TNF and metabolic dysfunction-associated steatotic liver disease: Moreover, several probiotics (mainly Lactobacillus and Bifidobacterium) can effectively reduce hepatic lipid accumulation (38, 39) and decrease aminotransferase activity and circulating levels of pro-inflammatory mediators, such as TNF-α, IL-1β, and IL-6 in NAFLD patients (40), showing that probiotics can improve liver function and reduce inflammation to alleviate NAFLD.