It is prudent to however note that while TNF-α is a pleiotropic cytokine having varied roles in liver injury, exhibiting hepatoxicity in certain situations and aiding recovery in others49, it appears that in acute toxic liver injuries the latter role is more significant; this may explain in part the adverse outcomes seen in patients with severe alcoholic hepatitis treated with anti-TNF-α therapy50,51. Here, TNF is linked to alcoholic hepatitis.