However, the ULN of ALT remains controversial with limited value in distinguishing patients experiencing immune tolerance, as the patients are still at risk of liver inflammation or fibrosis when their ALT levels are defined as normal under the lowest ULN standard (Ormeci et al., 2016; Tan et al., 2017; Choi et al., 2019; Chang et al., 2021; Duan et al., 2021; Liu et al., 2022). The gene discussed is GPT; the disease is inflammation.