TNF and Hepatic steatosis: The potential beneficial effects of probiotics on ALD include (1) quantitative and qualitative improvement of gut microbiota composition (increase in Lactobacilli and Bifidobacteria, increase in gut microbiota diversity); (2) improvement of liver function tests; (3) strengthening of gut-barrier permeability; (4) decrease in pro-inflammatory cytokines like tumor necrosis factor α (TNFα) and bacterial endotoxin levels in the blood; and (5) histologic improvement of liver steatosis and hepatic inflammation [26,27].