TLR4 and metabolic dysfunction-associated steatotic liver disease: Furthermore, changes of intestinal microbiota composition and an increased translocation of lipopolysaccharide (LPS) subsequently leading to activation of Toll-like receptor 4 (TLR4) depending signaling cascades have been shown repeatedly to be associated with the development of MASLD,7, 8, 9, 10, 11 and also may interact with hepatic lipid homeostasis.12