TNF and serum lipopolysaccharide activity: Once the intestinal barrier is disrupted and endotoxemia circulates via the liver-gut through the gut-liver axis resulting in increased levels of PAMPs and DAMPs that bind with TLRs (TLR2, TLR4, TLR5, TLR9, etc.), the inflammatory cascade of releasing inflammatory cytokines (TNF-α, IL-8, IL1β) could be initiated, and lipid accumulation and cell death in hepatocytes could be stimulated leading to NAFLD, NASH, and cirrhosis [34,35,36,37,38].