NLRP6 and obesity due to melanocortin 4 receptor deficiency: Genetically driven dysbiosis, such as a deficiency in NACHT, LRR, and PYD domains protein 6 (NLRP6), exacerbates steatohepatitis (41), while obesity-induced dysbiosis promotes HCC formation through the cytotoxic effects of secondary bile acids (42, 43).