We can agree on many of the things that you wrote: - You need a combination of genetics + environment to have a phenotype (whether disease or otherwise) - Sev

We can agree on many of the things that you wrote: - You need a combination of genetics + environment to have a phenotype (whether disease or otherwise) - Several conditions have a relationship with the gut microbiome Also, I think you will enjoy this absolutely amazing study that found that the gut microbiome drives cerebral cavernous malformations(!!!) by interactions with TLR4: https://www.nature.com/articles/nature22075 https://www.nature.com/articles/nature22075 So, I just don't think that "typically" the gut microbiome is the driver of disease. In fact, it's a rare enough find that people get Nature papers out of it. But, if it is actually typical, then I stand by my assertion that someone will eventually get a Nobel prize from proving it.