In addition, a significant increase in Enterobacteriaceae abundance is found in patients with HF, and translocated E. coli in the liver could exacerbate HF in NAFLD mice by inducing endothelial-mesenchymal transition via the TLR5/MYD88/TWIST1 pathway (Champion et al., 2023; Shen et al., 2023). This evidence concerns the gene TWIST1 and hydrops fetalis.