Functionally these activated macrophages were responsive to microbial challenges, which resulted in the production of pro-inflammatory cytokines (IL-23, IL-6, and TNF-α) and contribute to mucosal, epithelial, vascular and immunological barrier dysfunction in cirrhosis (Kamada et al., 2008; Wiest et al., 2017; Sarin et al., 2019; De Muynck et al., 2021). Here, TNF is linked to Cirrhosis.