Clearly in almost every patient they see microbial dysbiosis, metabolic dysfunction and immune perturbation.
From the very early stages of data analysis they have seen remarkable dysbiosis and metabolic change and even changes over time.
As they begun to get results they saw some of their hypothesis was spot on.
They are speculating on molecular therapeutics, and maybe this could even help for other conditions.
More dysbiosis changes in newer patients but more metabolic changes in the blood in longer term patients. They think that while the dysbiosis is primarily seen in the shorter term patients it could have cumulative and long term effects.
Me/cfs might start out with some loss of the SCFA producers in the gut. This can then affect gut epithelial barrier integrity and then immune responce, and then result in more pervasive gastrointestinal phenotypes that is later reflected in plasma metabolites levels in the longer term patients. They are clear though that this is a hypothesis.
They further hypothesize that the loss of immune modulatory chemicals like e.g butyrate as well as loss of immune modulatory organisms is leading to sustained abbarrant immune responces that over time will introduce many of the other co-morbidities that are typical in mecfs. That co-morbidities are added
over time is apparently a typical pattern in mecfs.
-Personally i think this hypothesis sounds very solid, seems to bring alot of observations together into a nice coherent story.