The mechanism that causes dysbiosis in patients with HA20 is mediated by Tregs because it is a key factor of immunoregulatory disorders in patients with HA20 (Liu et al., 2021), and in the mouse model of Treg-associated monogenic autoimmune disorders, Aire knockout mouse showed significant dysbiosis (Dobeš et al., 2015). The gene discussed is AIRE; the disease is A20 haploinsufficiency.