LBP and metabolic syndrome: • Dysfunction is best documented in diseases where there is known alteration in histology, anatomy, or function• No evidence yet that repair of intestinal barrier can, by itself, be used to treat a disease in humans• In disease states (e.g., metabolic syndrome), it is inferred that altered barrier function plays a role in disease pathogenesis on the basis of surrogate biomarkers (e.g., LPS or LPS-binding protein in metabolic syndrome), but no direct evidence of causality in humans