As far as the hard science is concerned, this is a chicken or the egg kind of situation which has been defined in general terms at this point in time. Most of the researchers that I have spoken with believe that it is a precursor event, and not a by-product event. Yes it is a component of active diseases many times, but the appearance of it often precedes the symptomatic disease. So the question is, is it a facilitator and promoter or not?