Acute ALD remains challenging, and therapies such as pentoxifylline and corticosteroids shown to decrease short-term, but not medium-term, mortality.508 Although corticosteroids may reduce short-term mortality, their long-term safety profile is concerning due to the risk of severe infections.509 TNF-α inhibitors, such as infliximab and etanercept, reduce inflammation but increase infection risks.510 There is emerging interest in the role of intestinal microbes in ALD, though clinical validations are still preliminary.511. The gene discussed is TNF; the disease is infection.