Furthermore, it was reported that most of the patients with NAFLD and NASH have an aberrant overgrowth of intestinal bacteria (20–22) as well as detectable lipopolysaccharide (commonly referred to as LPS) in portal blood (23); the latter will serve to augment TNF-α production in Kupffer cells through enhancement of the Toll-like receptor (TLR) 4 signal. The gene discussed is TNF; the disease is metabolic dysfunction-associated steatohepatitis.