SPOI™ (Systemic Perturbation of the Orobiome-Intestinal Axis): Rationale for a Composite Gut-Skin Assessment Score Without Laboratory Testing in Latin American Populations

This paper proposes SPOI™ (Systemic Perturbation of the Orobiome-Intestinal Axis), a 12-item self-report composite score stratifying individuals across three dysbiosis tiers — Primary (cutaneous-dominant), Mixed (bidirectional), and Secondary (gut-dominant) — without requiring microbiome sequencing or laboratory diagnostics. The instrument uses three evidence-grounded item blocks: Block A (direct gastrointestinal signals, weight 1.2×), Block B (indirect systemic correlates, 1.0×), and Block C (cutaneous suggestive markers, 0.8×). The LATAM-specific epidemiological context is formally characterized: elevated MTHFR C677T prevalence, chronically low dietary fiber intake, widespread endocrine disruptor exposure, and documented antibiotic overuse. SPOI™ is integrated as a sub-index of the IDIBS™ system and represents the first formally proposed gut-skin perturbation score designed for phenotype stratification in personalized cutaneous phytonutrition protocols.