From a clinical perspective on LPS, I’d actually prefer to see IgG and IgM reported separately rather than combined.

Here’s why: if I have the individual values, I can always add them together myself to get that global snapshot. But when they’re already combined, I lose the ability to pull them apart, and that’s where the clinical nuance lives.

Knowing whether someone’s LPS reactivity is predominantly IgM-driven versus IgG-driven changes how I interpret what’s happening in real time. An IgM-dominant response tells me something very different than an IgG-dominant response. One suggests an active, early-phase breach of gut barrier integrity. The other points to a chronic, sustained endotoxin exposure pattern. The research is early, but potentially those are two different clinical conversations, two different levels of urgency, and potentially two different intervention strategies, but reality is the science is so new, I think it’s too early just to combine them so we can actually see the dominance of one verse the other.

When we combine them, we flatten that distinction. We get a number that says “yes, there’s immune activation to LPS,” but we lose the texture of what that activation actually looks like. And for those of us making treatment decisions based on these results, that context matters.

So my ask would be to consider reporting IgG and IgM separately, and then if you want to include a combined total as an additional data point, that gives clinicians the best of both worlds. We get the granularity we need for precision decision-making, and anyone who prefers the global view still has it.

I’d love to see that kind of reporting flexibility built into future iterations of the panel. It would make an already excellent test even more clinically actionable.