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Gut dysbiosis ME/CFS patients often have gastrointestinal (GI) symptoms (189) with gut inflammation (190), gut microbiome dysbiosis (57, 191) and changes in the gut microbiome (191, 192)

Secondary BAs play a role in the modulation of immune system activity through BAs receptors, such as Takeda G-protein-coupled BAs receptor-1 (TGR5), farnesoid X receptor (FXR), pregnane X receptor (PXR), retinoid-related orphan receptor-t (RORyt), and Vitamin D receptor (VDR) [25]

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Image processing Cryo-EM data processing was processed using RELION-3.1.2 (ref

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