Lipopolysaccharide, which activates TLR4, can be transported by bacterial extracellular vesicles, spherical structures produced by eukaryotic and prokaryotic cells that transfer information to distant cells and may represent novel players in NAFLD development and progression, such as liver inflammation, angiogenesis, and fibrogenesis [23]. This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatotic liver disease.