In addition, several studies reported that probiotics including lactobacillus inhibited inflammatory signaling such as NF-κB, reduced serum LPS and liver TLR4 expression and delay NAFLD progression (Li et al. 2003; Nagashimada and Honda 2021; Xue et al. 2017). This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatotic liver disease.