For instance, in models of non-alcoholic fatty liver disease (NAFLD), combinations of HIIT with L. rhamnosus consistently yielded synergistic suppression of key inflammatory mediators (TLR4, MYD88, NF-κB) and improved lipid markers (Eyni Gandomani and Reisi, 2020; Kayacan et al., 2022; Rasheh and Ahmadi, 2021). This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatotic liver disease.