Besides, higher levels of downstream inflammatory factors, such as TNF-α, IL-1β, and IL-6, and elevated serum lipopolysaccharides (LPS) levels indicating TMAO exacerbates intestinal barrier damage in NAFLD rats, plays a negative regulatory role in disease progression (Nian et al., 2024). The gene discussed is TNF; the disease is metabolic dysfunction-associated steatotic liver disease.