TNF and metabolic dysfunction-associated steatohepatitis: Enhanced oxidative stress in NASH is explained by (1) free fatty acid and cholesterol buildup increasing mitochondrial ROS, causing liver damage via TNF-α and IL-6; (2) high fructose intake producing ROS toxins that worsen NASH; and (3) depleted antioxidant stores by activating oxidases that increase oxidative stress [39,40].