TNF and non-alcoholic fatty liver: Thus, based on this possibly dual facet of TNF-α, also observed in other cytokines and adipokines [25], we could speculate that the upregulation of TNF-α in NAFL and NASH may primarily target to a cytoprotective effect, when lipids are increasingly accumulated into the hepatocytes; however, if this hepatoprotective effect fails, TNF-α induces the cell death of the affected hepatocytes.