TNF and metabolic dysfunction-associated steatotic liver disease: The results from an open-label study in patients with non-alcoholic fatty liver disease (NAFLD) by using “Symbiter” containing 14 alive probiotic bacteria of concentrated biomass showed a significant reduction in serum pro-inflammatory cytokines (IL-6, IL-10, and TNF-α) after 4 weeks of therapy in patients with normal or increased aminotransferase activity above the baseline [68].