Conversely, the increased presence of Escherichia-Shigella, a well-established driver of TLR4-mediated pro-inflammatory responses, may indicate underlying gut dysbiosis, exacerbating liver injury in chronic hepatitis B (Duan et al., 2019), Similarly, Prevotella_9, enriched in patients with progressive hepatocellular carcinoma (HCC), is associated with tumor advancement and poorer clinical outcomes. Here, TLR4 is linked to hepatocellular carcinoma.