxis
all playing critical roles in POTS!
@Dysautonomia
@MCortez_DO
@POTSparents
@AmerGastroAssn
@AmCollegeGastro
@ANMSociety
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@AASAutonomic
annual meeting, gastrointestinal dysmotility is common in
#dysautonomia
,
#POTS
.
@ANMSociety
@Dysautonomia
@TheEDSociety
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And while we are at it; functional gastrointestinal and functional neurological disorders are a constellation of symptoms, not a diagnosis! We must push the science forward to understand the biology! This advances care!
@MetrodoraInst
Aphasia is a symptom, not a diagnosis.
That’s all I have to add.
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I am advocating for
#Neuroimmune
axis disorders which cover all of these conditions and so many more that disproportionately and more severely impact women!
How do we make sure
#dysautonomia
#pots
#mecfs
#EDS
get included in the Women’s Health Initiative?
@SummerDashe
@JessMcMasterKC
@dysclinic
@LauraAPace
I’m ready to work for a cure! What should chronically ill women do?
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We must move with URGENCY to accelerate our understanding of the biology of these devastating conditions. However, we must simultaneously leverage scientific knowledge and leading technology to radically improve clinical care, NOW!
#SystemsBiology
#ComparativeBiology
#POTS
#EDS
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Congratulations to Dr. Satish Rao, an incredible
#mentor
& world leader in
#neurogastroenterology
, who received the
@AmerGastroAssn
Distinguished Mentor Award at
@DDWMeeting
! Dr. Rao’s groundbreaking work has impacted millions of patients worldwide
#DDW2023
#GITwitter
@ANMSociety
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After COVID, individuals have a > 40% increased risk of developing autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, dermatopolymyositis, systemic sclerosis,
#Sj
ögren's syndrome, mixed connective tissue disease,
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Biology is incredibly complex and for people living with complex conditions such as those impacting the
#Neuroimmune
axis we need to leverage all of our clinical partners & tools to make true progress!
#MECFS
#Sjogrens
#POTS
#Gastroparesis
#EDS
#MCAS
#GIDysmotility
#Migraine
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Proud to have signed this petition!
@MetrodoraInst
we have maintained our masking policy and our team is more than happy to continue this to protect our patients, themselves, and their families! We know that
#LongCOVID
is real and can be devastating!
#POTS
#MECFS
#IBS
As states throughout the U.S. begin to discontinue mandatory
#masking
in healthcare facilities, they place the most vulnerable populations at enormous risk, in the very places and by the very people, they go to for help. We are urging each State Department of Health, State Health
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@BernieSanders
@BernieSanders
you are the leader these times demand! Please un-suspend your campaign!
#PeopleOverPolitics
#PeopleOverProfits
#MedicareForAll
#GreenNewDeal
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Thank you for highlighting these incredibly important points! This is certainly not a new phenomenon! I will also add that we can push even further with diagnostics which will help us better understand the biology which will guide us on how best to help our patients!
#Neuroimmune
Long COVID. It’s a new name coined in 2020.
However, it does NOT represent a new or unique outcome after someone has had an acute infection.
Before that name was created, we all existed and suffered.
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We need to think about neurological disorders, immune mediated disorders (i.e. eosinophilic, mast cell, autoimmune, immunodeficiency, complement, autoinflammatory), connective tissue disorders, genetic disorders, metabolic disorders, etc.
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#Efgartigimod
(
#Vyvgart
) is already FDA approved for Myasthenia Gravis (
#MG
). Clinical trials are underway for
#Sjogrens
&
#LongCOVID
#POTS
().
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Today we’re building the system to solve this at
@MetrodoraInst
. Scientific & medical progress is not an engine that moves on its own. We need to
#collaborate
to improve the lives of millions of people living w/
#MECFS
& so many other debilitating conditions!
#MECFSAwarenessDay
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As physicians it is our obligation to work to recognize & appropriately diagnose conditions early in the clinical course and prescribe our patients the best therapeutics!
#MedTwitter
#neurotwitter
#GITwitter
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Thank you
@BernieSanders
!
To
@realDonaldTrump
, this is what leadership looks like! Do your job to save our lives!
@Docs_4_Bernie
#SanderIsMyPresident
Mr. President, get your act together. Utilize the Defense Production Act and protect our medical personnel.
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Excited to be speaking on The Microbiota-Gut-Brain Axis! So much exciting progress in this area! So many important advancements that will improve treatment options for patients!
#GutMicrobiota
#Neurogastroenterology
#Dysautonomia
#MCAS
The
#DysConf2021
agenda is now available at ! We are so excited for this incredible lineup of speakers! If you register for this free conference, you'll receive an email with a detailed conference program and session links on Wed. Conference is July 15-18
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@Dysautonomia
@BluesteinLinda
@pisocolins
I think about this as immune activating events (such as infection, surgery, concussion, major hormone changes, and even stress) can trigger autonomic nervous system and other immune disorders.
#Neuroimmune
#POTS
#EDS
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We also have to remember that often times our patients have more than one of these contributing disorders! Think
#Microbiota
#Neuroimmune
axis disorders.
We need the data to optimize the treatment plan!
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Thank you for participating! This is potentially a huge opportunity for the entire
#POTS
community! Here we go 🔥🔥🔥
Day 1
#longCovid
clinical trial for
#POTS
The study is investigating whether a new medication, efgartigimod (Vyvgart), is effective at reducing/improving symptoms related to post-Covid POTS.
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There are host genetic determinants contributing to the development of severe COVID-19 infection, which means there are very likely genetic determinants for
#LongCovid
,
#MECFS
,
#POTS
, and other
#Neuroimmune
axis disorders.
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Honored to have hosted
@DouglasAdlerMD
for a tour of Metrodora Institute last week! Here we are standing in the Center for Advanced Interventions at
@MetrodoraInst
Opening early 2023! We are seeking innovative & collaborative gastroenterologists!
#GITwitter
@AmCollegeGastro
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This is not a joke!
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For some people their
#POTS
is caused by an
#autoimmune
process. Which means that therapeutics targeting autoantibodies could be very beneficial!
#MedTwitter
@NIH
#neurotwitter
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And don’t forget
#COVID
may cause long term disability in 20-30% of people infected! We must do better!
#LongCovid
#POTS
@POTUS
@CDCgov
If a heavily contagious airborne disease—that causes a severe viral respiratory infection—isn’t something that we address on a Federal level, then what the f*ck actually warrants a comprehensive Federal response?
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Dr. Glen Cook teaching all of us at the
#POTSandBeyond
conference about pharmacological therapy for
#POTS
.
@Dysautonomia
@POTSActivist
@POTSparents
@UKPoTS
@AASAutonomic
@TheEDSociety
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Please vote by mail for
@BernieSanders
, our lives depend on it!
@Docs_4_Bernie
@NationalNurses
@ACPinternists
@AmerMedicalAssn
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Therefore, anyone who knows me, knows I don't recognize
#IBS
as a diagnosis.
We need to look for the biological driver! We have the tools!
#GITwitter
#neurotwitter
#MedTwitter
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1
24
The
@MetrodoraInst
team traveled to Germany to train on the
#Cellvizio
confocal laser endomicroscopy system (CLE). This technology will revolutionize our ability to detect alterations in intestinal permeability and diagnose
#FoodAllergy
in realtime.
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5
21
After
#COVID
, individuals with a preexisting
#autoimmune
condition, have a 23% increased risk of developing another autoimmune disorder.
@argenxglobal
developed Efgartigimod a neonatal Fc receptor antagonist that reduces circulating levels of IgG to treat autoimmune diseases.
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Yes there is a trial for
#LongCovid
#POTS
!
@MetrodoraInst
is proud to be a clinical trial site for this study, along with:
-Johns Hopkins Medicine
-Stanford Movement Disorder Center
-Northshore University HealthSystem
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Great meeting
@AANMember
! Any other neurogastroenterologists here? The gastrointestinal tract is the largest interface of the nervous and immune systems. We should all be working together!
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I am really proud of what we are building
@MetrodoraInst
! Together we are advancing care & accelerating cures for neuroimmune axis disorders all the while creating amazing career opportunities for clinicians who truly want to innovate and collaborate!
#GITwitter
#MedTwitter
Metrodora Institute is hiring!
We are seeking innovative and collaborative gastroenterologists and neurogastroenterologists to join our growing team!
@ANMSociety
@AmCollegeGastro
@AmerGastroAssn
@MedtronicGI
@maunakeatech
#WorkLifeBalance
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We have always needed
#MedicareForAll
! Thank you
@PramilaJayapal
and
@BernieSanders
for fighting for this!
@Docs_4_Bernie
#SandersIsMyPresident
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Complex medical disorders can affect multiple organ systems, making them very difficult to treat in our current siloed medical system. Here is our new review of disorders at the interface of neurology, immunology, and gastroenterology.
#EDS
#Dysautonomia
1
7
20
Another fantastic example of why we need true
#precision
medicine & strong partnerships with our patients! This is something only practicing physician-scientists can do!
New Insights Revealed On Tissue-Dependent Roles of JAK Signaling in Inflammation - MarketWatch
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The potential this technology holds to advance our understanding of host-microbe interactions within the human gastrointestinal tract is extraordinary! This work will have huge implications for advancing knowledge of microbiota-neuroimmune axis disorders!
@NIH_ORWH
@IFFGD
On Monday, Dr. Heidi Smith,
@BiofilmFirst
microscopy manager, & I placed an order for a
@LeicaMicro
SP8 with Stimulated Raman option. The 2 of us raised $1.15M for this. Once installed, this instrument will only be the 3rd commercial Stimulated Raman scope at a US university
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I was awarded a grant from the University of Utah Center for Genomic Medicine to identify genetic variants associated with hEDS and POTS using transcriptomics. I'm very excited to compare this to our recent whole genome sequencing results.
#EDS
#POTS
#Dysautonomia
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The future of
#medicine
requires continual
#innovation
which allows us to continually improve
#patientcare
. Grateful for our amazing partners at
@fujifilmhealth
for leading in
#endoscopy
imaging technology and ergonomics!
@metrodorainst
!
#DDW2023
#GITwitter
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The neurological complications of
#EDS
,
#POTS
greatly impact gastrointestinal function. The gastrointestinal system has its own nervous system and is heavily innervated by the autonomic nervous system. The GI tract is the largest interface for neurological + immune interactions.
We are delighted to be hosting a dedicated virtual event for
#neurological
complications in
#EhlersDanlosSyndrome
and
#hypermobilityspectrumdisorder
from September 25-26. View the agenda and learn more at
#MedTwitter
#MedEd
#Neurology
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They can also help with
#fatigue
and components of cognitive impairment (The term
#brainfog
does not do this justice!) by addressing craniocervical, visual, and proprioceptive dysfunction!
#neurotwitter
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For those with
#LongCovid
#POTS
,
@argenxglobal
is testing if depleting circulating autoantibodies will help with recovery. This same therapy has already been FDA approved to treat another autoimmune disease.
"Anti-inflammatory drugs & drugs that suppress the function of substances released by microglia could be a treatment for
#LongCovid
" commented research team member Yoshitaka Kase, a specially appointed lecturer in neuroscience at Keio University.
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I am delighted to be speaking as part of the Lesser Studied Pathologies Section organized by research scientist Beth Pollack. The series is FREE, however, registration is required, link below.
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In any patient presenting with symptoms after any immune activating event (infection,
#COVID
, surgery, concussion, etc.) or with
#LongCovid
we need to be testing for these autoimmune conditions! And we need to be leveraging immune modulators for these devastating illnesses!
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@C19LH_Advocacy
@LongCovidCanada
@Dysautonomia
@DysSupport
@NeuroSjogrens
@TheEDSociety
@MCDiseasesUnite
@MastocytosisCA
WE HAVE OPTIONS, WE NEED TO ACT!!!
1
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The prior authorization process interferes with critical clinical decision making and negatively impacts patient care!
#MedTwitter
#burnout
1 in 3 doctors has seen serious adverse outcomes due to prior authorization
#fixpriorauthorization
#respectmyprescription
@AmerMedicalAssn
@AmCollegeGastro
@SenatorLankford
@OKMed
@aonp_okla
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Behçet's disease, polymyalgia rheumatica, vasculitis, psoriasis, inflammatory bowel disease, celiac disease, & type 1 diabetes.
1
6
22
Hello to all interested in
@Dysautonomia
,
#POTS
, and
#EDS
, LIVE NOW, Dr. Melissa Cortez educating us about
#Dysautonomia
1
5
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Solve
#MECFS
!
#Neuroimmune
axis disorders are complex from a biological standpoint & a clinical care standpoint, we are here to solve both.
#PatientPartners
#PEM
,
#GI
dysfunction,
#fatigue
&
#cognitive
impairment are all symptoms of
#MECFS
.
At
@MetrodoraInst
we're partnering with patients to increase quality of life & identify the biological mechanisms of this life-altering illness.
Let's solve
#MECFS
🧵 (1/)
#MEAwarenessDay
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Eliminating the elimination diet!
Excited to join
@maunakeatech
at
#DDW2023
tonight to discuss novel ways of assessing
#foodallergy
with
#CLE
! Cellvizio can detect food allergies in real-time for
#GI
conditions like
#IBS
and
#FD
.
#GITwitter
📍RSVP here →
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If you want to make real change and create an economy that works for all, you know what you need?
You need to take on Wall Street, the drug companies, the insurance companies, and the fossil fuel industry.
You don’t take campaign contributions from them.
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@fidjissimo
, a true thought leader in health creation, highlighted the importance of food as a determinant of health. Leading the way by creating healthcare and food industry partnerships to help us achieve or best life!
#HLTH2022
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@SummerDashe
@cyan0bacteria
@MCortez_DO
@AASAutonomic
@Dysautonomia
I am continuously amazed by everyone living with
#POTS
,
#EDS
,
#MCAS
. You are all amazing and so much stronger than most can imagine! ❤️
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We are also seeing derangements in cytokine & chemokine pathways and there are so many drugs in this space already
#FDA
approved for other indications that we need to be leveraging for
#LongCovid
and other
#neuroimmune
axis disorders.
@ahandvanish
@LongCovidAdvoc
@research_long
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Incredible night at
#DDW2023
with Dr. Sheila Crowe & Dr. Mae Go – two of the pioneering women in
#Gastroenterology
!
It was amazing to spend time with these brilliant physicians who have led the way in this critical field of
#medicine
.
#GITwitter
#WomeninGI
#WomeninEndo
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Congratulations to Dr. Sheila Crowe, an amazing
#mentor
, scientific collaborator & dear friend, who was awarded the
@AmerGastroAssn
Julius Friedenwald Medal🥇–
#AGA
's highest honor!
I am so proud of what she has achieved over her inspiring career!
#DDW2023
#GITwitter
#WomeninGI
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Gastrointestinal motility testing only tests motility, there is so much more to gastrointestinal function. We can and must do better to investigate symptoms especially in patients with known neurological and / or immunological disorders.
@AASAutonomic
@AANMember
@Dysautonomia
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Neuroimmune axis disorders are conditions impacting tens of millions in the US. These conditions affect the nervous, immune, endocrine, and gastrointestinal systems and require coordinated & innovative care.
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We need more studies interrogating immune system dysfunction in
#POTS
#MECFS
#LongCovid
because we need to find actual therapies that make people better! Many potential immune therapies are already FDA approved for other conditions that could also be leveraged in this space!
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