No need for skepticism of #microbiome + virome involvement in #ME/CFS 👉 But we must factor in the activity of organisms (bacteria, viruses, phages, fungi etc) that often persist + interact outside the gut☝️And many such organisms are not “good” but are pathogens/#pathobionts
In fact, Komaroff asked if anyone has a model for #ME/CFS that links together many findings recently presented at #MECFSatNIH19 👉 Well, that’s what my recent paper on ME/CFS does!...w/ #microbiome + virome activity central to how separate findings connect:frontiersin.org/articles/10.33… 
That is b/c 👉 Humans are now understood to be #holobionts: our activity is controlled by the human genome, our microbial/#viral genomes and their respective proteins + metabolites working in tandem (together!): nph.onlinelibrary.wiley.com/doi/full/10.11…
Eg: teams demonstrated #circulatory issues in #ME/CFS 👉 So it’s worth noting studies like this where #microbiome-derived fatty acids travelled to kidneys + blood☝️There, they impacted the activity of 2 human receptors that control circulation + blood flow:ncbi.nlm.nih.gov/m/pubmed/23401…
Or NK cell issues? 👉 Well, this team found NK activity is modulated by the bacterial #microbiome☝️eg: bile acids modified by the microbiome impacted liver cell gene expression in a manner that controlled #NK cell accumulation + anti-tumor activity: ncbi.nlm.nih.gov/m/pubmed/29798…
Or changes in #microglia signaling/activation? 👉 Well, this team found that #tryptophan created by gut #microbes interacted w/ a receptor on microglia/astrocytes☝️Subsequent changes in gene expression regulated how to two cell types communicated: ncbi.nlm.nih.gov/m/pubmed/27158…
Or, as @MBVanElzakker alluded to, this paper which reviews recent studies showing how the gut #microbiome modulates #microglial development + function☝️and highlights possible future research to develop novel microbial treatments for disorders of the brain:ncbi.nlm.nih.gov/m/pubmed/30385…
Also, the #vagus nerve is central to the gut-brain #microbiome axis 👉 which cld explain why when this team transplanted gut microbiome fecal samples from patients w/ #Parkinson's disease into germ-free mice, the mice exhibited Parkinson's symptoms: ncbi.nlm.nih.gov/m/pubmed/27912…
Also Younger + VanElzakker pointed out brain #pathogens can drive neuroinflammation 👉 This topic is exploding in the #Alzheimer’s community, where #HHV-6, p. gingivalis + other organisms are being identified in brain tissue (+ the Harvard Brain #Microbiome Project in progress!)
And the composition + activity of any #microbiome community helps determine whether invading pathogens can “stick around” or #persist in the body 👉 Eg: susceptibility to HIV #infection varies based on the composition + diversity of the vaginal microbiome: ncbi.nlm.nih.gov/m/pubmed/29424…
