TNF and metabolic dysfunction-associated steatotic liver disease: Endo et al. have reported that 8–16 weeks’ administration of C. butyricum MIYAIRI 588 (butyrate-producing probiotic) to mice with NAFLD significantly decreased gut derived endotoxin levels in the portal blood by changing the intestinal flora and restoring gut-barrier functions, as well as lowering the levels of pro-inflammatory cytokine TNF-α in liver which results in regulating transcription factor NF-kB thereby causing inhibition of NAFLD progression [51].