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et al.: Age-induced accumulation of methylmalonic acid promotes tumour progression (2020) Nature | DOI: 10.1038/s41586-020-2630-0

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215 The gut microbiome plays a critical role in regulating gut-brain communication by producing chemicals that modify hormone and neurotransmitter release, and possibly induce epigenetic changes (changes in DNA structure that impact gene expression) in the central nervous system

These classifications are not based on the severity of disease, although certain phenotypes may correlate with increased risk for more severe disease