TNF and metabolic dysfunction-associated steatotic liver disease: Other studies have shown that even the early stages of fructose-induced NAFLD (e.g., steatosis) are associated with increased intestinal translocation of endotoxin and expression of TNF-α in the liver, whereas TNF-α expression and steatosis were markedly lower in the liver of fructose-fed mice treated with antibiotics or TLR-4-mutant mice [96, 97].