6,25,26 Interestingly though, a prospective study in LS patients found that adenoma development was not associated with these well-studied oncomicrobes but was rather associated with microbiota components that broadly influence gut microbial ecology.8 Our results support a scenario in which global changes in epithelial homeostasis, evoked by shifts in the gut microbiota composition, contribute to the accumulation of mutations in MSH2-deficient crypts. This evidence concerns the gene MSH2 and Leigh syndrome.