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Microbial-associated molecular patterns, such as LPS, translocate to the liver through the damaged gut barrier, are recognized by TLR4 on the surface of Kupffer cells, activate the downstream MyD88/NF-κB signaling pathway, drive the massive release of pro-inflammatory cytokines (such as TNF-α, IL-1β, IL-6), and thereby initiate and maintain the inflammatory state of the liver, which is crucial in the pathogenesis of ALD and NASH
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